How do you treat non-melanomatous skin cancers in poorly vascularized tissue?

BCC/SCC? An unusual differential. Was it biopsied?

If it meets anatomic, size, and depth criteria, radiation oncology options would include electronic brachytherapy. Would likely offer 40 Gy in 10 fractions, twice weekly. Of course, would need to travel to an appropriate facility.

I would agree with Dr. @Dr. First Last. I would favor a hypo fractionated approach esp. in a poorly vascularized disease (contingent on tolerance of subjacent tissues). Brachytherapy is also a consideration. Protracted fractionation is clearly reasonable but there is no advantage to "re-oxygenation"...

Is the primary goal "Cure" or "Control of symptoms"?

For BCC (depending on the subtype), another option would be utilizing Vascular Lasers in a way to debulk the tumor.

Imiquimod cream is possibly an option as well.

For SCC, depending on the sub-type, intralesional MTX or 5-FU.

Another consideration...