What Is Basal Cell Carcinoma?
The most common of all cancers, Basal Cell Carcinoma affects 800,000 Americans each year. One of three cancers in America is a skin cancer, and 75 percent of skin cancers are Basal Cell Carcinoma. This type of cancer has a 95 percent cure rate but can cause complications or even death if it is neglected.
What characterizes Basal Cell Carcinoma?
Basal Cell Carcinoma occurs most often on areas of the body frequently exposed to the sun –the face, ears, neck, scalp, shoulders, and back. Tumors sometimes develop on areas not often exposed to the sun, but this is rare. Other contributing factors are exposure to or contact with arsenic or radiation, or complications from burns, scars, or tattoos. Basal Cell Carcinoma sometimes resembles psoriasis or eczema; therefore, a physician should examine your skin regularly and suggest regular time intervals for examination depending upon your risk factors.
Watch for changes in size, color, texture, and appearance, as well as skin pain, bleeding, itching, or inflammation. Common characteristics of Basal Cell Carcinoma include a bleeding or non-healing sore, a reddish patch, a shiny bump, a pink growth, or a scarred area.
Who is most likely to have Basal Cell Carcinoma?
This slow-growing disease affects individuals who have regular exposure to sunlight. Until recently, this cancer was most common in older people, particularly men who worked outdoors. Now, however, more women and younger individuals are being diagnosed with Basal Cell Carcinoma, especially those who spend leisure time in the sun. People with fair skin; blonde or red hair; or blue, green, or gray eyes have higher than average risk. People with Basal Cell Carcinoma have about a 50 percent chance of developing another tumor within the next five years. Avoid long exposure to the sun, especially at midday, to prevent Basal Cell Carcinoma. If outdoors for a long time, consider wearing a hat, sunscreen, long sleeves, and a long skirt or pants.
How does a pathologist diagnose Basal Cell Carcinoma?
Your primary care physician or specialist will gather a biopsy specimen from an area of the skin with Basal Cell Carcinoma characteristics for the pathologist to examine under a microscope.
How do doctors determine what surgery or treatment will be necessary?
The pathologist consults with your primary care physician or specialist after reviewing the biopsy test results. Together, using their combined experience and knowledge, they determine treatment options most appropriate for your condition.
What kinds of treatments are available for Basal Cell Carcinoma?
Depending upon the size, depth, and location of Basal Skin Carcinoma, it can be treated by topical medications, curettage and electrodessication, surgery, or radiation therapy. It’s important to learn as much as you can about your treatment options and to make the decision that’s right for you. Common topical medications for the treatment of superficial Basal Cell Carcinoma include imiquimod and 5-FU. Using curettage and electrodessication, the physician scrapes off the growth and dries up the tumor site with an electrocautery needle.
Surgical approaches include excisional surgery, during which a surgeon removes the tumor along with a margin of normal skin as a safety margin. The pathologist examines the removed tissue to assure all cancer cells are gone. Another surgical approach is micrographic surgery, during which a physician removes the visible tumor and then removes surrounding skin one layer at a time. Each layer is checked under a microscope for signs of cancer until the physician is sure all the cancer is gone. This technique has the highest cure rate and can save the greatest amount of healthy tissue.
Cryosurgery is a technique that can be performed without any cutting or anesthesia. Liquid nitrogen is applied to the tumor with a cotton-tipped applicator or spray device. The tumor then becomes dry and crusted and falls off. The procedure is repeated until the cancer is gone. Side effects may include temporary redness, swelling, or loss of pigment.
Laser surgery is often used for cancers on the lip, face, or scalp because this treatment provides surgeons with greater control over the depth of skin that is removed. Often used as a secondary therapy after the first option is unsuccessful, this option has a slightly higher risk of scarring or pigment loss.
Radiation therapy uses high-energy, pinpointed x-rays to kill cancer cells. This type of treatment is directed at a specific area. It can be used to treat small tumors, minimizing the damage to normal cells or tissue surrounding the tumor, or can be used to destroy cancer cells that remain after surgery. Radiation therapy is only rarely used for Basal Cell Carcinoma.
Photodynamic therapy is best used on cancers on the face and scalp or if individuals have multiple malignancies. A physician applies a topical treatment that is activated by a strong light. The treatment destroys cancer while sparing surrounding tissue.
This information is intended for patient education and information only. It does not constitute advice, nor should it be taken to suggest or replace professional medical care from your physician. Your treatment options may vary, depending upon your medical history and current condition. Only your physician and you can determine your best treatment option.
For more information:
American Academy of Dermatology
930 E. Woodfield Road
Schaumburg, IL 60173
American Cancer Society
250 Williams Street NW
Atlanta, Georgia, 30303
Skin Cancer Foundation
149 Madison Avenue, Suite 901
New York, NY 10016