Basal Cell Carcinoma
I was diagnosed with Basal Cell Carcinoma, what does this mean?
Basal Cell Carcinoma (BCC) is the most common type of cancer, therefore, making it the most common type of skin cancer. About one in five people will get a basal cell carcinoma in their lifetime. They usually begin as small red, pink or shiny bumps on the skin. They can sometimes look like flat pink patches. Sometimes they can be rough or scaly to the touch. On occasion they may bleed or form scabs and never heal completely. They are typically very slow growing and can take years to cause a problem.
Basal cell carcinoma skin cancer is not fatal. You will not die from this type of skin cancer. However, that does not mean that you should neglect it and not treat it. Basal cell carcinoma can grow large over time and be quite disfiguring, so early detection and early intervention is key to a satisfactory outcome.
Risk factors for basal cell carcinoma include sun exposure, sun burns, fair skin and genetics. The sun exposure that can affect us and cause this type of skin cancer usually begins when we are younger. Our cumulative life time exposure to the sun puts us at greater risk for developing skin cancer. People who grew up at the beach, playing sports outdoors or working outside in the sun are more susceptible to developing a basal cell carcinoma. Historically, basal cell carcinoma affected people as they grew older. That is still true today, however we are seeing many younger people being diagnosed with basal cell carcinoma. The reason for this is largely due to indoor tanning bed use and also a depletion of the ozone layer which helped to filter some of the harmful rays of the sun from reaching us.
The best protection against basal cell carcinoma is education! Wearing sunscreen, protecting our younger generations, avoiding indoor tanning and being as careful as we can when playing or working outdoors is our best defense against developing this form of skin cancer.
- Apply a broad-spectrum sunscreen of SPF 30 or higher 20-30 minutes before sun exposure.
- Re-apply sunscreen every 60-90 minutes while in the sun.
- Avoid peak hours of the sun between 10am and 2pm.
- Wear sun protective clothing.
- Do not burn!
- Avoid indoor tanning.
- Examine your skin once a month for new or changing spots.
- Have a yearly skin examination to ensure your skin is in good health.
How is Basal Cell Carcinoma treated?
Basal cell carcinoma is completely curable with appropriate treatment. The best treatment often depends on the size and location of the skin cancer. There are many acceptable options for treating basal cell carcinoma.
- Excisional Surgery: Most basal cell carcinomas are best treated with complete surgical excision. The entire skin cancer plus a small margin of healthy tissue is removed and the surgical defect is stitched closed. This is usually done right in the office. The end result is a surgical scar - a small price to pay to be cancer free. Check out the section on Procedure Care to learn how to take care of your excision site after this is done.
- MOHS Micrographic Surgery: This is a technique used for large skin cancers or lesions in tissue sensitive areas (scalp, face, ears, nose, hands, shins, feet, toes). The skin cancer is removed in layers and microscopically examined in the office, while you wait, to ensure all the skin cancer is completely removed. Once all the skin cancer is taken out completely, the area can then be stitched closed. This has one of the highest cure rates for treatment of basal cell carcinoma. Check out the section on Procedure Care to learn how to take care of your excision site after this is done.
- Electrodessication and Curretage: This is an acceptable form of treatment for superficial skin cancers and smaller lesions on preferred parts of the body. This requires a local numbing agent to be given by injection to the area where the skin cancer is located. The skin cancer is then burned with an electric needle and scraped away. The site typically heals well and cure rates are acceptable. Check out the section on Procedure Care to learn how to take care of the sites after this procedure is done.
- Cryotherapy: This is better known as freezing. This method can also be used for superficial and smaller skin cancers. This skin cancer gets frozen with liquid nitrogen which results in a destructive blister to the skin causing the skin cancer cells to fall off as it heals. When done properly cure rates are high. Check out the section on Procedure Care to learn how to take care of the site after freezing.
- Radiation Therapy: Radiation can often be done for lesions that are hard to treat surgically or on patients that are not good surgical candidates. This would be done at an appropriate radiation facility. Treatment is usually spread out over a 4-6 week period consisting of treatments up to 5 days a week. Cure rates are acceptable when the treatment is followed exactly as it is recommended by the Radiation Oncologist.
- Topical Therapy: Certain types of basal cell carcinoma may be appropriately treated with prescribed topical creams. One cream works as a topical chemotherapy (5-fluorouracil) while another works to stimulate the body's immune system (imiquimod) to fight the skin cancer.
If you have been diagnosed with basal cell carcinoma I want you to know that their are many great options to treat this. At our visit I can discuss all the treatments above and explain to you what treatment(s) would be best for you based on these different factors. Remember, there is no one-size-fits-all approach to dealing with skin cancer. Each patient is evaluated on an individual basis to determine the best plan of action for you.