What is Basal Cell Carcinoma?
Basal cell carcinoma is a type of cancer which develops on those skin regions, which are exposed a lot to the sun. It is one of the least dangerous types of skin cancer, and when caught early, can be completely cured. Basal cell carcinoma usually does not spread to other parts of the body, but it can move to adjacent bone or tissue under the skin. There are several treatments which can prevent it and help in getting rid of the basal cell carcinoma. The tumors of this cancer appear as small and shiny bumps, mostly on the nose or other areas of the face. However, other areas on the body such as trunk, arms and legs can also have these bumps. Fair skinned individuals are more likely to get basal cell carcinoma.
Basal cell carcinoma is very slow in growth and mostly starts showing after many years of prolonged sun exposure. People who use tanning beds or who are exposed to a lot of sun in young age are more likely to get it.
Causes of Basal Cell Carcinoma
UV or Ultraviolet rays either from the sun or a tanning bed are the main root cause for developing basal cell carcinoma. When the UV rays hit the skin, gradually they destroy the DNA of the skin cells. The DNA is responsible for how this skin grows. Over the time, this damage to the DNA causes development of cancer. This whole process can take many years.
Signs & Symptoms of Basal Cell Carcinoma
- Basal cell carcinoma appears as a dome shaped growth on the skin, which has blood vessels in it.
- Basal cell carcinoma can be of brown, pink or black color.
- In the initial stages, a basal cell carcinoma looks like a small, pearl like bump and also resembles a flesh-colored pimple or mole which persists and doesn't go away.
- Basal cell carcinoma can also look dark sometimes.
- This cancer can also start as slightly scaly, shiny pink or red patches on the skin.
- A hard and waxy skin growth is also one of the symptoms of basal cell carcinoma.
- These growths are fragile and tend to bleed easily.
Investigations for Basal Cell Carcinoma
A biopsy taken from the skin helps in the diagnosis of Basal Cell Carcinoma. A small piece of the skin is excised and sent to laboratory for testing and confirmation of diagnosis.
Treatment for Basal Cell Carcinoma
The aim of the treatment is to get rid of the cancer or basal cell carcinoma and leave as small a scar as possible. Treatment depends on the size and location of the cancer, and the duration of the time the patient has had it. The chances of scarring and patient's general health are also factors which the doctors consider. Some of the treatment options for basal cell carcinoma are:
- Excising the tumor (basal cell carcinoma) is cutting out the tumor and its surrounding skin. The doctor will first anesthetize the tumor and the surrounding skin. Then the tumor is scraped using a spoon-shaped device. Next, he will cut out the tumor and a small area of the surrounding normal-appearing skin and send it to lab for analysis. If the report comes back that there are cancer cells in the area surrounding the tumor, then the doctor needs to remove more skin.
- The doctor will perform a procedure known as "curettage and desiccation," where after numbing the skin, the doctor curettes or scrapes off the tumor. Then after controlling the bleeding, the doctor uses an electric needle to kill the remaining cancer cells.
- Radiation therapy is a treatment procedure for basal cell carcinoma where strong x-ray beams are used to kill the cancer cells. Radiation therapy for basal cell carcinoma spans a period of several weeks.
- Cryosurgery for basal cell carcinoma is a procedure where the cancer cells are frozen using liquid nitrogen.
- Mohs surgery for removing basal cell carcinoma is a technique, where the surgeon removes the tumor layer by layer. He removes a layer of tissue, then analyzes it under the microscope to see if it contains cancer cells, then moves onto the next layer.
- Surgery for basal cell carcinoma is recommended if the tumor covers a large area, or is present in a sensitive area, or if it has been present for a long time or if it has recurred after other treatments.
- Medicines comprising of creams and pills are prescribed to treat basal cell carcinoma. Two of the creams which are used to apply on the skin are: imiquimod and fluorouracil (5-FU). These creams need to be applied for several weeks and follow up checkups are needed, so that the doctor can assess how well they are working.
- Erivedge is a pill which can be prescribed if the basal cell carcinoma has metastasized to other body parts.
Certain steps need to be taken to lower the risk of recurrent cancer, such as:
- Checking your skin for growths. Any changes in the skin which is bleeding or growing needs immediate attention.
- Avoid too much exposure to the sun. It is strongly advised that the patient stay out of the sun from between 10 a.m. to 2 p.m., as this is the time when the sun's UVA and UVB rays are at their strongest.
- Even if you have to step out in the blazing sun, always wear a broad-brimmed hat and cover your body as much as possible by wearing long-sleeved shirts and long pants.
- Always and always use a sunscreen before stepping out in the sun. The UVA rays of the sun are present all day, even when it is cloudy. That why it is important to wear a sunscreen with a minimum SPF of 30 to all the exposed parts of the body. Reapply the sunscreen every couple of hours when outside.
Prognosis of Basal Cell Carcinoma
The prognosis of basal cell carcinoma is relatively good; it can be completely cured, especially when it is detected in the initial stages. The following is the prognosis in different situations:
- Basal cell carcinomas (BCCs) rarely metastasize, for this reason the mortality is low.
- Recurrent tumors, however, have poorer cure rates when compared to primary tumors.
- Patients are at an increased risk for developing subsequent basal cell carcinomas at other sites after the initial development at a primary site.
- Patients with tumor clusters and with truncal BCC are at a high risk groups for developing Basal cell carcinoma in the future.
- Patients having basal cell carcinoma are also at an increased risk for developing squamous cell carcinoma and malignant melanoma.
- There is a slightly increased risk for other malignancies, such as lung cancer, thyroid cancer, mouth cancer, breast cancer, and cervical cancer and also non-Hodgkin's lymphoma.