Basal Cell Carcinoma

Understanding Skin Cancer: Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is the most common type of skin cancer, accounting for the majority of skin cancer cases. Originating in the basal cells, which are found in the deepest layer of the epidermis, BCC is generally considered slow-growing and non-aggressive. However, if not treated early, it can still cause significant local tissue damage.

Basal cell carcinomas often manifest on the skin as growths or lesions, which may appear as red patches, pink growths, open sores, or shiny bumps. These carcinomas are predominantly caused by overexposure to ultraviolet (UV) rays. While BCCs are rarely life-threatening when treated properly, early detection and treatment are crucial.

Each year, nearly three million people are diagnosed with BCC. It is most common in individuals exposed to excessive UV rays, particularly those over 40 years old. However, the average age of diagnosis is declining. People with fair skin, blond or red hair, and blue, green, or grey eyes are more susceptible. Men are also at a higher risk of developing BCC. Protecting your skin from UV exposure is vital in reducing the risk of developing this type of skin cancer.

While basal cell cancer is most often caused by cumulative sun exposure, many cases can be prevented or caught early with the right habits. Practicing sun protection year-round and regular skin checks can help reduce risk. Understanding what BCC looks like, especially in the early stages, is critical for catching it before it becomes severe. 

Common preventative measures include:

• Using a broad-spectrum sunscreen with SPF 30 or higher daily, even on cloudy days
• Avoiding sun exposure during peak hours (10 AM – 4 PM)
• Wearing protective clothing, wide-brimmed hats, and UV-blocking sunglasses when outdoors
• Staying in the shade whenever possible, especially during midday
• Avoiding tanning beds, which significantly increase skin cancer risk
• Performing regular self-skin checks and being aware of BCC symptoms, such as shiny bumps, open sores, or scar-like patches
• Learning to recognize what basal cell carcinoma looks like using credible resources and basal cell carcinoma pictures of the early stages
• Scheduling annual total body skin examinations with a dermatologist for professional screening

Treatment for BCC depends on several factors, including the size, depth, and location of the lesion, as well as the patient’s overall health. With various effective approaches available, from surgical options to newer non-invasive therapies, it’s crucial to tailor the treatment to each case. Early intervention can improve outcomes and minimize scarring. Whether the goal is basal skin carcinoma removal or long-term management, knowing the range of available treatments is essential.

Non-Surgical Treatments

There are several non-surgical treatment options for patients who are not candidates for surgery or prefer less invasive approaches. These include topical medications such as imiquimod or 5-fluorouracil, which can be effective for superficial BCCs. 

Basal cell carcinoma radiation treatment may be recommended for older adults or those with tumors in difficult-to-operate locations. Electrodesiccation and curettage involve numbing the area, scraping off the lesion, and cauterizing it to destroy remaining tumor cells and control bleeding. Cryotherapy is another option, which freezes the lesion with liquid nitrogen. Additionally, superficial radiation therapy (SRT) treatment for skin cancer is emerging as a non-invasive alternative for certain patients, particularly for low-risk lesions.

Surgical Procedures

Surgery remains the most common and effective option for basal cell carcinoma treatment. Excisional surgery involves cutting out the cancerous lesion along with a small margin of healthy tissue to ensure complete removal. Another highly effective technique is Mohs surgery for basal cell carcinoma, especially used for facial areas or lesions with a high risk of recurrence. 

This precise method involves removing the cancer layer by layer while examining each layer under a microscope, ensuring minimal damage to surrounding healthy skin. Mohs surgery offers the highest cure rates, around 98% for primary, non-recurrent BCC, while preserving healthy tissue and delivering excellent cosmetic outcomes. 

New and Emerging Treatments

Advancements in skin cancer treatment have led to promising new therapies for basal cell carcinoma. Targeted drugs such as hedgehog pathway inhibitors are used for advanced or recurrent cases that don’t respond well to conventional treatment. Immunotherapy and photodynamic therapy are also being explored in clinical settings for patients who need alternatives to traditional basal cell carcinoma surgery.

Topical therapeutic options, including certain creams or ointments, may also be considered for specific lesions. Your dermatologist will discuss these based on the characteristics of your basal cell carcinoma.