Basal Cell Carcinoma FAQs
Basal Cell Carcinoma Skin Cancer
What is basal cell carcinoma? »
Basal cell carcinoma is the most common type of skin cancer and the most frequently occurring of all cancers. Eight out of every 10 skin cancers are basal cell carcinomas, making this form of skin cancer far and away the most common. They grow in the lowest layer of the epidermis, the basal cell layer. These cancers usually develop on sun-exposed areas, especially the head and neck. They tend to grow slowly and it is rare that they spread to other parts of the body. If left untreated, basal cell carcinomas can grow into nearby areas and invade bone or other tissues beneath the skin, making removal potentially disfiguring.
What do basal cell carcinomas look like? »
Basal cell carcinomas look like flesh-colored, pearl-like bumps or pinkish patches of skin. They can develop into sores. They tend to grow most often on areas of the skin that are exposed to the sun, such as your arms, face, and neck. Often the first detected symptom of a basal cell carcinoma is a bleeding spot without a preceding cause. It is extremely rare to see regional spread or metastasis to other locations in the body. However, if left untreated, the lesion will expand and destroy more tissue locally where it is found.
What causes basal cell carcinomas? »
Basal cell carcinoma occurs when one of the skin’s basal cells develops a mutation in its DNA. Basal cells are responsible for producing new skin cells. As they do so, older skin cells are pushed toward the skin surface, where they die and are sloughed off. DNA in the basal cell controls this function.
When the DNA mutates, things change. The mutation causes a basal cell to multiply rapidly, and they continue growing when normally they would die and be shed. Eventually, the accumulating abnormal cells form a cancerous tumor that shows as a lesion on the surface skin.
What are the signs of a basal cell carcinoma? »
Basal cell carcinomas invariably develop on areas that receive lots of sun exposure. They are typical on the head, neck, and arms. Basal cell growths can form on the shoulders, but are less frequent on the lower trunk and the legs.
A basal cell carcinoma will show itself as a change in the skin. It can appear as a pearly white, skin-colored, or pink bump that is somewhat translucent. It can also be a brown, black, or blue lesion with slightly raised borders. On the back or chest, a flat, scaly, reddish patch is more common.
How are basal cell carcinomas treated? »
How we treat your basal cell carcinoma will often be dictated by its location. There are numerous treatment options.
Surgery is the typical treatment method. Depending on the size and location of the removed growth, the wound may be sutured closed, covered with a skin graft, or allowed to heal on its own.
These are the surgical procedures:
Electrodesiccation and curettage — With small or superficial basal cell growths, we remove the surface of the skin cancer with a blade or often a scraping instrument known as a curette. Then the base of the cancer is seared with an electric needle. This both closes off blood vessels and kills any stray cancer cells. In some cases, the underlying area is frozen with liquid nitrogen, rather than cauterized with electricity.
Surgical excision — This involves cutting out the cancerous lesion with a scalpel, along with a margin of healthy skin around it. The sample is then sent to a lab to confirm that removal was successful.
Cryosurgery — Spraying liquid nitrogen onto growths is the preferred method for removing precancerous actinic keratoses, but it can also be used on very thin basal cells carcinomas with little depth. The problem with this method is that the freezing time may need to be prolonged, which can possibly damage nerves in the area.
Mohs surgery — This method has the highest success rate of removing all of the basal cell growth. Your surgeon removes the basal cell cancer layer by layer. After a layer is removed, it is examined immediately to check for any remaining cancer cells on the borders. If cancer cells are still found, another layer or ring is removed. This process is continued until the sample shows itself to be clean. This is especially effective for removing growths on the face, as only the minimum amount of tissue is removed.
Topical treatments can be successful on superficial basal cell carcinomas with little depth. These drugs work by inflaming the area where they are applied. The body responds by sending white blood cells to attack the inflammation. These white blood cells go after the mutated basal cells. Aldara, Efudex, and Fluoroplex are three of the most used drugs.
What is the success rate for treating basal cell carcinoma? »
Mohs micrographic surgery has the best cure rates with basal cell carcinoma, a 99 percent cure rate for carcinomas that are not returning growths. The cure rate when basal cell carcinomas are removed with wide excision can be as high as 98 percent. With curettage and electrodesiccation the rate is from 91 to 97 percent.
Basal cell carcinoma is not considered life threatening in almost all cases. It is simply disfiguring.