Basal Cell Carcinoma

Basal Cell Carcinoma

Basal cell carcinoma is the most common type of skin cancer. It is almost always curable with simple local treatment (excision, curettage or radiation). Most of these cancers occur in sun-exposed sites (head, neck, shoulders, back and upper extremities) and are related to sun damage to the skin. This type of cancer virtually never spreads to other areas or organs or the body (metastases). If the cancer is not completely removed, it may recur in the same area and can involve vital structures like the nose, ear, and eyes by local growth. The cancer usually begins as a slowly expanding growth or as a non-healing sore.

A biopsy (removal of a piece of skin) will be necessary to confirm the diagnosis. The tissue is examined by a pathologist under the microscope.

Basal cell carcinomas rarely occur in non-sun-exposed sites. Black individuals rarely develop basal cell carcinoma. Many more cancers are seen in the southern, sunny climates than in the northern climates.

Prevention

The skin damaging affects of sun-exposure are cumulative over a life-time. Tanning is a response of the skin to sun damage even if sunburn is avoided. Wrinkling, loss of elasticity, skin cancer, easy bruising and bleeding, and pigmentation abnormalities develop in later life many years after tanning and sun worship. You cannot undo this damage. Prevention of further skin injury by use of sunscreens, protective clothing and avoidance of intense sun exposure may help.

Patients who have had one skin cancer are at high risk for development of another skin cancer somewhere else. You should have any new growth or non-healing sore examined by a skin specialist. The cancers are much easier to treat when they are small.

Treatment

Excision-Many of the cancers are best treated by excision (cutting out) with closure of the wound with stitches. A risk of scar, infection, bleeding and recurrence of the cancer is always present after treatment.

ED&C (electrodessication and curettage)-A scraping and electrical burn procedure may be used for many lesions.

Mohs’ Surgery-Mohs’ micrographic surgery is a specialized technique for removing skin cancers. The specimen that is removed is immediately examined under a microscope while you wait. If cancer is seen at the edge of the piece, more is taken right away. The cure rate is nearly 100%. Mohs’ surgery is used for large cancers close to important structures such as the nose or eye, or for recurrent cases.

Radiation Therapy-Radiation offers excellent treatment without disruption of normal appearance. It is best used for larger skin cancers especially if located on the nose or ear.

Immune Modulation-New medications are available to treat small superficial cancers with a topical cream. Current studies are showing excellent cure rates with minimal irritation. At this time, topical therapy is not the first choice of treatment. In the future, however, it may become the “gold standard.”

No matter the method of treatment, you should be seen at 6 and 12 months after surgery and at least once a year thereafter to detect any evidence of regrowth or new cancers and to help your doctor assess any scarring as a result of surgery.