Basal Cell Carcinoma

What is a basal cell carcinoma?

Basal cell carcinoma or BCC, is the most common form of cancer of any type. Approximately 3.6 million Americans are diagnosed with a BCC every year. The name basal cell carcinoma comes from the fact that the cancerous cells originate from the basal or bottom layer of the epidermis. This type of cancer is very slow growing, often taking months or even years for a patient to decide to come in for evaluation. They typically appear as pink, shiny bumps that bleed and don't completely heal. Patients often report they thought the cancer was just a pimple that wouldn't heal. 

What causes basal cell carcinoma?

Basal cell carcinoma is primarily due to sun or ultraviolet light exposure. Recurrent sunburns dramatically increase the risk of BCC. Patients with fair skin are much more prone to developing BCC and other types of skin cancer. Family history of basal cell is not a significant risk factor other than the fact that you inherit your skin type from your parents. Also, to a large degree your sun exposure habits are influenced by your parents, at least until adulthood. 

How is a basal cell carcinoma diagnosed?

Diagnosis of a BCC is best done by a trained skin specialist such as a dermatologist. A dermatologist will use a dermatoscope to examine the skin. This is a specialized instrument used to visualize features in the deeper layers of the skin. If concerning features are seen, the dermatologist will recommend performing a biopsy where a sample of skin is removed and sent to be examined under the microscope. 

How is basal cell carcinoma treated?

Once a diagnosis is established, your dermatologist will help you decide on a treatment plan. There are multiple subtypes of BCC: superficial, nodular, and infiltrating are the main subtypes. The least aggressive type is superficial. This type can be treated with a simple procedure called a curettage and destruction where the cancer is removed from the surface with a sharp curette. Alternatively chemotherapy creams can be used. Nodular BCC is typically removed by an excision where the cancer is cut out going deep into the fat, and the resulting wound is then stitched back together. An infiltrating BCC is the most aggressive type. These are also typically excised, and if they are on the face, a specialized procedure called Mohs Micrographic Surgery is usually performed.  

Is a basal cell carcinoma dangerous?

The good news about BCC is that they are almost never fatal. Patients would typically have to ignore their cancer for decades and let it grow to a very large size before there is any realistic risk of death. That being said, early diagnosis and treatment is still essential as an untreated BCC can grow very large, bleed frequently and can eat through the skin, fat, and even bone. Because a BCC is rarely fatal, less aggressive options may be chosen in patients with a limited lifespan, inability to sit through a longer procedure, or even in situations where cost of the procedure is a factor. Your dermatologist will take all these factors into account when determining the right treatment for you.