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Cancer (Oncology)

Basal Cell Cancer

Basal cell cancer (also known as basal cell carcinoma) is a type of slow-growing skin cancer that affects cells on the bottom layer of the epidermis. It is usually found on skin that is exposed to the sun, particularly the head and neck. Basal cell cancer does not normally spread to lymph nodes nor metastasize to other parts of the body. However, if left untreated, it can affect nearby bone and tissue. Basal cell carcinoma has a very high cure rate, but patients who develop it have a tendency to develop new lesions; about half of people who have had this cancer will experience it again in another location.

Risk Factors and Prevention

Sun exposure (or ultraviolet light radiation) is the biggest risk factor for developing basal cell cancer. Caucasian people have a higher risk than African Americans or Hispanics because their skin contains less protective melanin (skin pigment). Men are twice as likely as women to have basal cell cancers. Age is another risk factor, although the rate of basal cell and squamous cell cancers is increasing in younger people – most likely because of sun exposure. Exposure to industrial metals and chemicals also raises the risk of Basal cell carcinoma.

Many skin cancers can be avoided. Limiting ultraviolet (UV) exposure by avoiding prolonged exposure to the sun, steering clear of tanning beds, wearing protective clothing, wearing a wide-brimmed hat, using sunscreen, and wearing sunglasses that block UVA and UVB light, decreases risk. It is very important to protect children; frequent sunburns in childhood may increase the risk for future basal cell cancer.

Symptoms and Diagnosis

Basal cell cancers can be found early through a routine skin-checkup by a health-care professional or through a self-exam. Any new bumps or growths, or any changes in the size, shape or color of existing moles, freckles, and marks on the skin could be cause for concern. Basal cell carcinomas can range from flat, firm, and pale to dark looking spots. They could also be raised, pink or red, translucent, shiny, and waxy. Patches that ooze or bleed easily or become scaly, crusty, red or swollen should be examined by a dermatologist.

Treatment

If basal cell cancer is diagnosed, it can usually be removed by minor surgery or topical treatments. Some tumors can be excised using a local anesthetic. Others are scraped and treated with an electric needle (in a process called curettage) to kill any remaining cells. Tumors in delicate areas like the face might require Mohs Surgery, a technique performed by highly trained doctors. In Mohs Surgery, the tumor is removed layer by layer, and microscopically examined during the procedure to ensure removal of the cancer, while preserving that area of the skin.

Small tumors and pre-cancerous lesions are often treated by freezing cells with liquid nitrogen (cryosurgery), by using a topical chemotherapy cream, by light, laser or other, more experimental treatments. Radiation may be used for large or oddly-situated tumors or on patients who cannot tolerate surgery. It can also be used after surgery as adjuvant (additional) therapy to kill any remaining cancer cells. Newer oral treatments have been developed that treat large or aggressive tumors that may be difficult to remove surgically, as well as tumors that have metastasized.

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