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SKIN CANCER SERIES - Part 1: BASAL CELL CARCINOMA

Further to the overwhelming interest in our Education Information Seminars held earlier in the year, over the following few weeks we will be posting Skin Cancer information, beginning with information on Basal Cell Carcinoma.

PART 1: Basal Cell Carcinoma

Basal cell carcinoma (or rodent ulcer) is the most common type of skin cancer. Luckily it is very rarely a threat to life, as it has almost no tendency to cause secondary growths.

Basal cell carcinoma causes destruction of normal local tissues as they grow.

Basal cell carcinomas typically affect people of fair complexion who have had lots of sunshine over the course of their life. Sunshine many years previously can cause basal cell carcinomas to develop in later life. The tendency to develop them may be inherited.

They vary in size from a few millimetres to several centimetres. Luckily, the vast majority grow quite slowly over months or years.

What does a Basal cell carcinoma look like?

There are a number of types:

Nodular basal cell carcinoma is most often found on the face. It presents as a small pearly growth. It may be pigmented (brown) or there may be small blood vessels on the surface. It may bleed with minimal trauma.

Superficial basal cell carcinomas are often multiple and occur most commonly on the upper trunk and lower legs. They are shiny pink or slightly scaly patches.

There are four more difficult but much less common types of basal cell carcinoma; these are the Micronodular, Infiltrative, Metatypical and Morphoeic basal cell carcinomas.

These more commonly present as a translucent or waxy patch. These types of basal cell carcinomas are more difficult to get rid of than nodular and superficial basal cell carcinomas because they often have extensive roots which cannot be appreciated when examining the lesion clinically.

These more aggressive types of basal cell carcinoma are commonest on the face.

How are basal cell carcinomas treated?

The treatment for a basal cell carcinoma depends on its type, size, location, the number to be treated, and the preference of the patient and doctor.

Freezing – Dermatologists sometimes use liquid nitrogen with a special technique. This is a much more severe treatment than that you may have had from your general practitioner for sun damage spots (solar keratoses). Freezing treatments for basal cell carcinoma cause extensive blistering which takes 6-8 weeks to heal, leaving behind a white shiny patch.

Shave, curettage and cautery (and other similar techniques). – Small, low risk skin cancers may be successfully treated by removing just the top surface of the skin where the skin cancer is. The wound heals without stitches, similar to that after a freezing treatment, to leave a white round spot. Freezing and shave curettage and cautery techniques are suitable for primary small superficial types of basal cell carcinoma not on the face.

Excision – The lesion is cut out and the skin is stitched up. The specimen can be sent for pathology to check to ensure that the lesion has been completely removed. In certain areas, particularly in the face, closure may require a plastic surgery procedure called a skin graft or a flap.

Radiotherapy (Xray treatment) – can be used for some skin cancers, however, it may cause cancers to recur many years later and therefore this treatment is reserved for elderly patients. This treatment must be carried out in Hamilton. Although the scars initially look good they tend to deteriorate and look more obvious and become unsightly with time.

Mohs surgery – Mohs surgery is the most accurate technique to remove skin cancer. It is used almost exclusively for skin cancers on the face where its major advantages are highly accurate removal of skin cancers, even difficult and recurrent skin cancers, with the removal of minimal amounts of tissue.

The best chance of cure of a basal cell carcinoma is the first time the lesion is treated. The basal cell carcinomas which cause the most trouble are those which have been previously inadequately treated.

What shall I do now?

If you have had a basal cell carcinoma treated, you will have a high chance of developing another one. Early treatment means easier treatment, and less scarring.

  • Protect your skin from the sun at all times
  • Arrange a complete skin examination once a year
  • Ask your dermatologist or GP to check any bleeding spots, rapidly growing lumps or dark brown/black splotchy moles.
Watch The Skin Centre Video for further information: