About Basal Cell Carcinoma
The Most Common Skin Cancer
Basal cell carcinoma is the most common form of skin cancer. In fact, it is the most common of all cancers in Australia. One out of every three new cancers is a skin cancer, and the vast majority are basal cell carcinomas, often referred to by the abbreviation, BCC. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer). Until recently, those most often affected were older people, particularly men who had worked outdoors. Although the number of new cases has increased sharply each year in the last few decades, the average age of onset of the disease has steadily decreased. More women are getting BCCs than in the past; nonetheless, men still outnumber them greatly.
BCCs are generally not life threatenning as they do not commonly spread to other parts of the body. In very rare circumstances a BCC may metastasize internally.
BCCs cause major problems when left untreated, or incorrectly treated, because they continue to grow and eventually result in local destruction of skin and surrounding or deeper tissues. This is partcularly a problem on the face and can require major reconstructive surgery to cure.
The Major Cause
Chronic exposure to sunlight is the cause of almost all basal cell carcinomas, which occur most frequently on exposed parts of the body — the face, ears, neck, scalp, shoulders, and back. Rarely, however, tumors develop on non-exposed areas. Uncommon genetic disorders can result in multiple BCCs. In a few cases, contact with arsenic, exposure to radiation, and complications of burns, scars, or even tattoos are contributing factors.
Who Gets It
Anyone with a history of frequent sun exposure can develop basal cell carcinoma, often referred to as BCC. But people who have fair skin, light hair, and blue, green, or grey eyes are at highest risk. Those whose occupations require long hours outdoors or who spend extensive leisure time in the sun are in particular risk. Dark-skinned individuals are far less likely than fair-skinned to develop skin cancer.
What to Look For
The five most typical characteristics of basal cell carcinoma are shown below. Frequently, two or more features are present in one tumour. In addition, basal cell carcinoma sometimes resembles non-cancerous skin conditions such as psoriasis or eczema. Learn the signs of basal cell carcinoma, and examine your skin regularly — as often as once a month if you are at high risk. If you observe any of the warning signs or some other change in your skin, consult your doctor immediately. Dr O’Brien recommends those at high risk have their skin examined annually. If the risk is very high, more frequent examinations may be required.
Warning Signs of Basal Cell Carcinoma
An Open Sore that bleeds, oozes, or crusts and remains open for three or more weeks. A persistent, non-healing sore is a very common sign of a basal cell carcinoma.
A Reddish Patch or irritated area, frequently occurring on the chest, shoulders, arms, or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no noticeable discomfort. Superficial BCC.
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 which is white, yellow or waxy, and often has poorly defined borders. The skin itself appears shiny and taut. Although a less frequent sign, it can indicate the presence of an aggressive tumour. This may be called a morpheoform or sclerosing BCC.
There are several ways to treat BCCs. The most common is surgical excision of the tumour. BCCs may sometimes be treated using Cryotherapy, Curettage, Photodynamic therapy or topical agents.