Skin Cancer Foundation
BASAL CELL CARCINOMA
Reprinted with permission from the book/program HEALTH REFERENCE
Basal cell carcinoma is a painless and slow growing cancer of the skin. It is the most common type of cancer in the year 2002. Typically, it is a sore that appears on the face with outer margins that are raised. This type of cancer grows in the basal cells of the skin (the lowest area of the outer skin - epidermis). Men are afflicted more than women, especially those who have endured much sun exposure in their lives.
TYPES: Basal cell carcinomas are categorized as: nodular, cystic, superficial and sclerosing (hardening) types. The most common is the "nodular" ... it is a small, knob like growth that appears translucent and skin colored. The border is usually "rolled" and the center depressed with overlying dilation (stretching) of small blood vessels. The "sclerosing" type appears as a yellow patch ... it is the most agressive type. COLOR: Basal cell carcinomas are usually skin-colored. However, cases have been reported of pigmented sores in dark-skinned persons.
CAUSES: Excessive sunlight is considered the primary cause, however contact with arsenic, radiation exposure, scars, burns, vaccinations, tattoos can increase one's risk.
LOCATIONS: The face, ears, neck, scalp, shoulders, and back. Seldom does basal cell carcinoma occur at sites that are not "exposed" to the envitronment.
RISK FACTORS: 1) A history of frequent sun exposure. 2) People who have fair skin, light hair, and blue, green, or gray eyes.
PROGNOSIS: In the earliest stages basal cell carcinoma is easily treated by removal. However, if it is allowed to grow to large proportions it can cause considerable damage and require the removal of an eye, ear or nose. This type of cancer virtually never spreads to vital organs.
COSMETICS: Surgery always leaves a scar. It is not possible to remove a basal cell carcinoma without producing a scar. Basal cell carcinomas are usually larger beneath the skin thea on the surface. That is the reason that hole left after surgery can be larger than what can be seen prior to the surgery. When the cancer is allowed to grow very large then the scar may not be cosmetically acceptable ... a skin graft may be required to cover the area. The removal of small cancers is typically acceptable, especially if it is in the vicinity of a natural fold lik the nasolabial fold (where the nostrils meet the face).
DIAGNOSIS: The only way to be sure if a sore is a skin cancer is to have it analyzed under a microscope and even this is not 100% proof. The doctor will remove a portion of the tumor with a procedure called a "biopsy". Often the skin will heal over the sore left by the biopsy, however this does not mean that the cancer is gone, it merely means that the cancer is covered by a layer of skin.
RECOMMENDATIONS: 1) Have a qualified health care provider examine any sore that resists healing or keeps growing. 2) Use sunscreens with as SPF (sun protection factor) of 15 or greater and wear sun protective clothing. 3) Do not use artificial tanning machines. 4) Be observant and watch for any signs of skin cancer.
RECURRENCE RATES FOLLOWING TREATMENT: The rate of recurrence of basal cell carcinoma after five years is ... 1% for Mohs surgery, 7.5% following cryosurgery ... 7.7% following curettage (scraping cells) and dessication (the act of drying) ... 8.7% following radiation therapy ... 10.1% following surgical removal.
WARNING SIGNS: Skin cancer, in general, occurs as a skin change like: 1) a sore that will not heal, 2) a lump that appears smooth and shiny, or 3) a flat, red, scaly spot. A common sign of an early basal cell carcinoma is a persitent sore that bleeds, oozes or crusts and remains open for weeks or longer. It can also occur as an irritated patch of skin that may itch, hurt or result in no discomfort as all. It may take the form of a shiny bump or pink growth with it's borders minimally elevated and a crusted indentation in the middle. Finally, be on the alert for scar-like areas that are not symmetrical.