photo c/o Ed Euthman
While melanoma is the most widely known and aggressive form of skin cancer, it’s actually the rarest type. Non-melanoma skin cancers, such as squamous cell carcinoma and basal cell carcinoma, are the most common forms of skin cancer. Melanoma begins in melanocytes cells in the deepest layer of skin, also known as the hypodermic or subcutaneous tissue, while non-melanoma cancers are found in the upper and middle layers of skin, called the epidermis and dermis.
Basal cell carcinoma is a non-melanoma type of skin cancer that starts in the basal cells of the skin.
These are the cells that produce new skin cells as old ones die and are discarded. This type of cancer usually occurs on areas of the skin that are frequently exposed to the sun, such as the head and neck. It rarely spreads to other areas of the skin outside of the original tumor site. Only in very rare cases does it metastasize to other parts of the body.
Basal cell carcinoma Symptoms
Basal cell carcinoma typically presents itself as a waxy or pearly white bump or nodule on the face ears or neck. These bumps may bleed or develop a crust. It can also appear as a slowly growing flat, brown or red patch that can look similar to eczema. Or, in rarer instances, it can take the form of a waxy looking scar or a thickening of skin tissue. This is a sign of infiltrative or morpheaform basal-cell cancers.
Basal cell carcinoma Causes & risk factors
Most basal cell carcinomas are a result of long-time, repeated sun-exposure or occasional intense sun-exposure. That’s why the cancer is most common on areas of the skin regularly exposed to the sun, including the face, neck, scalp, shoulders, back and ears. Other rarer causes include exposure to radiation (especially arsenic), open sores that won’t heal, vaccinations, or chronic inflammatory skin conditions.
Anyone can develop this type of cancer but it is more common in light-skinned individuals with blond or red hair and light green or blue eyes. It most frequently occurs in elderly males, but it can also occur in younger males and females. If a family has a history of basal cell naevus syndrome, Bazex-Dupré-Christol syndrome, Rombo syndrome, Oley syndrome or xeroderma pigmentosum they are at greater risk for basal cell carcinoma.
Basal cell carcinoma Types
· Nodular: This is the most common type that occurs on the face as a shiny, pearly nodule with a smooth surface. Sometimes blood vessels are visible across the nodule’s surface.
· Superficial: This is the most common type in younger adults and is typically found on the upper trunk and shoulders. It presents itself as an irregular looking patch with a rolled border.
· Morphoeic: This type appears as a waxy, scar like patch with fuzzy edges. This form may invade deeper into the cutaneous nerves of the skin.
· Basisquamous: This is a combination of basal cell carcinoma and squamous cell carcinoma. It is potentially more aggressive than other varieties of the cancer due to its mixed nature.
· Fibroepithelial tumor of Pinkus: This is a rare form of the cancer that appears as a warty patch on the skin, usually on the trunk.
Basal cell carcinoma Treatment
After a doctor examines the carcinoma, a biopsy is needed to confirm the cancer. If tumor cells are visible, treatment is required. Treatment will vary based on the type, size, depth and location of the carcinoma as well as individual patient concerns. The cancer is most commonly treated through surgery on an outpatient basis in a physician’s clinic or office.
A doctor will usually choose from the following main forms of treatment:
· Excision biopsy: This is when the lesion is cut out and the skin is stitched closed. This is usually the treatment chosen for nodular and morphoeic BCCs.
· Mohs micrographically controlled excision: This is a type of excision that uses a microscope to remove the lesion layer by layer until no signs of cancer are present. The microscope allows the doctor to pinpoint the cancerous areas of skin to better target removal and save healthy skin. This is a very effective form of removal with a success rate of 99 percent or higher.
· Superficial skin surgery: This form of excision works well for small, contained tumors. It is a quick technique that uses local anaesthesia and does not require sutures.
· Cryotherapy: This treatment works by freezing the superficial skin lesion with liquid nitrogen. It works best on small, shallow BCCs on the trunk and limbs.
· Radiotherapy: This treatment directs x-ray beams through the skin at the tumor and does not require any cutting or anesthesia. However, it does usually require several treatments over the course of a few weeks to kill all the cancer cells. It is best suited for tumors that are hard to treat surgically, especially those in older adults or people with poor health.
If you have any suspicions about any marks, lesions or bumps on your skin, be sure to contact a doctor immediately for a second opinion. While basal cell carcinoma is rarely a life-threatening cancer, it can still pose a serious risk to your skin and, in some instances, invade bone and cartilage if left untreated.