Basal Cell Carcinoma

Basal Cell Carcinoma

skin cancer clinic BrisbaneBasal Cell Carcinoma is the most common type of skin cancer.  Initially, it appears as a raised area of skin, that is usually shinny with some blood vessels running through it.  This type of skin cancer grows very slowly and is highly unlikely spread to other areas of the  body or result in death.  This form of cancer totals 32% cancers globally.  Approximately 35% of adult men and 25% of women will be affected by basal cell cancers at some point in their lives.

Risk Factors

  • Exposure to ultraviolet light
  • Low pigmentation in skin
  • Long term exposure to arsenic
  • Poor immune system
  • UV light exposure during childhood
  • Use of tanning beds

Signs and Symptoms

Patients with basal cell carcinoma will present with a shiny, pearly skin nodule.  However, they can also present as a red patch similar to eczema.  For medical practitioners, it is often difficult to distinguish basal cell cancers from acne scar or skin inflammation.  Therefore, it sometimes useful to do further testing.

What Causes It?

Most cancers occur in sun exposed areas of the body.  For the one third of cancers that don’t appear in sun exposed areas, this emphasises the genetic link.  What researches understand is that sun exposure leads to a form of DNA damage that the bodies DNA repair system fails to rectify.  Therefore, it is the cumulative DNA damage leading to mutations that is the problem.  They also understand that overexposure to the sun weakens the bodies immune surveillance for new tumour cells.

Diagnosis

Most GPs will diagnose this form of skin cancer with a skin biopsy.   The most common method is the shave biopsy, done under local anaesthetic.  This involves the GP shaving a section of the affected skin region and sending it off to a pathology company for further testing.  It should be noted that most cancers of this type can be diagnosed visually.

Types of Basal Cell Cancer

Superficial Basal Cell Carcinoma.  Characterised by a superficial proliferation of neoplastic basal cells.  Very responsive to chemotherapy.

Infiltrative Basal Cell Carcinoma.  Penetrates deeper into the skin.  More difficult to treat with conservative methods.

Nodular Basal Cell Carcinoma.  Most commonly occurs on the sun exposed areas of the head and neck.

Prevention

Due to UV radiation being the cause in 2/3rds of this form of cancer it is recommended to use sunscreen with at least SPF 30+ or avoiding sun exposure where possible

The use of a chemotherapeutic agent 5-Florouracil or Imiquimod to prevent skin cancer in the first place is also recommended.  People with extensive skin damage, multiple skin cancers or a family history of skin cancer are recommended to take it every 2-3 years as a precaution.

Treatment

Surgery

Moh’s Surgery.  Occurs when the GP surgically cuts out the affected skin cancer and then examines under a microscope.  When used for this type of cancer – the cure rate is very high, provided a 4mm surgical margin is followed by the GP when cutting out the skin cancer.

Cryosurgery

This has historically been used to treat skin cancers but has been superseded by more advanced methods now. However, when it is used correctly it can be effective in treating this form of cancer.  Disadvantages include lack of margin control, tissue necrosis, over or under treatment of the tumour and long recover time.  There have been no studies comparing the efficacy with other forms of treatment.  It’s biggest advantage is that sections of skin don’t need to be cut out from a person’s body.

Chemotherapy

Some superficial cancers respond well to 5-fluorourcil or chemotherapy agent.  Treatment is with a 5% Imiquimod cream with 5 applications per week for 6 weeks.  Efficacy is 70-90% at removing or reducing basal cell cancers.  Chemotherapy is often used in combination with Moh’s surgery.  The cream is usually applied after the surgery has been completed.  Usually a period of approximately 1 month is observed before chemotherapy treatment begins.

Electrodessication and Curettage.

This type of surgery is used with a round knife to scrape away any soft cancer tissue.  The skin is then burnt with an electric current to help soften the skin, allowing the knife to cut more deeply into the skin on the next treatment.  The cycle is repeated 3 to 5 times for it to be effective.  The efficacy of this type of treatment depends on the size and type of tumour.  Generally, this form of therapy is not used on visible areas of the skin such as face or neck.

Photodynamic Therapy

This is a relatively new form of therapy for the treatment of basal call carcinomas.  It is administered by the application of photosensitisers to the target area.  When these skin molecules are activated by light, they became toxic, destroying the target cells.  This form of treatment is used for low risk, superficial basal cell cancers.

Prognosis

Changes of making a full recovery from this type of cancer is great if it is detected early.  Recurrent cancers are unfortunately much harder to treat with all the methods of treatment identified in this article.  The good news is that this type of cancer doesn’t tend to spread throughout the body (metastasize).  As a result death is vary rarely caused by this type of cancer.  The vast majority of this form of cancer can be treated before serious complications occur.

Sooo…if you are worried that you may have a basal cell carcinoma, give you local GP or skin clinic a call to get tested.  Most of the cost is usually covered by Medicare.  If the GP needs to treat it, you will be confident that the skin cancer will be effectively removed. For bulk billing skin cancer clinic Brisbane Northside or mole removal or skin tag removal follow one of the links.

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