Basal Cell Carcinoma
Medical Dermatology
Basal cell carcinoma (BCC) is the most common form of skin cancer. More than two million cases of this skin cancer are diagnosed in the United States each year. This skin cancer usually develops on skin that gets sun exposure, such as on the head, neck, and back of the hands. BCC is especially common on the face, often forming on the nose. It is possible to get BCC on any part of the body, including the trunk, legs, and arms.
It’s The Most Common Form Of Skin Cancer
People who use tanning beds have a much higher risk of getting BCC. They also tend to get BCC earlier in life. This type of skin cancer grows slowly. It rarely spreads to other parts of the body. Treatment is important because BCC can grow wide and deep, destroying skin tissue and bone. Basal cell carcinoma (BCC) shows up on the skin in different ways. That’s because there are different types of this skin cancer. If you see any of the following on your skin, you should immediately make an appointment to see one our dermatologists:
- Dome-shaped skin growth with visible blood vessels. Often pink or skin-colored. Can also be brown or black or have flecks of these colors in the growth. Grows slowly. May flatten in the center, ooze, and crust over. Tends to bleed easily.
- Shiny pink or red, slightly scaly patch, especially when appears on the trunk. It grows slowly and may be mistaken for a patch of eczema.
- Waxy feeling, hard, pale-white to yellow or skin-colored growth that looks like a scar. Can be difficult to see the edges.
BCCs may look like a sore that:
Although rare, BCC can feel painful or itch. Usually, the only sign of BCC is a growth on the skin. Anyone can get this common skin cancer, but some people have a greater risk. People with a greater risk of getting basal cell carcinoma (BCC) have one or more of the following risk factors:
Your physical traits
- Light-colored or freckled skin.
- Blue, green, or gray eyes.
- Blond or red hair.
- An inability to tan.
What you’ve done
- Spent a lot of time outdoors for work or leisure, without using sunscreen or covering up with clothing.
- Frequently used tanning beds.
Your medical history
- If you had one BCC, your risk for developing a second one increases by about 40%.
- Close blood relative had BCC.
- Taking one or more drugs that suppress the body’s immune system. People take these drugs after receiving an organ transplant and to treat a medical condition, such as severe arthritis, lymphoma, or human immunodeficiency virus (HIV).
- Overexposure or long-term exposure to x-rays, such as patients who received x-ray treatments for acne in the 1940s.
The only way to diagnose any type of skin cancer, including basal cell carcinoma (BCC), is with a skin biopsy. Dr. Jochen can perform this procedure during an office visit.
There are several ways to treat BCC:
- Excision: This is a surgical procedure that your dermatologist often can perform during an office visit. It involves numbing the area to be treated and cutting out any remaining tumor plus some normal-looking skin around the tumor.Like the skin biopsy, this removed skin is examined under the microscope. This may be done at a laboratory or by your dermatologist. The doctor who looks at the removed skin needs to see whether the normal-looking skin is free of cancer cells. If not, more skin will need to be removed. This is a common way to treat BCC.
- Curettage and electrodessication: This treatment consists of two steps. First, your dermatologist scrapes away the tumor. Then electricity is used to destroy any remaining cancer cells. The two steps are then repeated.
- Mohs surgery: Named for the doctor who developed this surgery, Mohs (pronounced “moes”) is a specialized surgery used to remove some skin cancers. It offers the highest cure rate for difficult-to-treat basal cell cancers. Dr. Jochen is an expert in Mohs surgery and can tell you if Mohs is right for you.
If Mohs is recommended, this is what you can expect. The surgeon will cut out the tumor plus a very small amount of normal-looking skin surrounding the tumor. While the patient waits, the Mohs surgeon uses a microscope to look at what was removed. The surgeon is looking for cancer cells. If necessary, during the Mohs surgery, the surgeon will continue to remove a very small amount of skin and look at it under the microscope. This continues until the surgeon no longer sees cancer cells. - Cryosurgery: This treatment uses liquid nitrogen to freeze cancer cells, causing the cells to die.
- Radiation: This treatment usually is reserved for BCCs that cannot be cut out, or when surgery may not be the best choice. A patient may need 15 to 30 radiation treatments.
- Photodynamic therapy (PDT): This treatment uses light to remove early skin cancers. PDT is a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed. Then the skin is exposed to a special light to kill the cancer cells.
- Medicated creams: Creams that contain a drug, such as imiquimod or 5-fluorouracil, can be used to treat early BCC. Use as directed by our dermatologist.
- Pills: While extremely rare, there are reports of BCC spreading to other parts of the body. Patients who have BCC that spreads may be prescribed vismodegib. This medication also may be prescribed for patients who have advanced BCC that cannot be cut out or treated with radiation.
Outcome
Nearly every basal cell cancer can be cured, especially when the cancer is found early and treated. Be sure to perform regular skin self-exams. We can show you how to examine your skin for signs of skin cancer. Be sure you perform a monthly self-examination, you will be looking for changes in the shape or size of spots or moles and other irregularities. Use the ABCDE’s of skin cancer to help with your skin check. Call us at 760-423-4000, if you have any questions or find an irregular spot, mole, or other skin irregularity.
