Basal Cell Carcinoma

Skin cancer is the growth of abnormal cells in the skin. Specific types of skin cancer affect the different types of skin cells in the skin’s different layers. Basal cell carcinoma (BCC), affects the basal cells, which form the base layer of the epidermis. It is the most common form of skin cancer, and, in fact, the most common type of cancer overall. Basal cell carcinoma represents approximately 80 percent of all skin cancers, according to the American Cancer Society (2010).

UV Light: The Most Common Cause of Basal Cell Cancer

Basal cell carcinoma almost always develops as a result of damage from the sun’s ultraviolet rays. Like other forms of skin cancer, BCC can be caused by damage to the skin’s DNA from UV light exposure. UV rays damage the function of tumor suppressor genes, which can result in unchecked growth of cancerous cells. In the case of basal cell carcinoma, the PTCH gene may be affected.

Lesions most often appear on skin that receives a high degree of sun exposure. Common areas include:

  • Arms
  • Ears
  • Face
  • Hands
  • Shoulders.

Rarely, basal cell cancer can develop in areas not exposed to sun.

People with fair complexions and light hair and eyes are at the highest risk for developing basal cell carcinoma. Light coloring results in increased sensitivity to the damaging effects of the sun’s UVA and UVB rays. In addition, people whose occupations or hobbies require them to spend long hours in the sun are at increased risk. Limiting sun exposure and using sun protection, such as sunscreen and protective clothing, can help to reduce your risk.

Other Causes and Risk Factors of Basal Skin Cancer

Exposure to chemicals or radiation can also contribute to the development of basal cell carcinoma. Skin conditions that increase reaction to sunlight, such as xerodersa pigmentosum (XP), a rare genetic condition affecting the skin’s ability to repair damage caused by UV light, can also increase basal skin cancer risks.

Though most BCC cases were once confined to the middle-aged or elderly populations, increasing numbers of basal cell lesions are being found in younger people, possibly because of increased sun exposure.

Basal Cell Carcinoma Symptoms

Basal cell carcinoma can have a number of different presentations. Potential signs of BCC may include:

  • A patch of red, irritated skin that may be itchy or painful
  • A persistent sore that will not heal, or sores that seem to heal only to re-open
  • A pink growth with an elevated border and a scaly or crusty center
  • A shiny or waxy-looking bump (brown, red or pink in color)
  • A smooth scar-like growth, white to yellow in color (sometimes called morpheaform basal cell carcinoma).

Skin Examinations for Skin Cancer

Annual skin examinations by a doctor and self-exams of your entire body are the best ways to find skin cancer lesions. Basal-cell carcinoma is a slow-growing cancer, and when it is found in its early stages, prognosis for recovery is favorable.

However, disfigurement or nerve damage can occur when the lesion invades surrounding tissue, as significant amounts of tissue may need to be excised. It is therefore important to report immediately to your doctor any suspicious changes in your skin. A biopsy, a procedure that involves taking a sample of the lesion and examining it under a microscope, can confirm the diagnosis.

Treatment for Basal Cell Carcinoma

Basal cell carcinoma does not often metastasize to lymph nodes or distant organs, like some other forms of cancer can. However, it can travel to surrounding skin tissue, making removal more difficult and more likely to cause scarring.

Often, surgical treatment is used to remove a BCC lesion. Mohs Micrographic Surgery is a common treatment for basal skin cancer. Mohs surgery removes affected and adjacent tissue one thin layer at a time, until all cancerous cells are removed. This technique ensures that as much healthy tissue as possible is left behind, while removing all cancerous cells. In other cases, the lesion and a border of surrounding tissue is excised.

Other surgical and nonsurgical techniques may also be appropriate for some cases of basal cell carcinoma. These include:

  • Cryosurgery
  • Electrodessication and curettage
  • Laser therapy
  • Photodynamic therapy
  • Radiation therapy
  • Topical therapy.

Basal cell carcinoma can recur after treatment, and people who have had a BCC lesion are more likely to develop another or to develop another skin cancer, such as melanoma. It’s important to see your dermatologist for annual skin exams. Be sure to monitor your moles and the appearance of your skin yourself, so you can report changes to your doctors.

Resources

American Academy of Dermatology. (2009). Basal cell carcinoma. Retrieved July 1, 2010, from http://www.aad.org/public/publications/pamphlets/sun_basal.html

American Cancer Society. (2010). Skin cancer: Basal and squamous cell. Retrieved July 1, 2010, from http://www.cancer.org/acs/groups/cid/documents/webcontent/003139-pdf.pdf

The Skin Cancer Foundation. (2010). Basal cell carcinoma: The most common skin cancer. Retrieved June 18, 2010, from http://www.skincancer.org/basal-cell-carcinoma.html