Basal Cell Carcinoma
Basal cell carcinoma is the most common type of skin cancer, accounting for 75 percent of all skin cancers. About one million people in the United States are diagnosed with basal cell carcinoma each year, but the good news is that it is highly treatable and highly curable.
Basal cell carcinoma develops in the basal cells of the epidermis, one of three layers of the skin. It is usually found on sun-exposed areas of the skin, especially the head and neck. Basal cell carcinoma grows slowly and rarely spreads to lymph nodes or distant parts of the body. But if it is not treated, it can grow into nearby areas and invade the bone or tissues beneath the skin. About 35 to 50 percent of people diagnosed with basal cell carcinoma will develop a new skin cancer within five years of the first diagnosis.
The best way to prevent basal cell carcinoma and other skin cancers is to limit unprotected exposure to the sun. When you are out in the sun, remember to wear a wide-brimmed hat, use sunblock, and limit your time in the sun to before 10 a.m. and after 3 p.m.
If you are diagnosed with basal cell carcinoma, dermatologists and other skin cancer experts at The Cancer Center at Hackensack University Medical Center are highly skilled in providing several treatment options. The Cancer Center features:
- board-certified dermatologist and surgeons skilled in Mohs surgery, laser surgery, cryosurgery, and other surgical options
- clinical research studies that are investigating new treatments for skin cancer
- a full range of support services
Exposure to ultraviolet radiation present in sunlight and artificial sources, such as tanning booths and sun lamps, puts you at risk for basal cell carcinoma. Other risk factors include:
- fair skin (The rate of skin cancer is 10 times higher for Caucasians than dark-skinned African-Americans.)
- being male
- chemical exposure (especially arsenic)
- long-term or severe skin inflammation or injury
- treatment for psoriasis
- a weakened immune system
Symptoms of basal cell carcinoma include:
- any change on the skin, especially in the size or color of a mole or other darkly pigmented growth or spot
- scaliness, oozing, bleeding, or a change in the appearance of a bump or nodule
- the spread of pigmentation beyond its border
- a change in sensation, itchiness, tenderness, or pain
Most basal cell carcinomas can be completely cured with fairly minor surgery. Sometimes, radiation therapy may be combined with surgery to make sure that all cancerous cells are destroyed after surgery. Chemotherapy is generally not used to treat basal cell carcinoma.
The type of surgery depends on how large the basal cell carcinoma is and where it is found on the body. Your doctor may recommend one of the following types of surgery:
- simple excision: removal of the tumor and some surrounding normal skin
- curettage and electrodesiccation: scraping out the tumor with a long, thin instrument then using electrodes to destroy any remaining cancerous cells
- cryosurgery: using liquid nitrogen to freeze and kill abnormal cells
- Mohs surgery: a highly specialized technique during which a surgeon or dermatologist removes a layer of skin and then maps the cancer's location. After the sample is checked, more skin is removed if the tissue is malignant. The physician continues to remove more skin and examine it until no more cancerous cells are found. Mohs surgery creates a better appearance after surgery.
- laser surgery: a beam of laser light is used to vaporize cancer cells
- lymph node removal surgery: may be used if the skin cancer is suspected to have spread into nearby lymph nodes
- skin grafting and reconstructive surgery: may be used if a very large tumor has been removed, to help the wound heal and replace tissue
External beam radiation is the most common type of radiation therapy used to treat basal cell carcinoma. It may be used as the primary treatment if the tumor is large, is located on an area of the skin that makes surgery difficult, or if a patient cannot tolerate surgery. Radiation therapy may also be used as an adjuvant (additional) treatment after surgery to kill any cancerous cells that may not be visible during surgery.