Basal Cell Carcinoma

What is Basal cell carcinoma?

Basal cell carcinoma or basal cell skin cancer is a type of cancer that occurs most often in areas exposed to the sun, especially the face, head, and neck. Basal cell carcinoma can take many forms but it usually appears as a slightly transparent bump, growth, or a sore that won’t heal.

Basal cell carcinoma begins in the basal cells. Basal cells are cells within the skin that produces new skin cells as old ones die off. Mostly basal cell carcinoma is caused by long-term exposure to ultraviolet (UV) radiation from sunlight. Rarely, basal cell carcinoma can develop on parts of your body usually protected from the sun, such as the genitals.

Symptoms of Basal Cell Carcinoma/ Basal Cell Skin Cancer

  1. A lesion with dark spots,
  2. Raised reddish itchy patches,
  3. Brown, blue or black lesions,
  4. A scar-like flat, firm, pale, or yellow areas,
  5. Scaly reddish patches with a raised edges,
  6. Open sores that don’t heal, or that recur after healing,
  7. Pink growths with raised edges and lower in their center,
  8. White, waxy, scar-like lesion without a clearly defined border,
  9. Pear-shaped white, pink, or skin-colored bump that is translucent,
  10. Small, pink or red, translucent, shiny bumps, which might have blue, brown, or black areas

Does basal cell cancer run families? Is Basal cell skin cancer genetic?

Apart from a rare familial condition called Gorlin’s syndrome, Basal cell carcinomas BCCs are not hereditary. Several hereditary syndromes and genes are also associated with an increased risk of Basal cell cancers (BCC) and squamous cell carcinoma (SCC). Some conditions that lead to BCC might be inherited such as fair skin, sunburn tendencies, and freckling.

Causes of Basal Cell Carcinoma

Basal cells are found at the bottom of the epidermis. Basal cells produce new skin cells and push older cells toward the skin’s surface, where the old cells die and are sloughed off. The process of the creation of new skin cells is controlled by the DNA of the basal cells.

Basal cell carcinoma occurs when one of the skin’s basal cells develops a mutation in its DNA. The mutation tells the basal cell to multiply speedily and continue growth. These accumulating abnormal cells form a tumor. These tumors may then convert into lesions and finally into basal cell skin cancer.

It is thought that most of the damage to DNA in basal cells is due to ultraviolet (UV) radiation found in sunlight. Commercial tanning lamps and tanning beds may also cause basal cell carcinoma.

How to reduce your risk of basal cell carcinoma?

Reduce the risks of basal cell carcinoma by following:

  • (1) Wear protective clothing.
  • (2) Use a broad-brimmed hat.
  • (3) Apply sunscreen generously on your skin.
  • (4) Cover your arms and legs with dark, tightly woven clothes.
  • (5) Avoid a baseball cap or visor as it doesn’t provide much protection.
  • (6) Check your skin regularly and report changes to your healthcare provider.
  • (7) Avoid the sun during the middle of the day between 10 a.m. to 4 p.m.
  • (8) Use a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days.
  • (9) Use such sunglasses that block both types of UV radiation, UVA radiation, and UVB rays.
  • (10) Tanning beds are harmful as they emit UV rays and can increase your risk of skin cancer. So avoid them.
  • (11) Reapply sunscreen after every two hours or more during swimming or perspiring.
  • (12) Examine your skin regularly in a mirror and check for new skin growths or changes in existing moles, freckles, bumps, and birthmarks.

Risk factors of basal cell cancer

  1. Longtime exposure to the sun is considered a major risk factor
  2. Commercial tanning beds increase the risk of basal cell carcinoma. Commercial tanning lamps and tanning beds may also cause BCC.
  3. Severe sunburns also increase your risk of developing skin cancers
  4. People who have very fair skin, light skin, red or blond hair, or light-colored eyes
  5. The risk of basal cell carcinoma is higher among people who freckle or burn easily
  6. The majority of BCCs occur in older adults. So age is an important factor
  7. Some immunosuppressant drugs significantly increase your risk of skin cancer
  8. Drinking arsenic-contaminated well water may cause BCC.
  9. The risk of developing basal cell cancer is greater if you live in a sunny or high-altitude location
  10. Exposure to arsenic increases the risk of BCC and other cancers
  11. Radiation therapy to treat acne or other skin conditions may increase the risk.
  12. If you’ve had this sort of cancer one or more times, you have a greater chance of developing it again
  13. Anti-rejection drugs used after transplant surgery may develop basal cell carcinoma cancer
  14. People who have a job that involves producing or uses arsenic may develop this cancer
  15. If you have a family history of skin cancer, you may have an increased risk of developing this skin cancer.
  16. Certain rare genetic diseases or inherited syndromes can increase the risk of basal cell carcinoma. Xeroderma pigmentosum and Nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) may cause basal cell carcinoma.

Survival Rate for Basal cell carcinomas

Basal cell carcinomas are curable if diagnosed early and treated properly. The 5-year survival rates for people whose melanoma is diagnosed and treated early before spreading to the lymph nodes are 99%.

Stages of Basal Cell Carcinoma

Basal cell skin cancer is seldom staged. All other cancers are staged cancers. Cancer stages are measured on the parameters of spreading to other parts of the body from their site of origination. It is highly unlikely for BCC to spread, so it is not staged cancer.

Metastasis of BCC

Basal cell carcinomas rarely spread (metastasize) to other parts of the body and the growth rate of BCC varies greatly from tumor to tumor. Mostly, BCC tumors enlarge very slowly so that they go unnoticed as new growths or lumps. Some tumors however grow as much as ½ inch or about 1 centimeter in a year.

BCC of the skin metastasizes very rarely. Its metastasis ranges between 0.0028 and 0.55 in all BCC cases. Basal cell carcinoma accounts for 80% of all non-melanoma skin cancers.

The tumors grow so slowly that they go undetected. Some tumors can grow as much as ½ inch (about 1 centimeter) in a year.  The growth rate varies greatly from tumor to tumor. BCC rarely metastasizes to other parts of the body.

About 90% of cancers are carcinomas that affect epithelial cells. Carcinomas can affect areas of the body other than the skin. Epithelial tissue is also present in the digestive tract, breasts, intestines, blood vessels, bladder, and other organs. Thus carcinomas may affect these organs too if cancer cells in a tumor metastasize.

Basal cell carcinoma
Neglected Basal Cell Carcinoma

Complications of basal cell carcinoma

  • (1) Basal cell carcinoma may increase the chance of developing other types of skin cancer, such as squamous cell carcinoma (SCC).
  • (2) Basal cell carcinom commonly recurs, even after successful treatment.
  • (3) Basal cell carcinoma can spread to nearby lymph nodes and other areas of the body, such as the bones and lungs but rarely.

Basal Cell Carcinoma Important Questions & their Answers

Can you leave BCC untreated?

Basal cell cancer rarely spreads to other parts of the body. If left untreated, basal cell carcinomas can become quite large. It can grow into nearby areas and invade the bone, and other tissues beneath the skin or spread to other parts of the body and cause death. BCC has a high cure rate, however. This type of skin cancer needs to be treated early and If not removed completely, basal cell carcinoma can recur in the same place on the skin.

Can you die from basal cell skin cancer? Will I die from basal cell carcinoma?

About 2,000 people die from basal cell and squamous cell skin cancer each year. Basal cell carcinoma rarely spreads to other parts of the body. This type of skin cancer has a high cure rate. If left untreated, basal carcinomas can become quite large and spread to other parts of the body. About 80% of non-melanoma skin cancer is basal cell carcinoma.

Does basal cell carcinoma need to be removed?

In cosmetically important areas, basal cell cancer removal disfigures the skin. However, it can be cured when diagnosed early. Basal cell skin cancer rarely metastasizes into the body.

Does basal cell skin cancer hurt?

Skin cancers usually do not cause pain. They are painful and irritating at advanced stages. But normally, they are detected before they go into such a stage. Typically they can be seen or felt long before they reach this point. But at an advanced stage, they may itch, bleed, or even hurt.

Does basal cell skin cancer increase the risk for other cancers?

People who develop basal cell carcinoma are at greater risk of developing other types of cancers, including blood, colon, breast, and prostate cancers.

Is Basal cell skin cancer life-threatening?

Basal cell carcinomas are the least dangerous of skin cancers. They rarely grow to metastasize to other organs. But the main problem with them is that even when they appear small, they may invade deeper into the skin. This condition makes them dangerous.

Does basal cell carcinoma appear suddenly?

Basal cell carcinoma is the most common type of skin cancer. Signs of basal cell carcinoma include a new growth or bump that is skin-colored, pink, or shiny. The tumor growth can develop slowly or appear suddenly anywhere on the skin.

Which is the worse basal cell or squamous cell skin cancer?

Basal cell carcinoma is the most common of all cancers and accounts for more than 90 % of all skin cancers in the United States. Basal cell carcinoma is slow-growing cancer that seldom spreads to other parts of the body.

The major difference between basal cell and squamous cell cancers is that squamous cell cancer is more likely to grow deeper into the layers of your skin. The other main difference is that squamous cell cancers spread more than basal cell carcinoma.

How does basal cell carcinoma spread?

Basal cell carcinoma is unlikely to spread from the skin to other parts of the body. However, it may spread into bone or other tissue under the skin. So, if basal cell carcinoma is left untreated then it can spread deeper into the skin and other organs of the body.

Is basal cell carcinoma malignant or benign?

The majority of skin cancers are basal cell carcinomas and squamous cells carcinomas.

A small but significant number of skin cancers are malignant melanomas. While malignant, basal cell carcinomas are unlikely to spread to other parts of the body..

Is Basal Cell Carcinoma serious?

Basal cell carcino is the least dangerous of all skin cancers as they rarely metastasize. You can bear them until they become too itchy or bleeding. Otherwise, they barely appear to grow or change for years.

Can a basal cell carcinoma go away on its own?

Many keratoacanthomas shrink or even go away on their own. But some continue to grow, and may even spread to other parts of the body. The growth of basal cell carcinoma is very difficult to predict so skin cancer doctors treat them as squamous cell skin cancer.

Can basal cell carcinoma come back?

After removal, basall cell carcinoma does recur at some other spot on the body in about 40% of people. Routine skin checkups or examinations can find recurring cancers while they are still very small.

Is Basal Cell Carcinoma really cancer?

Basal cell cancer is a type of skin cancer that begins in the basal cells — a type of cell within the skin that produces new skin cells.

Does basal cell carcinoma pop like a pimple?

At first, a basal cell cancer appears as a pearly-shaped bump. This skin growth or bump looks like a pimple or a skin-colored mole that doesn’t go away. Basal cell carcinomas may sometimes look dark, shiny pink or red patches.

Is surgery necessary for basal cell carcinoma?

Different types of surgery can be used to treat basal cell carcinomas. Mohs surgery has the best cure rate for basal cell cancer. Electrodesiccation and Curettage are common treatments for small basal cell carcinomas. This type of treatment might be repeated to help remove all of cancer.

When to see your doctor if you doubt you have Basal cell carcinoma cancer?

If you feel changes in the appearance of your skin such as a new lump or growth then contact your dermatologist. If you also feel a change in a previous growth or a recurring sore, then it is a worrisome situation that you are developing basal cell skin cancer.

How much does it cost to have a basal cell carcinoma removed?

Mohs surgery is around 7,000$ for three stages or $3,000 +/-$500 for one stage, and excision is usually a lot less.

What is the cure rate for basal cell carcinoma?

The five-year cure rate with Mohs’ micrographic surgery is up to 95% for recurrent basal cell carcinoma and 99% for the primary tumor.

What is the prognosis for bcc skin cancer?

If basal cell carcinoma is diagnosed early, then there are more chances of survival. Basal cell carcinoma has an 85% to 95% recurrence-free cure rate with modern treatment options. Radiotherapy is a useful treatment that is generally used for elderly patients.

Disclaimer:

The image used above, “Basal Cell Carcinoma”, is a derivative of “image labeled as A mutilating tumor on the right side of the patient’s face.” and “image labeled as The patient is tumor-free, but his face has not been reconstructed functionally or esthetically.” originally published by Erika Varga et al, used under CC BY. “Basal Cell Carcinoma” is licensed under CC BY by King.

What does basal cell carcinoma skin cancer look like?

At first, Basal cell cancer appears as a change in the skin, such as a growth or a sore that won’t heal. It appears like a small “pearly” bump that looks like a flesh-colored mole or a pimple. You can see a bit through the surface of this pearly bump as it is translucent. Sometimes these growths may look dark or shiny pink or red patches that are slightly scaly. You must also be concerned when you see a waxy, hard skin growth.

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