Basal Cell Carcinoma
BASAL CELL CARCINOMA
The most common cancer
Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting about 800,000 Americans each year. In fact, it is the most common of all cancers. The vast majority of new skin cancers are basal cell carcinomas. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer).
The major cause
Chronic exposure to the sunlight is the cause of almost all basal cell carcinomas, which occur most frequently on exposed parts of the body—the face, ears, neck, scalp, shoulders, and back. Rarely, however, tumors develop on non-exposed areas. In a few cases, contact with arsenic, exposure to radiation, and complications of burns, scars, vaccinations, or even tattoos are contributing factors.
Who gets it
While anyone with a history of sun exposure can develop basal cell carcinoma, people who are at highest risk have fair skin, blonde or red hair, and blue, green, or grey eyes. Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are particularly susceptible. Geographic location is also a factor - the closer to the equator, the higher the number of cases, particularly among fair-skinned individuals. The disease is rarely seen in children, but occasionally a teenager is affected. Skin specialists report that more and more people in their twenties and thirties are being treated for skin cancer.
What to look for
The five most typical characteristics of basal cell carcinoma are an open sore, a reddish patch, a pink growth, a shiny bump, or a scar-like area. Frequently, two or more features are present in one tumor. Only a trained provider, usually a specialist in diseases of the skin, can decide for sure. Examine your skin regularly - as often as once a month - if you are at high risk. Be sure to include the scalp, backs of ears, neck, and other hard-to-see areas. (A full-length mirror and a hand-held mirror can be very useful.) If you observe any of the warning signs or some other change in your skin, consult our office immediately. The Skin Cancer Foundation advises people to have a total body skin exam by a qualified skin specialist at regular intervals. The physician will suggest the correct time frame for follow-up visits, depending on your specific risk factors, such as skin type and history of sun exposure.
Types of Treatment
After the physician’s examination, the diagnosis of basal cell carcinoma is confirmed with a biopsy. In this procedure, a small piece of tissue is removed and examined in the laboratory under a microscope. If tumor cells are present, treatment—usually surgery—is required. Fortunately, there are several effective methods for eradicating basal cell carcinoma. Choice of treatment is based on the type, size, location, and depth of penetration of the tumor, as well as the patient’s age and general health. Treatment can almost always be performed on an outpatient basis in the physician’s office or at a clinic. With the various surgical techniques, a local anesthetic is commonly used. Pain or discomfort during the procedure is minimal, and pain afterwards is rare.
Not a Trivial Cancer
When removed promptly, basal cell carcinomas are easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. Although this skin cancer hardly ever spreads or metastasizes to vital organs, it can damage surrounding tissue, sometimes causing considerable destruction and even the loss of an eye, ear, or nose. When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to cover the defect.
Risk of Recurrence
People who have had one BCC are at risk of developing others in later years. These may be in the same place or elsewhere on the body. BCCs on the scalp and nose are especially troublesome. The recurrences typically take place within the first two years following surgery.
Should the cancer recur, the physician may recommend a different type of treatment. Some methods, such as MOHS microscopically-controlled surgery, are more effective for recurrences. Because of the risk of recurrence, it is important to examine not only the sites(s) previously treated, but the entire skin surface. Therefore, regular visits to a skin specialist should become a routine part of health maintenance.