Quick Answers about Basal Cell Carcinoma
- Basal Cell Carcinoma Overview
- Basal Cell Carcinoma Warning Signs
- Diagnosing Basal Cell Carcinoma
- Treatment Options
- Post-Surgery Treatment
Basal Cell Carcinoma
Basal Cell Carcinoma Overview
Basal Cell Carcinoma (BCC) is the most frequently occurring type of skin cancer. Cancer starts in the basal cells at the outermost layer of the skin, deep in the epidermis. More than four million new cases are diagnosed in the United States every year. Typically, the disease is treatable by medical professionals after detection through imaging and lab test.
Basal cells in the body help generate new skin cells while old cells die off. The cancer is often the result of high-level exposure to sunlight and appears as a brown scaly patch, pink growth, red patch, open sore, scar, shiny bump or white waxy lump on the skin in areas exposed to the sun including the neck and face.
Basal Cell Carcinoma Warning Signs
Basal Cell Carcinoma can resemble noncancerous skin problems including eczema and psoriasis. However, trained doctors specializing in skin diseases can quickly identify the condition by observing notable warning signs. Typically, the beginning stages of basal cell carcinoma appear as a pearly, small bump much like a mole or a flesh-colored pimple that does not heal. Some cancerous growths appear dark in color while others are more red or shiny pink. These carcinomas tend to be fragile in nature and easily bleed with a minor injury.
If noticeable skin changes are observed, and new growths or changes appear, it is likely time to make an appointment with the doctor just to be sure. Shaving cuts and sores that do not heal might be early signs of basal cell cancers.
Diagnosing Basal Cell Carcinoma
Basal cell carcinoma usually develops over decades. To be certain that the cancer cells are not life-threatening, it is essential to seek out a skin condition specialist (dermatologist) who will obtain a medical history and perform a comprehensive exam. As a part of the examination, the doctor will likely ask numerous questions involving the patient’s medical history, any noticeable skin change or other symptoms that have been experienced. The most common questions the doctor will ask include:
- When did the patient first notice there was a lesion or growth on their skin?
- Has the lesion or growth continually change since it was first observed?
- Is there associated pain with the lesion or growth?
- Is this the only detected growth or lesion of concern?
- Have there been other skin cancers or carcinomas previously removed?
- Does the family have a history of skin cancer and if so, what kind?
- Does the patient routinely examine their skin?
- Are precautions taken when out in the sun including using sunscreen and staying out of the midday sun?
To perform an extensive examination, the physician will need to examine the patient’s entire body in search of other lesions. The doctor will likely perform skin biopsies on every unusual skin growth to determine if the lesion is cancerous and if so, what type of cancer. The form of treatment will likely depend on the size and type of the growth.
To confirm a diagnosis of basal cell carcinoma, the doctor will likely perform a biopsy. The procedure requires numbing the skin using local anesthesia to remove a small tissue sample that can be examined by a laboratory professional under a microscope. The type of treatment recommended will be determined by the carcinoma’s location, size, depth, and type of tumor. Usually, local anesthetics are used to surgically remove the carcinoma area once it is identified, creating only mild discomfort or pain. The doctor may recommend one or more methods or procedures for treating the Basal Cell Carcinoma that includes:
- Curettage and Electrodesiccation – This procedure is typically used to treat small lesions, the procedure scrapes away the carcinoma with a sharp curette and then burns (desiccates) it using an electrocautery needle.
- Excision Surgery – The doctor will excise (surgically cut away) the tumor and skin tissue using a sharp scalpel and then have the removed tissue specimen verified as being cancerous cells in a laboratory setting.
- Micrographic Surgery – A thin layer of tissue that contains the tumor is removed using micrographic surgery. Many patients choose this method because the procedure tends to destroy the least amount of healthy tissue and provides the highest rate of cure.
- Radiation – During the procedure, the technician directs x-ray beams at the tumor that will be destroyed after a few weeks and several treatments. However, the procedures can be risky and produce radiation risks and/or long-term cosmetic issues.
- Cryosurgery – The doctor will freeze the cancerous tumor tissue to destroy it using liquid nitrogen. This procedure often causes temporary swelling and redness in the treated area but is an ideal solution for patients who cannot use anesthesia or those who suffer from bleeding disorders.
- Photodynamic Therapy (PDT) – This effective solution can produce cure rates up to 90 percent. Drugs including topical 5-ALA (five-aminolaevulinic acid) are applied to the treating area and then activated using a blue light to destroy the cancerous area.
- Laser Surgery – Doctors can ablate (vaporize) the cancerous lesions using lasers that penetrate deep into the skin without destroying the skin’s top layers. Because this type of therapy has yet to be approved by the FDA, it is often used as a secondary therapy after other techniques have proven to be unsuccessful.
- Topical Medications – Doctors recommend various liquid solutions, gels, and creams to treat Basal Cell Carcinoma that include Imiquimod and 5-FU (5-Fluorouracil).
- Oral Medications – FDA approved Erivedge (vismodegib) and Odomzo (sonidigib) oral medications have been proven effective in treating some cases of basal cell carcinoma when cancer precludes other treatments like radiation or surgery. However, these medications have serious side effects including causing severe birth defects and death in a developing fetus.
When treating pre-existing basal cell carcinoma cancerous lesion or growth, it is necessary to follow specific steps that are known to lower the potential of developing a recurrent case of cancer. Post-surgery and post-treatment steps include:
- Routinely Check Your Skin – It is essential to look for any new growth or lesion that might be bleeding, changing or growing. The routine check requires viewing the naked body in a full-length mirror or hand-held mirror to look for any early indicators of cancers skin conditions.
- Avoid Direct Sunlight – It is necessary to stay away from midday sunlight (between 10:00 AM to 2:00 PM when the ultraviolet burning sun rays are at their peak.
- Use Sunscreen – Ultraviolet rays from the sun are always present throughout the day. Because of that, it is necessary to apply 30 SPF (sun protection factor) sunscreen daily to all uncovered skin. When outside, the sunscreen needs to be reapplied every 60 to 80 minutes.
- Dress Appropriately – Wearing a hat with a broad brim, long pants, and long-sleeve shirts can protect skin from harmful rays of the sun.
- Never Use a Tanning Bed – Tanning beds can damage skin from ultraviolet radiation which has been proven to increase the potential of developing skin cancer.
- Have Your Skin Routinely Screened – The doctor will recommend how often skin screening is necessary to ensure there is no recurrence of cancer.