• Basal Cell Carcinoma

    (Skin cancer-Basal Cell)

    Definition

    Basal cell carcinoma is a form of skin cancer. It is the most common type of skin cancer. Basal cell carcinoma develops in the outermost layer of skin. This cancer usually grows slowly and does not spread to other tissues in the body.
    Basal cell carcinoma is rarely fatal. However, it can cause damage to the tissue around the cancer. If there is risk of damage, the cancer may need treatment or removal.
    Basal Cell Carcinoma
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    Causes

    The primary cause of basal cell carcinoma is exposure to ultraviolet (UV) light. This occurs mostly through time spent in the sun, particularly as a child. However, genes that make developing the cancer more likely must also be present.

    Risk Factors

    Factors that increase your risk of developing basal cell carcinoma include:
    • Childhood sunburns , freckling, or long periods of sun exposure
    • Fair skin that rarely tans
    • Blue or green eyes
    • Blonde or red hair
    • A family history of skin cancer
    • A personal history of skin cancer
    • Treatment that suppresses the immune system (eg, having an organ transplant)
    • History of radiation therapy
    • Frequent use of tanning beds
    • Certain rare genetic disorders, such as Gorlin’s syndrome
    Talk to your doctor about your risk factors.

    Symptoms

    Symptoms 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

    The doctor will look at the skin growth. A sample of the growth will be taken. It will be sent for a biopsy to look for cancer cells. The doctor will then determine the size, growth, subtype, and location of the tumor. This information will be done to guide treatment and make a prognosis.

    Treatment

    A doctor may recommend any of the following treatments:
    • Mohs micrographic surgery—microscopic surgery that offers the best cure rate for basal cell carcinoma
    • Removal of the growth with simple surgery
    • Use of liquid nitrogen to freeze the growth
    • Electrodesiccation and curettage—treatment to remove section of skin
    • Radiation therapy
    • Photodynamic therapy—the cells absorb an acid that causes them to die when exposed to light
    • Creams, especially fluorouracil (5-FU) or imiquimod
    • Plastic surgery to repair any cosmetic problems that occur after treatment

    Prevention

    Steps to decrease your chance of developing basal cell carcinoma include:
    • 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 an 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.
    • Learn to recognize early basal cell carcinoma. Seek treatment.

    RESOURCES

    American Academy of Dermatology http://www.aad.org/

    The Skin Cancer Foundation http://www.skincancer.org/

    CANADIAN RESOURCES

    Canadian Dermatology Association http://www.dermatology.ca/

    Canadian Cancer Society http://www.cancer.ca/

    References

    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. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=116909 . Updated October 11, 2012. Accessed November 10, 2012.

    Basal cell carcinoma. American Academy of Dermatology website. Available at: http://www.aad.org/skin-conditions/dermatology-a-to-z/basal-cell-carcinoma . Accessed November 10, 2012.

    Wong C. Strange R. Lear J. Basal cell carcinoma. BMJ . 2003;327:794-798. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=214105 . Accessed November 10, 2012.

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