Basal cell carcinoma is the most common form of cancer, accounting for nearly 80% of all skin cancer in the United States.
Basal cell carcinoma rarely spreads to other parts of your body, and rarely results in death. However, because basal cell carcinomas often occur on the face, they can cause serious cosmetic damage and functional issue when they are not diagnosed and treated early.
The good news is basal cell carcinoma is not life threatening and can be easily and successfully treated.
Basal cell carcinomas are most commonly found on the face, neck, hands, or other parts of your body. In other words, the areas that are most commonly exposed to the sun.
Typically, the first sign of basal cell carcinoma is an unusual growth on your skin. Most appear as a waxy lump or a small, smooth, shiny or pale growth. You may notice a flat spot that looks slightly different from the rest of your skin in color and/or consistency.
Basal cell carcinoma usually appears as a:
While Basal Cell Carcinoma rarely causes pain when it’s developing, it may bleed after a minor injury, then form a scab and heal. If you notice this, please get it checked as an early diagnoses is key to successful treatment.
Basal cell carcinoma is caused by damage to your basal cells in the outer layer your skin. The major known cause: exposure to the sun’s ultraviolet (UV) rays and indoor tanning.
The most common risk factors for developing basal cell carcinoma include:
Diagnosing Basal Cell Carcinoma
In order to determine if you have skin cancer, our team will perform a comprehensive skin exam, checking for bumps or spots that look abnormal in color, size, shape or texture.
Our team will also review your medical history and ask you about:
Following the exam, if we think your spot should be evaluated further, we will biopsy the spot and send the tissue sample to our dermatopathology lab where our pathologist will examine it. If cancer is found, your doctor will discuss the different options you will have for removing the basal cell carcinoma.
We are able to easily and successfully treat basal cell carcinomas with currently available treatments. It’s a highly curable cancer with both surgical and non-surgical therapies, especially if treated early.
Which treatment is used depends on:
There are many treatment options available for basal cell carcinoma. Most can be easily done in your doctor’s office. They include:
Cryotherapy is a non-surgical treatment for basal cell carcinoma. Our team applies liquid nitrogen to the tumor, freezing the abnormal tissue. The frozen skin then sloughs off (falls away) as the skin underneath heals.
Curettage and Electrodesiccation
A very common treatment for basal cell carcinoma is curettage and electrodesiccation. It’s most effective for low-risk tumors found on your trunk and limbs.
First, the area is numbed with a local anesthetic. Once the freezing has taken effect, our team uses an instrument to scrape away the cancerous tissue. Once that is done, our team uses an electric needle to control the bleeding. This technique also destroys any cancer cells that may remain around the edge of the tumor. The wound usually heals within a few weeks.
With laser surgery, the tumor is vaporized with a highly focused light beam. Laser surgery only kills tumor cells on the surface of the skin and doesn’t go deeper, so its use is limited and close follow-up is essential.
For tumors with a high risk of recurrence, we may perform a highly specialized technique called Mohs surgery. In this procedure, our team removes the tumor tissue layer by layer, mapping and freezing each layer. Each layer is examined under a microscope for tumor cells before proceeding to the next. This is a precise, complex and time-consuming process, but Mohs surgery makes sure that the whole tumor is removed. It also limits the amount of scarring by keeping as much normal skin as possible.
Mohs surgery has the highest cure rate of all therapies and is especially effective for high-risk basal cell carcinomas, such as large tumors, tumors that have recurred after other treatments, and tumors in areas such as the face, where we want to preserve as much normal skin as possible.
High-risk basal cell carcinoma is usually removed by surgery, which can be done anywhere on your body. To perform the procedure, called standard surgical excision or removal, our team injects a local (area) anesthetic and then removes the tumor from your skin. A portion of tissue around the tumor (a safety margin) is also taken off to make sure that all the cancer cells have been removed. The wound is then closed with sutures (stitches).
Surgery is most effective for tumors with well-defined borders. One advantage to this procedure is that the tissue can be sent to a laboratory so a pathologist (a specialist who examines the tissue for signs of cancer) can verify if the whole tumor has been removed.
Radiation therapy, a treatment that involves x-rays or high-energy particles, can be useful for tumors in areas that are hard to treat surgically or for patients who are at a higher risk of having complications from surgery. Radiation is also sometimes used after surgery to destroy any cancerous cells that remain, or to treat tumors with a higher risk of recurrence.
Radiation is usually delivered in small doses over a period of three to four weeks to avoid burning the skin and to improve the cosmetic outcome.
Most people think of chemotherapy as something they get by IV or take as pills. But topical chemotherapy treatments also exist. These are creams and lotions that contain chemotherapy drugs. Topical chemotherapy targets damaged skin without touching the surrounding normal tissue. However, because the cancerous tissue is not removed, it can’t be tested.
Cure rates are typically lower with topical chemotherapy than with other therapies, so these treatments are usually reserved for small low-risk lesions. A drawback to topical chemotherapy is that it may not go through all the layers of the skin, so careful follow-up is essential after treatment.
One topical chemotherapy we offer is fluorouracil. It’s available in a lotion form, and you apply it at home for three to six weeks. Another topical treatment is imiquimod, a lotion that causes immune cells to attack the abnormal tissue.
Any form of surgery may leave a scar, and some scars are more noticeable than others. If removing a basal cell carcinoma leaves behind a wound that is too big to close with simple sutures (stitches), your surgeon may do reconstructive surgery, such as skin grafts and flaps. These techniques can help heal the skin and restore its appearance.