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Basal Cell Carcinoma

Definition

Basal cell carcinoma is the most common form of skin cancer. This cancer usually grows slowly and rarely spreads to other tissues in the body.

Basal cell carcinoma is rarely fatal but it can cause damage to the nearby tissue. If there is risk of damage, the cancer may need treatment or removal.

Basal Cell Carcinoma
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Causes

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The growths invade and take over nearby tissue. It is not clear exactly what causes these problems in the cells but is probably a combination of genetics and environment.

Risk Factors

Areas of skin that are damaged have higher risk of cancer. Skin that is regularly exposed to the sun is most likely to develop skin cancer. Basal cell carcinoma may also develop in skin that has scars, burns, or inflammatory skin diseases.

Factors that increase your risk of developing basal cell carcinoma include:

  • Blonde or red hair
  • Blue or green eyes
  • Childhood sunburns , freckling, or long periods of sun exposure
  • Fair skin that rarely tans
  • A family history of skin cancer
  • A personal history of skin cancer
  • Treatment that suppresses the immune system , such as having an organ transplant
  • History of radiation therapy
  • Frequent use of tanning beds
  • Certain rare genetic disorders, such as Gorlin’s syndrome

Symptoms

Symptoms of basal cell carcinoma include:

  • A sore that may crust, bleed, or ooze for three weeks without healing
  • A raised, red patch that may be itchy
  • A shiny bump that can be pearl-like in appearance or, less often, dark in color, much like a mole
  • A pink growth with a slightly raised border and dip in the middle
  • A patch of skin that seems shiny and tight, much like a scar

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done.

The doctor will look at the skin growth. A sample of the growth will be taken and examined for cancer cells. This examine will help determine the stage and type of the cancer. Your doctor will use this information to guide treatment and make a prognosis.

Treatment

Talk with your doctor about the best treatment plan for you. Options include:

  • Mohs micrographic surgery—microscopic surgery that offers the best cure rate for basal cell carcinoma
  • Removal of the growth with simple surgery
  • Plastic surgery to repair any cosmetic problems that occur after treatment
  • Electrodesiccation and curettage—treatment to remove section of skin

For people who are not able to have surgery, other treatment options include:

  • Use of liquid nitrogen to freeze the growth
  • Radiation therapy
  • Photodynamic therapy—the cells absorb an acid that causes them to die when exposed to light
  • Creams, especially fluorouracil or imiquimod

Prevention

To reduce your chances of getting basal cell carcinoma, take these steps:

  • Reduce your sun exposure. Wear sunscreen, long sleeves, pants, and hats.
  • Stay out of the sun during the middle of the day.
  • UV light is stronger at higher elevations. If you ski or do other winter sports, wear sunscreen.
  • At-risk adults should examine themselves monthly. They should also get regular full-body exams by a dermatologist. The doctor will check for moles, freckles, and other growths.
  • Limit how much time your child spends in the sun. Discourage your child from tanning.

Revision Information

  • American Academy of Dermatology

    http://www.aad.org

  • The Skin Cancer Foundation

    http://www.skincancer.org

  • Canadian Dermatology Association

    http://www.dermatology.ca

  • Canadian Cancer Society

    http://www.cancer.ca

  • Saraiya M, et al. Preventing skin cancer. MMWR . 2003 Oct 17;52(RR15):1-12. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5215a1.htm. Accessed November 10, 2012.

  • Basal cell carcinoma of the skin. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 17, 2013. Accessed March 28, 2013.

  • Basal cell carcinoma. American Academy of Dermatology website. Available at: http://www.aad.org/skin-conditions/dermatology-a-to-z/basal-cell-carcinoma. Accessed March 28, 2013.

  • Wong C, Strange R, et al. Basal cell carcinoma. BMJ. 2003;327:794-798.