Basal Cell Carcinoma

What is basal cell carcinoma?

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Basal cell carcinoma is a type of skin cancer that affects the basal cells. When these cells become cancerous, they form tumors that sit on the skin’s surface. These tumors can be difficult to identify, as they often look like non-cancerous skin lesions – moles, scars, red patches, sores, or acne.

Basal cell carcinoma is unlikely to metastasize. This means it is unlikely to spread throughout the body. However, if you believe you have this type of skin cancer, it is essential to visit a dermatologist or your primary care physician. While metastasizing is rare, it can happen. When basal cell carcinoma spreads, it can be life-threatening.

Basal cell carcinoma diagnosis and treatment are often straightforward. In most cases, the physician will take a sample of the skin lesion and test it for cancer cells. If cancer cells exist within the sample, the doctor will remove the cancerous area. Remember that only a skin care professional can identify and treat basal cell carcinoma. It is important to see a doctor as soon as you suspect you may have skin cancer.

What causes basal cell carcinoma?

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Basal cell carcinoma affects the basal cells, which are skin cells that line the epidermis. These cells grow, die, and are replaced often, constantly switching out old cells with new cells. As a result, it is more likely that one of those new cells will have a mutation, which can become cancerous. This is one reason why basal cell carcinoma is among the most common types of cancer.

Like in most skin cancers, long-term ultraviolet light or sun exposure is the primary cause of basal cell carcinoma. However, sun exposure is not the only means of developing this type of skin cancer. Some people may develop basal cell carcinoma after exposure to arsenic and radiation. Additionally, complications from other skin lesions, like burns, scars, and tattoos, could result in skin cancer.

Certain individuals are more likely to develop basal cell carcinoma. Those who have a light complexion, freckles, light-colored eyes, or blonde hair are at an increased risk. Additionally, a family history of basal cell carcinoma is more likely to result in a diagnosis.

There are also other, non-genetic risk factors to consider. This includes:

  • Living at high altitude
  • Taking immunosuppressing drugs
  • Chronic sun exposure
  • Severe sunburn

It is important to remember that, once a person is diagnosed with basal cell carcinoma, they are very likely to develop skin cancer in the future. If you suspect you have this condition, contact a doctor and begin building a relationship with a dermatologist. After treatment, you will likely need to have regular skin checks to survey the skin for cancer recurrence.

What are symptoms of basal cell carcinoma?

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Basal cell carcinoma symptoms are sometimes difficult to identify. They manifest as lesions, most often on parts of the body that see frequent sun exposure. This includes the neck, scalp, ears, face, shoulders, and upper arms. These lesions are often painless, but they change in appearance over time. Taking photos of a new bump or discoloration can help patients understand whether the growth is changing.

The type of lesion that appears will indicate the type of basal cell carcinoma a person has. Here are the most common, along with a description of how they appear on the skin.

  • Superficial Basal Cell Carcinoma: This type of basal cell carcinoma typically manifests as a red patch on the skin. It is usually scaly and flat, but it may have a raised edge.
  • Pigmented Basal Cell Carcinoma: Pigmented basal cell carcinoma appears as a lesion that looks black, brown, or blue. The lesion’s border is raised but translucent.
  • Basosquamous Basal Cell Carcinoma: Basosquamous cell carcinoma affects both the basal cells and the squamous cells. As a result, its appearance may mimic that of squamous cell carcinoma. This type of skin cancer, though very rare, is very likely to metastasize.
  • Morpheaform Basal Cell Carcinoma: This type of skin cancer appears as a scar-like growth. It can be waxy in appearance, and it usually has no border. This is the least common type of basal cell carcinoma, but it is more likely to grow and spread.
  • Nonulcerative Basal Cell Carcinoma: Nonulcerative basal cell carcinoma appears as a skin-colored bump. These lesions are sometimes translucent. This is the most common type of basal cell carcinoma. It is most likely to appear on the face, ears, and neck.

Remember that any new skin growth that changes shape, color, or size over time is likely to be cancerous. If you have a new bump on your skin, schedule an appointment with a dermatologist. While it may not be basal cell carcinoma, it could be a different type of skin cancer.

How is basal cell carcinoma diagnosed?

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If you believe you have basal cell carcinoma, the first step is to contact a doctor. The physician will first inspect and observe the growth. The patient will undergo a routine skin check, which includes a head-to-toe inspection for any suspicious-looking lesions. The doctor will also collect medical history and determine whether any lifestyle factors may increase skin cancer risk.

If the doctor finds any growths or discolorations that are concerning, they will biopsy the area. The type of biopsy you receive will depend on what form the lesion takes. In most cases, the doctor will use a numbing agent and extract a small sample of skin. They will then observe the sample under a microscope, checking for cancer cells. If cancer cells exist in the sample, additional treatment will be necessary.

If the doctor determines that you have an aggressive form of skin cancer, they may biopsy a lymph node. This allows the physician to see whether the cancer has spread.

What are common basal cell carcinoma treatments?

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The type of basal cell carcinoma treatment you receive will depend on the type of BCC your doctor identifies. However, in all cases, treatment will involve removing the cancerous cells. There are four primary procedures used in cases of basal cell carcinoma: excisional surgery, curettage and electrodessication, cryosurgery, and Mohs micrographic surgery.

  • Excisional Surgery: This treatment involves removing the lesion and the surrounding skin with a scalpel. The doctor typically needs to provide stitches to close the excision site. Excisional surgery is often used for more advanced forms of basal cell carcinoma. It is also likely to leave a small scar.
  • Curettage and Electrodessication: In this type of surgery, a dermatologist will scrape the lesion off using a curette, which looks like a looped blade. This surgery has a high success rate and can leave a small, round scar.
  • Cryosurgery: Cryosurgery is most often used for cancers that are “thin,” or that don’t extend far into the skin. Like with a wart, the doctor will freeze off the cancerous mass with liquid nitrogen. Over the following days, the lesion will blister, then fall off. This procedure comes with a risk of nerve damage at the site.
  • Mohs micrographic surgery: During this procedure, the doctor will remove the layer of cancerous tissue, then immediately freeze and inspect it under a microscope. Over the course of the procedure, the doctor will continue removing layers of cells until the cancerous cells disappear. This surgery has the highest cure rate of all procedures, and it is designed to save healthy tissue.

After treatment, patients are advised to avoid sun, to keep the surgical site clean, and apply over-the-counter medications to help it heal. In most cases, patients can immediately return to their day-to-day tasks – just with an extra emphasis on sun protection.

In cases where basal cell carcinoma has metastasized, a doctor may recommend radiation therapy. In more severe cases, they may recommend chemotherapy. The longer basal cell carcinoma goes without treatment, the more likely it is to metastasize. Seeking a fast diagnosis can limit the likelihood of a patient needing more invasive and debilitating treatment.

What is the outlook for people with basal cell carcinoma?

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In most cases, surgical treatment will completely remove the cancer, and the patient can return to life as normal. However, basal cell carcinoma is likely to recur, even after a successful surgery. Additionally, a basal cell carcinoma diagnosis increases a person’s likelihood of developing other types of skin cancer, like melanoma. In rare situations, basal cell carcinoma itself may metastasize and become life-threatening.

For most patients, however, a relationship with a dermatologist is the most noticeable difference between pre- and post-basal carcinoma life. Because of the risk of recurrence, basal call carcinoma patients are advised to schedule regular appointments with a dermatologist – even if the patient does not notice any new growths. In conducting regular skin checks, the dermatologist should be able to identify and treat any other types of skin cancer that may occur.

When treated promptly and effectively, basal cell carcinoma is usually a mild, non-life-threatening form of cancer. However, if you believe you may have a basal cell carcinoma lesion, it is important to seek medical support as soon as possible. Only a doctor can provide a definitive diagnosis.