Basal Cell Carcinoma - Dr Colin Hong

Basal cell carcinoma (BCC) is a form of skin cancer that occurs when the basal cells in the epidermis grow uncontrollably. BCC usually appears as a raised, pale or waxy bump on sun-exposed areas of skin such as the face, neck, and arms.

Although BCC is rarely life-threatening, it can cause disfigurement if not treated promptly. Treatment options for BCC include surgery, radiation therapy, chemotherapy, cryotherapy (freezing), curettage (scraping), and Mohs micrographic surgery. Early diagnosis and treatment often lead to the successful removal of cancerous cells.  

History and Definition

Basal cell carcinoma (BCC) is a type of skin cancer that begins in the basal cells, which are the cells in the lower layer of the epidermis (the outermost layer of the skin). BCC is the most common type of skin cancer, accounting for about 80% of all skin cancer cases.

BCC usually appears as a small, flesh-colored or white bump that can be smooth, waxy, or scaly. It can also appear as a flat, scaly area that may look like a scar. BCC grows slowly and rarely spreads to other parts of the body, but if left untreated, it can cause significant damage to the surrounding skin and tissues.

Dr. Arthur Jacob first described BCC in 1827, and called it “Ulcus rodens.” In the decades that followed, various forms of BCC were recognized and described by different doctors, leading to a better understanding of the condition.

Today, BCC is diagnosed through a biopsy, which involves removing a small piece of the affected skin for examination under a microscope. Treatment for BCC may include surgical removal, radiation therapy, or topical medications, depending on the size, location, and aggressiveness of cancer. Regular skin check-ups and avoiding excessive sun exposure can help prevent the development of BCC.

Symptoms

The symptoms of basal cell carcinoma (BCC) can vary, but common signs include:

  • A small, shiny, or pearly bump that may be flesh-colored, pink, red, or white
  • A flat, scaly area that may look like a scar
  • A raised area with a lower central depression that may bleed easily
  • A persistent, non-healing sore that may ooze or crust
  • A discolored patch of skin that may be brown, black, or multicolored

BCC typically grows slowly and does not cause pain, but if left untreated, it can cause significant damage to the surrounding skin and tissues. If you notice any changes in your skin or if you have a growth or sore that does not heal, it is important to consult a doctor. A dermatologist or plastic surgeon can perform a biopsy to determine if it is BCC or another type of skin condition.

Causes

Basal cell carcinoma is a type of skin cancer that is caused by long-term exposure to ultraviolet (UV) radiation from the sun and/or tanning beds. Other factors that may increase the risk of developing basal cell carcinoma include fair skin, freckles, a history of sunburns, a weakened immune system, and a family history of skin cancer.

It’s also important to note that exposure to UV radiation accumulates over time, so the risk of developing basal cell carcinoma increases as a person ages.

Diagnosis

Basal cell carcinoma is usually diagnosed by a visual examination of the skin and a biopsy. During the visual examination, the doctor will look for any suspicious growth or changes in the skin. If growth is suspected to be basal cell carcinoma, a biopsy will be taken to confirm the diagnosis. The biopsy will usually involve removing the entire growth or a portion of it, and then sending it to a laboratory for analysis.

In some cases, a dermatologist or plastic surgeon may use a dermatoscope, a specialized tool that allows for a magnified view of the skin, to examine the growth more closely. In addition, a skin scan called mole mapping may be performed to check for any other suspicious growths.

It’s important to have any changes in the skin checked promptly by a doctor, as early diagnosis and treatment can greatly improve the chances of a successful outcome.

Treatment

Basal cell carcinoma is a type of skin cancer that is typically treated with surgery, radiation therapy, or topical medications. The treatment options will depend on the size, location, and aggressiveness of the tumor.

Non-Surgical

Before undergoing treatment, it is important to have a biopsy of the suspicious lesion to confirm the diagnosis of basal cell carcinoma.

  • Radiation Therapy: Radiation therapy is another option for treating basal cell carcinoma. This non-invasive treatment uses high-energy beams of radiation to destroy cancer cells.

 

  • Topical Medications: For small, superficial basal cell carcinomas, topical medications such as imiquimod cream or 5-fluorouracil can destroy cancer cells.

Surgical

The most common treatment for basal cell carcinoma is surgical excision. The goal of this procedure is to remove the entire tumor and a margin of healthy tissue. The size and location of the tumor will determine the type of surgical procedure that is performed, which can range from simple excision to a more complex procedure, such as Mohs micrographic surgery.

After surgery, the wound will be covered with a dressing, and the patient may need to return for follow-up appointments to monitor the healing process. It is important to protect the skin from sun exposure to reduce the risk of future skin cancers. In some cases, radiation therapy or topical medications may be recommended after surgery to reduce the risk of recurrence.

In general, the prognosis for basal cell carcinoma is excellent, and the vast majority of patients can expect a complete cure following treatment. However, it is important to monitor the skin for any new or changing moles or spots, as basal cell carcinoma can recur or new tumors can develop.

Risk Factors

The risk factors of basal cell carcinoma (BCC) include:

  • Excessive sun exposure: UV radiation from the sun is the most common cause of BCC.

 

  • Light skin: People with fair skin are more susceptible to developing BCC than those with darker skin.

 

  • Age: BCC is more common in older individuals, especially those over 50 years old.

 

  • Family history: A family history of skin cancer increases the risk of BCC.

 

  • Personal history of skin cancer: Those who have had BCC in the past are at a higher risk of developing it again.

 

  • Weak immune system: Individuals with a weakened immune system are more susceptible to BCC.

 

  • Sunburns: People who have had multiple sunburns in their lifetime have a higher risk of developing BCC.

 

  • Exposure to environmental toxins: Exposure to chemicals such as arsenic and certain oils can increase the risk of BCC.

 

  • Chronic skin damage: BCC is more likely to develop in individuals with skin damage from scars, burns, or long-term exposure to radiation.

Complications

The complications of basal cell carcinoma (BCC) can include:

  • Recurrence: BCC has a high chance of recurrence, especially if it is not treated properly.

 

  • Spread to other parts of the body: In rare cases, BCC can spread (metastasize) to other parts of the body and become life-threatening.

 

  • Scarring: BCC treatment can result in scarring, especially if it is done using surgical methods such as excision.

 

  • Disfigurement: Treatment for BCC can result in disfigurement, especially if it is on the face or another visible part of the body.

 

  • Altered sensation: Treatment for BCC can damage nerves and cause altered sensation or numbness in the affected area.

 

  • Psychological effects: BCC and its treatment can have psychological effects, such as anxiety and depression.

 

  • Interference with daily activities: BCC and its treatment can interfere with daily activities and limit a person’s ability to perform their normal tasks.

 

  • Pain and discomfort: BCC treatment can cause pain and discomfort, especially if it involves surgery.

It is important to note that early detection and treatment of BCC can reduce the risk of these complications.

When to See a Doctor

Basal cell carcinoma (BCC) is the most common type of skin cancer and should be seen by a doctor as soon as it is noticed. If you have a spot or growth on your skin that:

  • Bleeds easily
  • Does not heal
  • Changes in color or texture
  • Itches or hurts

You should have it checked by a doctor as soon as possible. Early detection and treatment of BCC can prevent it from spreading and causing further harm. A doctor can perform a biopsy to confirm the diagnosis and determine the best course of treatment.

Step-by-Step Guide to Carpal Tunnel Syndrome Treatment

Here is a step-by-step guide to the treatment of basal cell carcinoma (BCC):

Consultation

The first step is to consult a doctor who is a specialist in skin cancer, such as a dermatologist or plastic surgeon. They will perform a physical examination and may do a biopsy to confirm the diagnosis.

Treatment Plan

Based on the results of the biopsy and the size, location, and type of BCC, the doctor will develop a treatment plan. Options include:

  • Mohs Micrographic Surgery: This is a highly specialized procedure that is often used to treat BCCs on sensitive areas, such as the face, as it minimizes scarring and maximizes removal of cancer.

 

  • Surgical excision: This involves removing the BCC and some surrounding tissue with a scalpel. The doctor will then close the wound with stitches or use skin grafts if necessary.

 

  • Cryotherapy: This involves freezing the BCC with liquid nitrogen, which destroys the cancerous cells.

 

  • Topical medications: These are creams or gels that are applied to the skin to treat smaller BCCs.

The selected treatment will be performed by the doctor.

Follow-Up

After treatment, regular follow-up appointments with the doctor are important to monitor for any recurrence of the BCC or the development of new skin cancers.

It is important to note that the treatment plan and options can vary based on the individual case and the doctor’s recommendation. It’s always best to follow the advice of a qualified medical professional.

Conclusion

Basal cell carcinoma (BCC) is the most common type of skin cancer. It is important to be aware of the potential signs and symptoms of BCC and to have any suspicious spots or growths checked by a doctor as soon as possible. Early detection and treatment can prevent the spread of cancer and minimize the risk of further harm.

A variety of treatment options are available, ranging from topical medications to surgical excision, and the best option will depend on the individual case. Regular follow-up appointments with a doctor after treatment are important to monitor for any recurrence of the BCC or the development of new skin cancers.

BOOK AN APPOINTMENT TODAY

Experience the benefits of Dr. Colin Hong’s 35+ years of expertise in Cosmetic, Plastic and Reconstructive surgery at an affordable cost in Toronto, North York and Markham! Contact our office today for a consultation by calling (416) 222-6986 or sending an email to info@drcolinhong.com.  

Please provide your full name, email address, and phone number so we can get back to you promptly. If you would like to set up an appointment for basal cell carcinoma with Dr. Colin Hong, please make sure to obtain a referral from your family doctor first.

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