Basal cell carcinoma

Description

Basal cell carcinoma is a type of skin cancer. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off.

Basal cell carcinoma often appears as a slightly transparent bump on the skin, though it can take other forms. Basal cell carcinoma occurs most often on areas of the skin exposed to the sun such as the head and the neck.

Most basal cell carcinomas are thought to be caused by prolonged exposure to ultraviolet (UV) radiation from sunlight. Avoiding the sun and using sunscreen can help protect against basal cell carcinoma.

Symptoms

Basal cell carcinoma usually develops in sun-exposed parts of your body, especially the head and neck. With less frequency, basal cell carcinoma can develop on the parts of your body, usually protected from the sun, such as the genitals.

Basal cell carcinoma appears as a change in the skin, such as a growth or a sore that does not heal. These changes in the skin (lesions) have one of the following characteristics:

  • A bright color of the skin hit that is translucent, which means that you can see a little bit through the surface. The lump may look pearly white or pinkish white skin. In brown and Black, the skin, the bump, it is often brown orr shiny black. Small blood vessels may be visible, though it may be difficult to see in Black and brown skin. The lump may bleed and form a scab.
  • A brown, blue or black lesion , or a lesion with dark spots — with a little high, translucent border.
  • A flat, scaly patch with a raised edge. Over time, these patches can become quite large.
  • A white, waxy, scar-like lesion without a clear border.

When to see a doctor

Make an appointment with your health care provider if you notice changes in the appearance of your skin, as a new growth, a change in a previous growth or recurrent pain.

Causes

Basal cell carcinoma occurs when one of the skin basal cell develops a mutation in its DNA.

The basal cells are found in the lower part of the epidermis — the outermost layer of the skin. The basal cells produce new skin cells. As new skin cells are produced, they push older cells toward the surface of the skin, where the old cells die and are sloughed off.

The process of creation of new skin cells is controlled by a basal cellDNA. The DNA contains the instructions that tell a cell what to do. The mutation tells the basal cells to multiply rapidly and continue to grow in that normally die. Finally, the accumulation of abnormal cells can form a tumor cancerous lesion that appears on the skin.

Ultraviolet light and other causes

Most of the damage to the DNA in the basal cells are thought to result from the ultraviolet (UV) radiation found in sunlight and commercial tanning lamps and tanning beds. But exposure to the sun doesn't explain skin cancers that develop on skin not normally exposed to sunlight. Other factors that may contribute to the risk and the development of basal cell carcinoma, and the exact cause in some cases it may not be clear.

Risk factors

Factors that increase the risk of basto cell carcinoma include:

  • The chronic exposure to the sun. A lot of time in the sun or in tanning beds, commercial — increases the risk of basal cell carcinoma. The threat is greater if you live in a sunny or high-altitude of the location, both of which expose tor more ultraviolet (UV) radiation. Severe burns that also increases your risk.
  • The radiation therapy. Radiation therapy to treat acne or other skin conditions can increase the risk of basal cell carcinoma in the previous treatment sites in the skin.
  • Fair skin. The risk of basal cell carcinoma is higher among people who freckle or burn easily, or who have very light skin, red or blond hair, or light-colored eyes.
  • The increase of the age. Because basal cell carcinoma often takes decades to develop, the majority of basal cell carcinomas occur in older adults. But it can also affect young adults and is becoming more and more common in people in their 20s and 30s.
  • A personal or family history of skin cancer. If you have had basal cell carcinoma, one or more times, you have a good chance of developing again. If you have a family history of skin cancer, you may have an increased risk of developing basal cell carcinoma.
  • Immunosuppressive medications. Taking medications that suppress the immune system, such as the anti-rejection drugs used after transplant surgery, significantly increases your risk of skin cancer.
  • Exposure to arsenic. Arsenic, a toxic metal that is found widely in the environment, increases the risk of basal cell carcinoma and other types of cancer. Everyone has the exposure to arsenic because it occurs naturally. But some people may have a higher exposure if they drink contaminated water, or have a job that involves the production or use of arsenic.
  • Inherited syndromes that cause skin cancer. Certain rare genetic conditions can increase the risk of basal cell carcinoma, including nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) and xeroderma pigmentosum.

Complications

The complications of the basal cell carcinoma may include:

  • A risk of recurrence. Basal cell Carcinomas are commonly repeated, even after successful treatment.
  • An increase in the risk of other types of skin cancer. A history of basal cell carcinoma may also increase the chance of developing other types of skin cancer, such as squamous cell carcinoma.
  • Cancer that spreads beyond the skin. Very rarely, basal cell carcinoma can spread (metastasize) to nearby lymph nodes and other areas of the body, such as bones and the lungs.

Prevention

To reduce the risk of basal cell carcinoma, you can:

  • Avoid the sun during the middle of the day. In many places, the sun's rays are strongest between 10 am and 4 pm Schedule outdoor activities for other times of the day, even during the winter or when the sky is cloudy.
  • Use sunscreen all year round. The use of a broad-spectrum sunscreen with an SPF of at least 30, even on cloudy days. Apply sunscreen generously, and reapply every two hours or more often if you're swimming or perspiring.
  • Wear protective clothing.Cover skin with dark, tightly woven clothing that covers the arms and legs, and a wide-brimmed hat, which provides more protection than a baseball cap or visor. Some companies also sell protective clothing. A dermatologist can recommend a brand. Don't forget the sunglasses. Look for those that block both types of Uv radiation (UV) Ultraviolet a (UVA) and Ultraviolet B (UVB).
  • Avoid tanning beds. Tanning beds emit UV rays and can increase your risk of skin cancer.
  • Check your skin regularly and report changes to your doctor.Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp. Examine your chest and the trunk and the upper and undersides of your arms and hands. Examine the front and the back of the legs and feet, including the soles of the feet and the spaces between the toes. Also make sure that your genital area and between your buttocks.

Wear protective clothing. Cover your skin with thek, of tightly woven clothing that covers the arms and legs, and a wide-brimmed hat, which provides more protection than a baseball cap or visor.

Some companies also sell protective clothing. A dermatologist can recommend a brand. Not toget the sunglasses. Look for those that block both types of Uv radiation (UV) Ultraviolet a (UVA) and Ultraviolet B (UVB).

Check your skin regularly and report changes to your doctor. Examine your skin often for new skin growths or changes in existing moles, freckles, bumps and birthmarks. With the help of mirrors, check your face, neck, ears and scalp.

Examine your chest and trunk, and upper and lower part of the arms and hands. Examine both the front and the back of the legs and feet, including the soles and the spaces between the toes. Also make sure that your genital area and between your buttocks.

Basal cell carcinoma

Diagnosis

In order to assess any growth or changes in your skin, your doctor or a specialist in the condition of the skins (dermatologist) will conduct a medical history and an exam.

History and general examination

Your doctor will perform a general physical exam and ask you questions about your medical history, changes in their skin, or any other signs or symptoms that you have experienced.

The questions may include:

  • When did you first notice this growth of the skin or injury?
  • Has changed since it was detected for the first time?
  • It is the growth or painful injury?
  • Do you have any other tumors or lesions that concern you?
  • You've had a skin cancer?
  • Has someone in your family had skin cancer? What kind?
  • Do not take precautions to stay safe in the sun, such as avoiding the midday sun and use sunscreen?
  • Do you examine your own skin on a regular basis?

Examination of the skin

Your doctor will examine not only the suspects in the area on your skin, but also the rest of his body for other injuries.

The skin of the sample for the test

Your doctor may perform a skin biopsy, which involves removing a small sample of the lesion for analysis in the laboratory. This will reveal if you have skin cancer and, if so, what type of skin cancer. The type of skin biopsy you undergo will depend on the type and size of the lesion.

Treatment

The goal of treatment for basal cell carcinoma is to eliminate the cancer completely. What treatment is best for you depends on the type, the location and the size of your cancer, as well as their preferences and their ability to perform the follow-up visits. The choice of treatment may also depend on whether this is the first time or recurrent basal-cell carcinoma.

Surgery

Basal cell carcinoma is most often treated with surgery to remove all the cancer and some healthy tissue around it.

The options may include:

  • The surgical excision.In this procedure, the doctor cuts the cancerous lesion and a surrounding margin of healthy skin. The margin is examined under a microscope to make sure that no cancer cells. The excision may be recommended for basal-cell carcinomas that are less likely to recur, such as those that form on the chest, back, hands, and feet.
  • The Mohs surgery.During Mohs surgery, the doctor will removes the cancer layer by layer, examining each layer under a microscope until no abnormal cells remain. This allows the surgeon to make sure that the total growth is removed and avoid taking an excessive amount of surrounding healthy skin. Mohs surgery could be recommended if the basal cell carcinoma have an increased risk of recurrence, such as if it is larger, extends more deeply into the skin or is in your face.

The surgical excision. In this procedure, the doctor cuts the cancerous lesion and an environment margin of the healthy skin. The margin is examined under a microscope to make sure that no cancer cells.

The excision may be recommended for basal-cell carcinomas that are less likely to recur, such as those that form on the chest, back, hands, and feet.

On the scale of Mohs surgery. During Mohs surgery, the doctor removes the cancer layer by layer, examining each layer under a microscope until no abnormal cells remain. This allows the surgeon to make sure that the total growth is removed and avoid taking an excessive amount of yourrrounding the skin healthy.

Mohs surgery may be recommended if the basal cell carcinoma have an increased risk of recurrence, such as if it is larger, extends more deeply into the skin or is in your face.

Other treatments

Sometimes, other treatments may be recommended in certain situations, such as if you are unable to undergo surgery or if you do not wish to undergo surgery.

Other treatments include:

  • Curettage and electrodesiccation (C & E).C and E, the treatment consists in the removal of the surface of the skin cancer with a scraping instrument (curet) and then sealing the base of the cancer with an electric needle. C and E could be an option for the treatment of small basal cell carcinomas that are less likely to recur, such as those that form in the back, chest, hands and feet.
  • Radia- tion therapy.Radiation therapy uses high-energy rays, such as X-rays and protons, to kill cancer cells. Radiation therapy is sometimes used after surgery when there is an increased risk of the cancer coming back. It can also be used when surgery is not an option.
  • Freezing.This treatment consists of freezing the cancer cells with liquid nitrogen (cryotherapy). May be an option for the treatment of superficial skin lesions. Freezing can be done after using a scraping instrument (curet) to remove from the surface of the skin cancer. Cryosurgery can be considered for the treatment of small and thin basal cell carcinomas when surgery is not an option.
  • The topical treatments. Prescription creams or ointments should be considered for the treatment of small and thin basal cell carcinomas in the southgery is not an option.
  • Photodynamic therapy.Photodynamic therapy combines drugs photosensitizing and light for the surface treatment of skin cancers. During photodynamic therapy, a liquid drug that makes cancer cells sensitive to light applied to the skin. Later, a light that destroys the cancer cell skin is lit in the area. Photodynamic therapy can be considered when surgery is not an option.

Curettage and electrodesiccation (C & E). C and E, the treatment consists in the removal of the surface of the skin cancer with a scraping instrument (curet) and then sealing the base of the cancer with an electric needle.

C and E could be an option for the treatment of small basal cell carcinomas that are less likely to recur, such as those that form in the back, chest, hands and feet.

The radiation therapy. Radiation therapy uses high-energy rays, such as X-rays and protons, to kill cancer cells.

Radiation therapy is sometimes used after surgery when there is an increased risk of the cancer coming back. It can also be used when surgery is not an option.

Freezing. This treatment consists of freezing the cancer cells with liquid nitrogen (cryotherapy). May be an option for the treatment of superficial skin lesions. Freezing can be done after using a scraping instrument (curet) to remove the surface of skin cancer.

Cryosurgery can be considered for the treatment of small and thin basal cell carcinomas when surgery is not an option.

Photodynamic therapy. Photodynamic therapy combines drugs photosensitizing and light for the surface treatment of skin cancer ofs. During photodynamic therapy, a liquid drug that makes cancer cells sensitive to light applied to the skin. Later, a light that destroys the cancer cell skin is lit in the area.

Photodynamic therapy can be considered when surgery is not an op- tion.

The treatment for the cancer that spreads

Very rarely, basal cell carcinoma can spread (metastasize) to nearby lymph nodes and other areas of the body. Additional treatment options in this situation are:

  • Targeted drug therapy.Targeted drug treatments focus specific weaknesses present within the cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted therapy drugs for basal cell carcinoma block molecular signals that allow the cancer to continue to grow. That could be considered after other treatments or when other treatments are not possible.
  • Chemotherapy. Chemotherapy uses powerful drugs to kill cancer cells. Could be an option when other treatments have not helped.

Targeted drug therapy. Directed drug treatments focus on specific weaknesses present within the cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die.

Targeted therapy drugs for basal cell carcinoma block molecular signals that allow the cancer to continue to grow. That could be considered after other treatments or when other treatments are not possible.

Preparing for your appointment

The following information may help you prepare for an appointment.

What you can do

  • Enter your medical history, Igo to other conditions for which it has been treated. Be sure to include any radiation therapy may be received, even years.
  • Note any personal history of excessive exposure to Ultraviolet radiation (UV) light, including the light of the sun or tanning beds. For example, tell your doctor if you have worked as an outdoor jacket or spent a lot of time on the beach.
  • Make a list of immediate members of the family who have had cancer of the skin, to the best of their ability. Skin cancer in a parent, grandparent, aunt, uncle or sibling , it is important story to share with your doctor.
  • Make a list of your medications and natural remedies. Include any prescription or over-the-counter medications you are taking, as well as any vitamins, supplements or herbal remedies.
  • Write down questions to ask your doctor. Creating your list of questions in advance can help you make the most of your time with your doctor.
  • Find a family member or friend who can join you to your appointment. Although skin cancer is usually very treatable, only to hear the word "cancer" can make it difficult for most people to focus on what the doctor says next. To have someone that can help you to assimilate all the information.

Questions for your doctor

Below are some basic questions to ask your doctor about basal cell carcinoma. If any additional questions that occur during your visit, do not hesitate to ask.

  • Do I have skin cancer? What kind?
  • How is this type of skin cancer different from other types?
  • Has my cancer spread?
  • What treatment approach do you recommend?
  • What are the pos -sible side effects of this treatment?
  • I have a scar after the treatment?
  • Am I at risk of this recurrent condition?
  • Am I at risk of other types of skin cancer?
  • How often should I follow up visits after the end of the treatment?
  • Are the members of my family at risk of skin cancer?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

What to expect from your doctor

Your doctor may ask you a series of questions. Be ready to answer them may reserve time to go over points you want to talk in-depth. Your doctor may ask:

  • When did you first notice this growth of the skin or injury?
  • It has grown significantly since the first time that he found it?
  • It is the growth or painful injury?
  • Do you have any other tumors or lesions that withthe cern you?
  • You've had a skin cancer?
  • Have someone in your family has had skin cancer? What kind?
  • The amount of exposure to the sun or tanning beds do you have as a child and teenager?
  • The amount of exposure to the sun or tanning beds do you have now?
  • Are you currently taking any medicines, supplements or herbal remedies?
  • Have you ever received radiation therapy for a medical condition?
  • Have you ever taken medications that suppress the immune system?
  • What other significant medical conditions has been treated (a), including in its infancy?
  • Do you or do you smoke? How much?
  • Do you already have or have ever had a job that may have been exposed to pesticides or herbicides?
  • Do you now use or have used the well water as their main source of water?
  • Do you take precautions to maintain the safety in the sun, such as avoiding the midday sun and use sunscreen?
  • Do you examine your own skin on a regular basis?
Symptoms and treatment of Basal cell carcinoma