Basal Cell Carcinoma
Basal Cell Carcinoma
If you’ve been diagnosed with basal cell carcinoma (BCC), you are not alone. BCC is the most common form of skin cancer. Each year, millions of cases of BCC are diagnosed in the United States. Nearly all are cured with treatment.
BCC appears on the skin in many shapes and sizes. You may see a:
- Dome-shaped growth with visible blood vessels
- Shiny, pinkish patch
- Sore that heals and then returns, often more than once
- Brown or black growth
- White or yellow waxy growth that looks like a scar
Most BCCs develop on skin that has been repeatedly exposed to the sun, such as the scalp, neck, and hands. BCC is especially common on the face, often forming on the nose, cheeks, and forehead. Although BCC rarely spreads, it can develop anywhere on the body, and treatment is important because they can grow wide and deep, destroying skin tissue and sometimes bone.
Risk Factors
People of all skin colors can get BCC, although it is much more common in light-skinned people. The sun’s ultraviolet (UV) rays damage your skin. Your everyday activities expose you to UV rays, such as going outdoors during the day without sun protection or when you drive your car or sit near your office window.
In addition, if you use indoor tanning beds, your skin is also exposed to dangerous UV radiation.
Your risk of developing skin cancer increases as this damage accumulates.
There are some people though who have a higher risk of getting BCC. For example, the risk increases with age. The older you are, the longer you have been exposed to the sun’s UV rays. People also may have a higher risk of developing BCC when they have:
- Pale, light-colored or freckled skin
- Blond or red hair
- Blue, green, or gray eyes
- A family history of skin cancer
- A weakened immune system or are taking medicine that suppresses the immune system
- Used tanning beds or other indoor tanning devices
Diagnosis
To diagnose BCC, a dermatologist performs a skin biopsy. This is the only way to confirm a diagnosis of skin cancer, including BCC. Your dermatologist can perform a biopsy using local anesthesia during an office visit.
To perform a biopsy, your dermatologist will remove the entire growth (or a part of it) that might be a BCC. Your dermatologist may send this to a laboratory or look at it under a microscope. The findings will be communicated in a biopsy report.
If the diagnosis is BCC, your dermatologist will consider many factors to determine the best treatment for you, including where the BCC appears on your body, the size and features of the BCC, and your overall health.
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When possible, BCC is treated with a procedure called “surgical removal.” If you have an early BCC, this can often be performed in your dermatologist’s office while you remain awake. The following explains the types of surgical removal used to treat BCC, along with other treatment options.
Surgical removal: Three types of surgical removal are used to treat BCC. The type of surgical removal you receive depends largely on the type of BCC you have, where it’s located, and how deeply it goes.
Here’s what involved with each type of surgical removal:
- Excision: Your dermatologist cuts out the skin cancer and an area of normal-looking skin around it. Removing some normal-looking skin helps to remove stray cancer cells.
- Mohs (pronounced moes) surgery: On some areas of the body, such as an eyelid or your nose, removing an area of normal-looking skin along with the cancer would cause problems. There’s not enough skin in these areas.
- Curettage and electrodesiccation: During this type of surgical removal, your dermatologist first scrapes the BCC from your skin, using a technique called curetting. Then, a procedure called electrodesiccation is used to destroy any remaining cancer cells with heat.
Radiation and Image-Guided Superficial Radiation Therapy (SRT): For those who may not be candidates for surgery or prefer a less invasive option, there are several different radiation-based technologies for the treatment of BCC. Cure rates and cosmetic outcomes vary based on the technology and protocol. At Metropolitan Dermatology we offer Image-Guided SRT because both the cure rate and cosmetic results are superior to all other radiation-based options. Treatments are usually given over a period of several weeks and are highly effective, with no downtime or scarring.
Freezing or light therapy: While surgical removal (described above) is often the preferred way to treat BCC, one of these following procedures may be recommended for some patients.
- Freezing: The procedure is called cryotherapy (cry-oh-ther-ah-pee), and it can be performed during an office visit. Cryotherapy involves spraying an extremely cold substance, such as liquid nitrogen, on the BCC to destroy the tumor.
- Light therapy: The medical name for this procedure is photodynamic therapy (PDT). It’s a two-part procedure. First, a solution that makes your skin more sensitive to light is applied to the cancer and a bit of skin around it. You’ll sit with this solution on your skin for one to several hours.
Medication applied to the skin: This is a treatment that you would use at home as prescribed. It’s often used before or after another treatment for BCC. When prescribed as the first treatment, applying medication to the skin cancer helps to reduce the size of the cancerous tumor. Applying the medication after having another treatment helps to kill any remaining cancer cells.
For a few patients, this may be the only treatment prescribed.
Two medications that you apply to the skin have been approved by the U.S. Food and Drug Administration (FDA) to treat BCC:
- Imiquimod (eh-mick-quie-mod): This medication is usually applied once a day or once every other day for 6 weeks or longer.
- 5-FU: This medication is usually applied twice a day for 3 to 6 weeks.
As these medications destroy cancer cells, you will likely feel the effects on the treated area. Side effects of these medications include skin redness, swelling, sores, crusting, itching, and tingling sensations.
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If I have BCC, am I at greater risk of developing other skin cancers?
Yes. Studies show that people who have one skin cancer are at greater risk of developing another skin cancer. Perform regular skin self-examinations, and protect your skin every day. Be sure to keep all appointments with your dermatologist, and make an immediate appointment of you notice anything changing, itching, or bleeding on your skin.
Can anyone get BCC?
Yes. People of all skin colors can get BCC, although it is much more common in light-skinned people.
Are tanning beds ever safe?
No. Never use a tanning bed. UV light from tanning beds can cause skin cancer and wrinkling. If you want to look tan, consider using a self-tanning product. Remember that even when using one of these products, you need to use sunscreen.
