Basal Skin Cancer

Basal Skin Cancer

What Is Basal Cell Carcinoma? Basal cell carcinoma is a cancer that grows on parts of your skin that get a lot of sun. It’s natural to feel worried when your doctor tells you that you have it, but keep in mind that it’s the least risky type of skin cancer. As long as you catch it early, you can be cured. This cancer is unlikely to spread from your skin to other parts of your body, but it can move nearby into bone or other tissue under your skin. Several treatments can keep that from happening and get rid of the cancer. The tumors start off as small shiny bumps, usually on your nose or other parts of your face. But you can get them on any part of your body, including your trunk, legs, and arms. If you’ve got fair skin, you’re more likely to get this skin cancer. Basal cell carcinoma usually grows very slowly and often doesn’t show up for many years after intense or long-term exposure to the sun. You can get it at a younger age if you’re exposed to a lot of sun or use tanning beds. Causes Ultraviolet (UV) rays from the sun or from a tanning bed are the main cause of basal cell carcinoma. When UV rays hit your skin, over time, they can damage the DNA in your skin cells. The DNA holds the code for the way these cells grow. Over time, damage to the DNA can cause cancer to form. The process takes many years. Symptoms Basal cell carcinoma can look different. You may notice a skin growth in a dome shape that has blood vessels in it. It can be pink, brown, or black. At first, a basal cell carcinoma comes up like a small “pearly” bump that looks like a flesh-colored mole or a pimple that doesn’t go away. Sometimes these growths can look dark. Or you may also see shiny pink or red patches that are slightly scaly. Another symptom to watch out for is a waxy, hard skin growth. Basal cell carcinomas are also fragile and can bleed easily.
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Basal Skin Cancer

Basal cell carcinomaBasal cell carcinomaBasal cell carcinoma is a type of skin cancer that most often develops on areas of skin exposed to the sun. This photograph shows a basal cell carcinoma that affects the skin on the lower eyelid. Basal cell carcinoma is a type of skin cancer. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off. Basal cell carcinoma often appears as a slightly transparent bump on the skin, though it can take other forms. Basal cell carcinoma occurs most often on areas of the skin that are exposed to the sun, such as your head and neck. Most basal cell carcinomas are thought to be caused by long-term exposure to ultraviolet (UV) radiation from sunlight. Avoiding the sun and using sunscreen may help protect against basal cell carcinoma.
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Basal Skin Cancer

Basal-cell cancer is a very common skin cancer. It is much more common in fair-skinned individuals with a family history of basal-cell cancer and increases in incidence closer to the equator or at higher altitude. There are approximately 800,000 new cases yearly in the United States alone. Up to 30% of Caucasians develop basal-cell carcinomas in their lifetime. In Canada, the most common skin cancer is basal cell carcinoma (as much as one third of all cancer diagnoses), affecting 1 in 7 individuals over a lifetime.
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Basal Skin Cancer

Individuals with a basal-cell carcinoma typically present with a shiny, pearly skin nodule. However, superficial basal-cell cancer can present as a red patch similar to eczema. Infiltrative or morpheaform basal-cell cancers can present as a skin thickening or scar tissue – making diagnosis difficult without using tactile sensation and a skin biopsy. It is often difficult to visually distinguish basal-cell cancer from acne scar, actinic elastosis, and recent cryodestruction inflammation.
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Basal Skin Cancer

Basal cell carcinomas can often come in association with other lesions of the skin, such as actinic keratosis, seborrheic keratosis, squamous cell carcinoma. In a small proportion of cases, basal cell carcinoma also develops as a result of basal cell nevus syndrome, or Gorlin Syndrome, which is also characterized by keratocystic odontogenic tumors of the jaw, palmar or plantar (sole of the foot) pits, calcification of the falx cerebri (in the center line of the brain) and rib abnormalities. The cause of this syndrome is a mutation in the PTCH1 tumor suppressor gene located in chromosome 9q22.3, which inhibits the hedgehog signaling pathway. A mutation in the SMO gene, which is also on the hedgehog pathway, also causes basal-cell carcinoma.
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Basal Skin Cancer

This the most common type of skin cancer. About 8 out of 10 skin cancers are basal cell carcinomas (also called basal cell cancers). When seen under a microscope, the cells in these cancers look like cells in the lowest layer of the epidermis, called the basal cell layer.
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Basal Skin Cancer

In the United States approximately 3 out of 10 caucasians develop a basal cell carcinoma during their lifetime. This tumor accounts for approximately 70% of non-melanoma skin cancers. In 80 percent of all cases, basal cell carcinoma affects the skin of head and neck. Furthermore, there appears to be an increase in the incidence of basal-cell cancer of the trunk in recent years.
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Basal Skin Cancer

Some superficial cancers respond to local therapy with 5-fluorouracil, a chemotherapy agent. Topical treatment with 5% Imiquimod cream, with five applications per week for six weeks has a reported 70–90% success rate at reducing, even removing, the BCC . Both Imiquimod and 5-fluorouracil have received FDA approval, and topical IMQ is approved by the European Medicines Agency for treatment of small superficial basal-cell carcinoma. Off label use of imiquimod on invasive basal-cell carcinoma has been reported. Imiquimod may be used prior to surgery in order to reduce the size of the carcinoma. One can expect a great deal of inflammation with this treatment. Chemotherapy often follows Mohs surgery to eliminate the residual superficial basal-cell carcinoma after the invasive portion is removed. Some advocate the use of imiquimod prior to Mohs surgery to remove the superficial component of the cancer. Removing the residual superficial tumor with surgery alone can result in large and difficult to repair surgical defects. One often waits a month or more after surgery before starting the Imiquimod or 5-fluorouracil to make sure the surgical wound has adequately healed. Some people advocate the use of curettage (see EDC below) first, followed by chemotherapy. These experimental procedures are not standard care. The 2008 study reported that topical IMQ appears effective in the treatment of primary small superficial BCCs, but only ‘may possibly’ have a role in the treatment of primary nodular BCC.
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These cancers usually develop on sun-exposed areas, especially the head and neck. These cancers tend to grow slowly. It’s very rare for a basal cell cancer to spread to other parts of the body. But if a basal cell cancer is left untreated, it can grow into nearby areas and invade the bone or other tissues beneath the skin.
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Basal cell carcinoma (BCC) (also known as basalioma or basal cell cancer), is the most common skin cancer, and one of the most common cancers in the United States. While BCC has a very low metastatic risk, this tumor can cause significant disfigurement by invading surrounding tissues.
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Five Warning Signs of Basal Cell Carcinoma En Español Frequently, two or more of these features are present in one tumor. In addition, BCC sometimes resembles noncancerous skin conditions such as psoriasis or eczema. Only a trained physician, such as a specialist in diseases of the skin, can decide for sure. If you observe any of the warning signs or some other worrisome change in your skin, consult your physician immediately. This slideshow made possible through a grant from Novartis An Open Sore An open sore that bleeds, oozes, or crusts and remains open for a few weeks, only to heal up and then bleed again. A persistent, non­–healing sore is a very common sign of an early BCC. A Reddish Patch or Irritated Area A reddish patch or irritated area, frequently occurring on the face, chest, shoulders, arms, or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no discomfort. A Shiny Bump or Nodule A shiny bump or nodule that is pearly or clear 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 normal mole. A Pink Growth A pink growth with a slightly elevated rolled border and a crusted indentation in the center. As the growth slowly enlarges, tiny blood vessels may develop on the surface. A Scar-like Area A scar-like area that is white, yellow or waxy, and often has poorly defined borders; the skin itself appears shiny and taut. This warning sign may indicate the presence of an invasive BCC that is larger than it appears to be on the surface. Not to Be Ignored BCCs are easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. While BCCs seldom spread to vital organs, they can cause major disfigurement and occasionally result in nerve or muscle injury. Certain rare, aggressive forms can be lethal if not treated promptly. When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to repair the wound in order to achieve the best cosmetic result and facilitate healing.