The most common form of skin cancer is basal cell carcinoma (BCC), also known as basal cell skin cancer. Basal cells produce new skin cells in the outer layer of the skin (epidermis) and are affected by it. In most cases, BCC develops on areas of the body exposed to the sun, such as the face, head, neck, and arms, but it can also occur in other areas, such as the genitals.
UV radiation from the sun or artificial sources, such as tanning beds, is the main cause of BCC. UV radiation damages the DNA of the basal cells, causing them to grow abnormally and form tumors. Additional factors that may increase the risk of BCC include:
Fair skin, light eyes, and blond or red hair.
Older age, as the cumulative sun damage increases over time.
A personal or family history of skin cancer.
A weakened immune system due to certain diseases or medications.
Exposure to radiation, arsenic, or other chemicals.
BCC may appear as a change in the skin, such as a growth, a sore, a scar, or a patch. The appearance of BCC may vary depending on the type and location of the tumor. Some common signs of BCC are:
A shiny, translucent, or pearly bump that may have visible blood vessels.
A flat, scaly, or crusty patch that may be lighter or darker than the surrounding skin.
A white, waxy, or scar-like area that may have no clear border.
A brown, black, or blue lesion that may have a raised or rolled edge.
A sore that bleeds, oozes, or does not heal.
BCC may be painless or itchy, and it may grow slowly or rapidly.
The doctor examines the skin and asks about the history and symptoms of the lesion to diagnose BCC. Additionally, a skin biopsy is possible, which involves taking a small sample and sending it to a laboratory for microscopic examination. In addition to confirming the diagnosis, a biopsy can also determine the type and extent of the cancer.
The treatment of BCC depends on several factors, including the size, location, type, and depth of the tumor, the patient’s age, health, and preferences, as well as the likelihood of recurrence. An effective treatment option for BCC is to eliminate it completely and prevent it from spreading or returning.
The tumor and some of the normal skin surrounding it are cut out in surgery. This can be done with a scalpel, a curette (a sharp, spoon-shaped instrument), or a laser. The wounds may be closed with stitches or a skin graft, or they may be left to heal on their own. The scarring rate of surgery is usually low and it is generally effective.
A mohs surgery is a specialized form of surgery in which the tumor is removed layer by layer and each layer is examined under a microscope until no cancer cells remain. It is often used for large, recurrent, or cosmetically sensitive BCCs, such as those on the face, in order to preserve as much healthy skin as possible while removing all cancer cells.
Liquid nitrogen is used to freeze the tumor, causing it to blister and fall off. Cryotherapy is usually used for small, superficial BCCs.
It involves scraping off the tumor with a curette and then using an electric needle to destroy any remaining cancer cells. Typically, electrodessication and curettage are used for small, superficial BCCs that are not on the face. They can be repeated several times to ensure all the cancer has been removed.
BCCs that are hard to treat with surgery, such as those on the eyelids, ears, or nose, may be treated with radiation therapy, in which high-energy rays are used to kill the cancer cells. Radiation therapy may also be used after surgery to reduce recurrence risk.
A topical treatment involves applying a drug to a cream or gel that kills cancer cells or stimulates the immune system to fight them. For superficial BCCs, topical therapy may be used. Among the most commonly used topical drugs for BCC are 5-fluorouracil (5-FU) and imiquimod.
It is used for superficial or nodular BCCs that are not on the face. Photodynamic therapy involves applying a light-sensitive drug to the tumor and then exposing it to a special light that activates the drug and kills the cancer cells.
Using drugs that block molecules involved in cancer cell growth and survival is referred to as targeted therapy. The most common targeted drug for BCC is vismodegib, which is used to treat advanced or metastatic BCCs that cannot be treated with surgery or radiation.
The best way to prevent BCC is to protect the skin from UV radiation. Some of the preventive measures include:
Avoiding sun exposure during the peak hours of 10 a.m. to 4 p.m., when the UV rays are the strongest.
Wearing protective clothing, such as long sleeves, pants, hats, and sunglasses, when outdoors.
Applying a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 30, and reapplying it every two hours or after swimming or sweating.
Avoiding tanning beds and sunlamps, which emit harmful UV rays.
Checking the skin regularly for any changes or signs of BCC, and seeing a doctor promptly if any are found.
A common form of skin cancer, basal cell carcinoma is treatable, but if left untreated, it can lead to serious complications. It is possible to reduce the risk of developing BCC and improve the chances of a successful outcome by being aware of the causes, symptoms, diagnosis, treatment, and prevention.
