Basal Cell Carcinoma
What is it?
Basal cell carcinoma is the most common form of skin
cancer. Basal cell carcinoma is named for the basal cells
from which it develops, which are located at the bottom of
the outer skin layer (epidermis).
Who gets it?
Basal cell carcinoma affects approximately 800,000
Americans each year. Anyone with a history of frequent sun
exposure can develop basal cell carcinoma. People who do
not tan easily, such as those with fair skin, light hair,
and blue, green, or gray eyes, are at highest risk. Until
recent years, basal cell carcinomas most commonly affected
older people, particularly men who had worked outdoors.
However, healthcare professionals are seeing more women
develop these lesions, and both men and women are
developing them at an earlier age. This is most likely
from purposeful tanning during the teenage years and more
time spent outdoors enjoying leisure activities.
What causes it?
Exposure to sunlight is the cause of almost all basal
cell carcinomas, which almost always occur on sun exposed
portions of the body -- the face, ears, neck, scalp,
shoulders, and back. Rarely, tumors can develop on
non-exposed areas. In a few cases, contact with arsenic or
exposure to radiation can be contributing factors.
What are the symptoms?
The most typical appearances of basal cell carcinoma
are:
- An open sore that bleeds, oozes, or crusts and
remains open for three or more weeks.
- A reddish scaly patch or irritated area, frequently
occurring on the chest, shoulders, arms, or legs.
Sometimes the patch may itch or hurt. More commonly, it
persists with no noticeable discomfort.
- A shiny bump or nodule that is pearly or translucent.
It may also be pink, red, or pigmented, especially in
dark-complected people.
- A scar-like area that is white, yellow, or waxy, and
often has poorly defined borders. The skin itself appears
shiny and tight. Although this is a less frequent sign,
it can indicate the presence of an aggressive tumor.
How is it diagnosed?
To make a diagnosis of skin cancer, your doctor will
take a complete medical history and also question you
about your sun exposure habits along with your personal
and family history of skin cancer. The doctor will then
need to know when the mark appeared, whether it has
changed in size or appearance, and if it has been treated
before. Next, he or she will perform a skin examination.
If your doctor finds any cause for concern, he or she will
recommend a skin biopsy. This procedure is performed in
the doctor's office with a local anesthetic. The portion
of skin that is removed with the biopsy is sent to a
dermatopathologist, who will examine it under a microscope
and determine if any cancer is present.
What is the treatment?
The majority of basal cell carcinomas are highly
curable with both surgical and non-surgical therapy. The
exact method chosen will depend on the tumor's location
and size along with the your general health, medical
history, and whether the tumor has been treated before.
There are many treatment options. Curettage and
electrodessication is highly effective for small,
well-defined, nonaggressive tumors. With this procedure,
the doctor uses a semi-sharp instrument with spoon-shaped
edge (called a curette) to scrape away tumor tissue. Then,
the area is treated with an electric needle that generates
enough heat to destroy any residual cancer cells that
might remain. The wound will usually heal within a few
weeks. Radiation therapy can be useful for tumors that
have spread into the lymph nodes. It may also be used for
patients whose medical condition will not allow him or her
to under go surgery. Unfortunately, radiation therapy can
cause skin cancer many years after treatment and the
appearance of irradiated skin can deteriorate over time.
For these reasons, radiation therapy is generally not
recommended for young patients. Cryosurgery uses very cold
liquid nitrogen to freeze the tumor and kill the cancer
cells. The tissue then blisters off in a few days and the
wound heals on its own in a few weeks. It is most
effective for superficial or small lesions. With a
procedure called standard excision, the skin is numbed
before the tumor is cut away with a 3 to 4 millimeter
border of normal skin. Standard excision is most effective
for tumors that have well-defined borders and have not
been treated before. Mohs’ micrographic surgery is a
highly specialized technique in which a trained Mohs’
micrographic surgeon removes tumor tissue surgically layer
by layer, mapping each layer and examining the excised
tissue for residual tumor cells under a microscope. If
residual tumor cells are identified, its location is
precisely mapped and an additional layer of tissue is
removed at that exact location. By examining 100% of the
margins, it provides the highest cure rate of all
therapies for basal cell carcinoma.
Self-care tips
The best way to prevent skin cancer is to protect you
and your family from excessive exposure to sunlight. 80%
of your lifetime sun exposure occurs before you are 20
years old. Therefore, both adults and children need to be
protected from sunburn by appropriate clothing, hats,
sunscreen and avoiding the mid-day sun. It is important to
have a full skin examination performed by a qualified
physician on a regular basis. You should also learn the
signs of basal cell carcinoma, and examine your own skin
regularly -- as often as once a month if you are at high
risk. Be sure to include the scalp, backs of ears, neck,
and other hard-to-see areas. (A full-length mirror and a
hand-held mirror can be very useful). If you observe any
of the warning signs or some other change in your skin,
consult your physician immediately.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
|
