Melanoma is a type of cancer that starts in the melanocyte cells of the skin, usually due to damage from UV light (sunlight). A new or changing mole may be a sign of a potential melanoma. Melanoma cells can spread to other parts of the body.…
Basal cell carcinoma
- Basal cell carcinoma is a very common type of skin growth.
- Treatment can take the form of surgery, skin treatments or radiotherapy.
- In nearly all cases, treatment is effective and the growth is safely removed.
- To prevent basal cell carcinoma, protect your skin from UV radiation, including sunlight and tanning beds.
What is basal cell carcinoma?
Basal cell carcinoma (BCC) is a type of skin cancer that originates in the skin's basal cells. These are cells located at the bottom of the skin's outer layer (the epidermis). Basal cell carcinomas are found on the areas of the body that are exposed to the sun. They can invade locally to deeper layers beneath the skin, but rarely spreads to other areas of the body.
The cause of skin cancer, as with other cancers, is due to damage to the DNA in our cells. In skin cancer, this damage is usually caused by exposure to ultraviolet (UV) radiation, which comes from sunlight and is also used in solariums and sunbeds. The lifetime exposure, pattern of exposure and intensity of UV radiation all influence the risk of developing skin cancer.
The DNA damage can cause a cell to reproduce uncontrollably, creating a mass of abnormal cells. In BCC, the skin's basal cells form a growth in the top layers of the skin.
Risk factors for basal cell carcinoma include:
- Age - the risk of skin cancer increases as you get older;
- UV radiation exposure - intense exposure that leads to sunburn, or accumulative exposure, such as working outdoors;
- Using tanning beds;
- Having a family history of skin cancer;
- Having fair skin, and;
- Having a weakened immune system.
Signs and symptoms
Basal cell carcinomas appear as bumps or sores that slowly increase in size and do not heal after an injury. They typically appear on sun-exposed areas such as the face, head, neck, shoulders and chest, but can also occur on other areas of the body. They tend to be pale, waxy, translucent and pearly, but can also appear pink, brown, black or skin-coloured.
Methods for diagnosis
Your doctor will look at the abnormal skin area, and will refer you to a specialist if they suspect it might be cancerous.
Your doctor will remove a small sample of your growth for analysis. A local anaesthetic is normally used, depending on the size of the sample removed.
There are four main types of skin biopsies:
- Excisional biopsies: removing the entire abnormal area of skin with a surgical knife (scalpel);
- Incisional biopsies: removing part of the abnormal area of skin, together with neighbouring unaffected skin, with a scalpel;
- Punch biopsies: removing a small circle of the whole skin layer, much like a hole puncher removes holes in paper, and;
- Shave biopsies: shaving off only the top layer of skin.
Types of treatment
The growth is surgically removed.
A surgeon will use a device cooled with liquid nitrogen or nitrous oxide to freeze-kill the growth.
Mohs micrographic surgery
The skin is removed in sections and examined for cancer. The process is repeated until all the cancer has been removed from the skin layers. This helps to minimise the area of skin that is removed, while ensuring all the cancer is completely removed.
Electrodessication and curettage
Electrodessication and curettage is a simple surgical technique. A curette, a device that looks like a spoon with a sharp edge, is used to remove the tissue. This is followed by electrodessication, in which a needle electrode delivers an electric current to the tissue to stop any bleeding.
A focused laser beam is used to cut the tissue, stemming the blood flow by simultaneously burning (cauterising) some of the skin.
Focused X-rays are applied to the area where the tumour is located.
Radiotherapy can be used alone, or together with surgery and/or chemotherapy.
Applying anti-cancer drugs (usually 5-Fluorouracil) directly to the skin.
Topical biologic therapy
Applying biologic drugs directly to the skin. These special drugs, such as imiquimod, either act on the immune system to help it fight infection, cancer and other diseases, or attack cancer cells directly.
Photodynamic therapy (PDT)
This treatment has two steps: In the first step, a special medication is applied as a cream to the skin. The medication is designed so that it is absorbed by the cancer cells. In the second step, a special light is shined on the skin. The light activates the medication, which destroys the cells.
PTD does not usually cause scarring. It can be very effective for some types of BCC, but is not recommended for cases of BCC where the cancer cells can be found in the deeper layers of the skin, where light cannot penetrate well.
Treatment side effects
- Inflammation, resulting in ulcers, can result from topical biologic therapy or chemotherapy;
- Scarring and changes to skin colour, and;
- Radiotherapy can cause nausea, vomiting and fatigue.
Advanced cancer spreads to other parts of the body through the bloodstream and lymphatic system (metastasis) affecting the vital function of organs. This is extremely rare for basal cell carcinoma.
In the large majority of cases, basal cell carcinoma is generally easily treated. The earlier a growth is identified and treated, the easier the treatment and the better the chances of success.
BCC can sometimes come back, with another growth appearing in the same area as the first one.
The best way to prevent Basal cell carcinoma (along with all other types of skin cancer) is to avoid UV radiation, which can be done by avoiding sunlight during the times specific to your state, seeking out shade and wearing protective clothing such as hats and long-sleeved shirts with collars to protect the arms and neck. Avoid tanning in the sun or using sun beds.
FAQ Frequently asked questions
What is basal cell carcinoma?
Basal cell carcinoma is a common type of skin cancer that originates in the basal cells, deep within the skin.
What are the signs and symptoms of basal cell carcinoma?
Basal cell carcinomas show up as crusty bumps or sores that bleed easily and do not easily heal. They are typically found on the head, neck, shoulders and chest. However, they can occur anywhere. They are often pale, waxy, …
What causes basal cell carcinoma?
Basal cell carcinoma occurs when the DNA of basal cells is damaged, causing them to replicate uncontrollably. Cell damage resulting in skin cancer is caused by UV radiation, which can come from sunlight and solariums. Total lifetime exposure, but also the …
Who gets basal cell carcinoma?
Although anyone can get basal cell carcinoma, the risk increases with age and is also higher if you have a family history of the disease, a weakened immune system, or if you are regularly exposed to UV radiation.
How is basal cell carcinoma diagnosed?
Basal cell carcinoma is diagnosed by a pathologist examining a skin biopsy under a microscope.
How is basal cell carcinoma treated?
Basal cell carcinoma is treated with surgery to remove the affected area and sometimes with laser surgery, electrodessication and curettage, as well as topical biologic, radiation, chemo and photodynamic therapy.
Can basal cell carcinoma be cured?
If the basal cell carcinoma is diagnosed and treated before it has spread, the prognosis is generally good.
Can basal cell carcinoma be prevented?
You cannot prevent skin cancer, but you can reduce your risk by minimising your exposure to UV radiation during peak UV times. You can also use shade, wear sunscreen and protective clothing such as hats and long-sleeved collared shirts to protect the …
What are the chances of basal cell carcinoma returning?
It is common for basal cell carcinoma to recur. How likely they are to recur depends on their location, with cancers on the face the most likely.