BASAL CELL CARCINOMA

Basal cell carcinoma (BCC) is the most frequently occurring form of skin cancer, consisting of abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin). They may look like open sores, red patches, pink growths, shiny bumps, or scars.

Causes
Usually caused by a combination of cumulative UV exposure, BCC can be highly disfiguring if allowed to grow, but almost never spreads (metastasizes) beyond the original tumor site. Only in exceedingly rare cases can BCC spread to other parts of the body and become life-threatening.

What You Can Do

Avoiding sun exposure is the best way to lower the risk for all types of skin cancer. We recommend that you:

  • Seek shade, especially during midday hours.
  • Wear clothing to protect exposed skin.
  • Wear a hat with a wide brim to shade the face, head, ears, and neck.
  • Wear sunglasses that wrap around and block as close to 100% of both UVA and UVB rays as possible.
  • Use sunscreen with sun protective factor (SPF) of 15 or higher, that offers both UVA and UVB protection.
  • Avoid indoor tanning.

Regularly checking your skin, both by self-examination and by our dermatologist, is also a good idea if you have fair skin and/or a family history that suggests you could be high risk.

Signs to look for when self-examining include:

  • An open sore that bleeds, oozes, or crusts and remains open for a few weeks, only to heal up and then bleed again. A persistent, non­–healing sore is a very common sign of an early BCC.
  • A reddish patch or irritated area, frequently occurring on the face, chest, shoulders, arms, or legs. Sometimes the patch crusts and it may also itch. At other times, it persists with no noticeable discomfort.
  • A shiny bump or nodule that is pearly or translucent and is often pink, red, or white. The bump can also be tan, black, or brown, especially in dark-haired people, and can be confused with a mole.
  • A pink growth with a slightly elevated rolled border and a crusted indentation in the centre. As the growth slowly enlarges, tiny blood vessels may develop on the surface.

A scar-like area that is white, yellow or waxy, and often has fuzzy edges; the skin itself appears shiny and taut. This warning sign may indicate the presence of an invasive BCC that is larger than it appears to be on the surface.

What We Can Do For You

A biopsy is needed to confirm the diagnosis of BCC. This is a minor procedure that can be done in a sterile treatment area. The skin will be injected first with local anaesthesic so that you feel no pain. A piece of tissue is then removed and sent to a laboratory to be examined under a microscope. If the diagnosis is confirmed, further treatment will be needed. BCCs are easily treated in their early stages. The larger the tumour has grown, however, the more extensive the treatment needed. Although this skin cancer seldom spreads it can damage surrounding tissue, sometimes causing considerable destruction and disfigurement — and some BCCs are more aggressive than others. Numerous treatment options are available for basal cell carcinoma. Your therapy will depend upon the type of skin cancer you have and the stage it is at.

  • Surgery — many skin cancers can be cut from the skin quickly and easily. In fact, the cancer is sometimes completely removed at the time of the biopsy, and no further treatment is needed.
  • Curettage and Electrodesiccation – Doctors commonly use a type of surgery called curettage. After a local anaesthetic numbs the area, the cancer is scooped out with a curette – an instrument with a sharp, spoon-shaped end. The area is also treated by electrodesiccation. An electric current is applied to control bleeding and kill any cancer cells remaining around the edge of the wound. Most patients develop a flat, white scar.
  • Cryotherapy liquid nitrogen is applied to the growth to freeze and kill abnormal cells. After the area thaws, dead tissue falls off. More than one freezing may be needed to remove the growth completely. Cryosurgery doesn’t usually hurt, but you may have pain and swelling after the area thaws. A white scar may form in the treated area.
  • Laser Therapy – a narrow beam of light is used to remove or destroy cancer cells. This approach is sometimes used for cancers that involve only the outer layer of skin.
  • Topical Chemotherapy – anti-cancer drugs (a cream or lotion) are applied to the tumour directly. This is a useful treatment for cancers on the top layer of the skin. The cream is applied daily for several weeks. Intense inflammation is common, but no scarring.

Moh’s Surgery – a special technique used for skin cancer. This method is used to remove large tumours, cancer in hard-to-treat places and growths that have recurred. This surgery is performed to remove all of the cancerous tissue. After local anaesthesia, the cancer is shaved off, one thin layer at a time, and checked under microscope until it is completely removed.

Radiation Therapy – high-energy rays are used to damage cancer cells and stop them from growing. This therapy is used for areas that are difficult to treat with surgery, such as the eyelid, tip of nose or ear.  Several treatments may be needed to destroy all cancerous cells. Possible complications include a rash or dry skin. Following treatment, most patients notice changes in the colour or texture of the treated skin.

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