Basal cell carcinoma

A close up of skin with two dark patches

What is basal cell carcinoma?

Basal cell carcinoma (also called basal cell cancer) affects the cells of the lower layer of the epidermis. It is the most common type of  skin cancer and it mostly appears on areas of the skin that have had a lot of sun exposure such as the face and neck. Typically, it grows slowly.

Prognosis

As with many other types of cancer, it’s a serious disease that requires prompt treatment. If left untreated, it can undergo metastasis – which means it can spread to other areas of the body and affect other tissues, bones and organs.

Due to it being a type of cancer that typically grows very slowly, it has a good prognosis for being fully cured when diagnosed early.

Symptoms of basal cell carcinoma

A slow-growing carcinoma might not have any symptoms for a long time. When symptoms show, they can appear as different marks on the skin:

  • a bump on the skin
  • an area of skin that is pearly, waxy, very pale, pink or brown in colour
  • a flaky and red patch of skin
  • a persistent sore or scar.

Medical tests for basal cell carcinoma

A dermatologist will perform a physical exam to look at the areas suspected for carcinoma. To determine the diagnosis, a biopsy will be performed and this consists of extracting a sample of affected skin to analyse its cells in a laboratory.

Causes of basal cell carcinoma

Most basal cell carcinomas occur from exposure to the sun, in areas that have been exposed to sunlight or other types of ultraviolet radiation. It usually occurs from middle age, due to the accumulation of sun damage to the skin, but it can also appear in young people who have overexposed their skin to the sun.

People who meet or have several of the following characteristics are more likely to develop basal cell carcinoma:

  • Very pale, freckled skin
  • Blond or red hair
  • Light eyes - blue or green
  • Family history of skin cancer
  • Multiple sunburns
  • High sun exposure
  • Smokers
  • Other skin diseases
  • A weak immune system

Can it be prevented?

Basal cell carcinoma can be prevented by avoiding excessive sun exposure, sunburns and ultraviolet radiation. Using sun cream with a high enough SPF (sun protection factor) is essential to reduce sun damage.

Early diagnosis can prevent the cancer from developing and so it’s recommended to have an annual dermatological exam. In this exam, pigmented scars and their development are monitored.

Treatments for basal cell carcinoma

The treatment of carcinoma will depend on its location and stage:

Surgical means:

  • Surgical excision: A surgeon removes the entire area affected by the carcinoma and a slight margin of surrounding healthy skin. They then use stitches to re-join the skin
  • Mohs surgery: removal of the affected layers of skin

Non-surgical means:

  • Curettage and electrodesiccation : The cancer cells are scraped off the skin using a curette and then electrodesiccation destroys the remaining cancerous via intense heat
  • Cryosurgery: The cancer cells are frozen to destroy the tumour. It can then blister and fall off
  • Topical treatments: Creams are applied to the area affected by BCC
  • Photodynamic therapy: Photosensitising cream is applied to on the skin with the tumour and then the area is irradiated with a dose of light
  • Radiation: X-ray beams destroy the tumour
  • Chemotherapy: This may be necessary in cases of cancer that has spread to other parts of the body

Which specialist treats it?

A dermatologist can diagnose basal cell carcinoma. Depending on the degree and progression of the disease, the patient may require radiotherapy or chemotherapy treatment with the oncologist.

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