Basal Cell Skin Cancer

What is it?

Basal cell carcinoma is a slow-growing type of nonmelanoma skin cancer, and is the most common form of cancer in the United States. According to the American Cancer Society, 75% of all skin cancers are basal cell carcinomas.

Basal cell carcinoma starts in the top layer of the skin called the epidermis. It grows slowly and is painless. A new skin growth that bleeds easily or does not heal well may suggest basal cell carcinoma. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation. They may also appear on the scalp. Basal cell skin cancer used to be more common in people over age 40, but is now often diagnosed in younger people.

Your risk for basal cell skin cancer is higher if you have:

  • Light-colored skin
  • Blue or green eyes
  • Blond or red hair
  • Overexposure to radiation

Basal cell skin cancer almost never spreads to the lymph nodes, lungs or liver. But, if left untreated, it may grow into surrounding areas and nearby tissues and bone.

Symptoms

Basal cell carcinoma may look only slightly different than normal skin. The cancer may appear as skin bump or growth that is:

  • Pearly or waxy
  • White or light pink
  • Flesh-colored or brown

In some cases the skin may be just slightly raised or even flat.

You may have:

  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore
  • Appearance of a scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a depressed (sunken) area in the middle

Tests & diagnosis

Your doctor will check your skin and look at the size, shape, color, and texture of any suspicious areas.

If skin cancer is a possibility, a piece of skin will be removed from the area and examined under a microscope. This must be done to confirm the diagnosis of basal cell carcinoma or other skin cancers. There are many types of skin biopsies. The exact procedure depends on the location of the suspected skin cancer.

Treatment

Treatment varies depending on the size, depth, and location of the basal cell cancer. It will be removed using one of the following procedures:

  • Excision cuts the tumor out and uses stitches to place the skin back together.
  • Curettage and electrodesiccation scrapes away the cancer and uses electricity to kill any remaining cancer cells.
  • Surgery, including Mohs surgery, in which skin is cut out and immediately looked at under a microscope to check for cancer. The process is repeated until the skin sample is free of cancer.
  • Cryosurgery freezes and kills the cancer cells.
  • Radiation may be used if the cancer has spread to organs or lymph nodes or for tumors that can't be treated with surgery.
  • Skin creams with the medications imiquimod or 5-fluorouracil may be used to treat superficial basal cell carcinoma.

Prognosis

The rate of basal cell skin cancer returning is less than 5% with complete excision. 

Complications

Untreated, basal cell cancer can spread to nearby tissues or structures, causing damage. This is most worrisome around the nose, eyes, and ears.

Prevention

The best way to prevent skin cancer is to reduce your exposure to sunlight. Ultraviolet light is most intense at midday, so try to avoid sun exposure during these hours. Protect the skin by wearing hats, long-sleeved shirts, long skirts, or pants.

Always use sunscreen:

  • Apply high-quality sunscreens with SPF (sun protection factor) ratings of at least 15.
  • Look for sunscreens that block both UVA and UVB light.
  • Apply sunscreen at least 30 minutes before going outside, and reapply it frequently.
  • Use sunscreen in winter, too.