Basal Cell Carcinoma: Symptoms, Causes, Risks, Diagnosis, Treatment and Prevention

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1Overview

Skin cancer comes in various shapes, types, and severity. The most commonly diagnosed skin cancer is basal cell carcinoma (BCC). This type of skin cancer develops on the skin that is always exposed to the sun, such as the head, back of the hands and the head. It is also common on the face and nose.

Basal cell carcinoma is a form of skin cancer, which originates in cells called basal cells, types of cells that create and produces new skin cells as old ones die off. This cancer is unlikely to spread from the skin to other parts, but it can multiply to the surrounding tissues and lymph nodes.

Cancer starts off as small shiny bumps on the nose and other parts of the face.
These lesions can also appear on the other parts of the body, like the legs, arms, and trunk.

Basal cell carcinoma grows very slowly and often does not become noticeable for many years after intense or prolonged exposure to the sun. For people who are fond of using tanning beds and tanning lights, this lesion may show up earlier.

2Symptoms

Basal cell carcinoma usually develops and appear on areas which are prone to sun exposure, such as the neck and head. This type of skin cancer develops lesson hidden areas such as the legs and trunk. Rarely, basal cell carcinoma develops on the parts that are protected from the sun such as the breasts and genitals.

The lesions usually look like:

  • Pearly white, pink or skin-colored bump that is translucent
  • Tiny blood vessels are noticeable under the lesion
  • Blue, brown or black lesion, which has a raised border, which is also translucent
  • White, scar-like and waxy lesion without a clear and defined border dubbed as morpheaform.
  • Flat, scaly and reddish patch with a raised border
  • Painless lesions

3Causes

Skin cancers, including basal cell carcinoma, are mainly caused by the long-term sun exposure or ultraviolet light exposure. Both long-term sun exposure over the lifetime and occasional or intense exposure, which causes sunburn, combine to cause damage to the skin and may lead to the development of BCC. On rare occasions, however, tumors may develop in unexposed areas.

Basal cell carcinoma happens when one of the basal cells of the skin develops a mutation in the DNA, leading to its uncontrollable multiplication and spread. Basal cells are located at the bottom of the epidermis, which is the outermost layer of the skin. These cells produce new cells and push older ones toward the surface of the skin. The process of producing new cells is monitored and controlled by a basal cell’s DNA.

When there is a mutation in the DNA, this will cause the cells to produce new cells rapidly, and continue spreading and growing when it would normally die. Eventually, the accumulated abnormal cells become a tumor, which is cancerous if it’s left untreated.

4Risk Factors

Anyone with a history of sun exposure can develop basal cell carcinoma. However, certain factors may heighten one’s risk of this type of skin cancer.

Having fair skin, blond or red hair, and blue, green or gray eyes – People with these characteristics may have increased risks of developing BCC. Also, basal cell carcinoma risk may increase in people with fair skin, who freckle or burn easily.

Prolonged and chronic exposure to the sun – When people spend a lot of time in the sun, such as those who sunbathe regularly, are at a higher risk of having basal cell carcinoma. Also, those who work under the sun, such as farmers and those who live in tropical areas and high altitude areas, who do not protect their skin are at a higher risk of having BCC.

Radiation therapy – Radiation therapy to treat certain skin conditions such as acne and psoriasis may boost the risk of basal cell carcinoma at the areas previously treated for the skin disorders.

Being male – Men are at a greater risk of developing basal cell carcinoma than women.

Older age – Since basal cell carcinoma develops slowly and it may even take decades before it appears, older people are at a higher risk of having BCCs.

Weakened immune system – People with weakened immune systems, like those who have HIV, AIDS, and leukemia are at a higher risk of having basal cell carcinoma.
Also, those who are taking immune-suppressing drugs significantly increase the risk of skin cancer, particularly basal cell carcinoma.

Personal or family history of skin cancer – People who previously had basal cell carcinoma or other types of skin cancer, are at a higher risk of developing them again. Also, people with relatives and family members who have the condition have a higher tendency to develop the skin cancer.

Chemical exposure – Exposure to arsenic, a toxic metal that is widely found in the environment, may increase the risk of skin cancer, including basal cell carcinoma.

Inherited syndromes linked to skin cancer – People with rare genetic diseases such as nevoid basal cell carcinoma or Gorlin-Goltz syndrome, may lead to the development of many basal cell carcinomas. Aside from that, they can develop other types of skin cancer. Another disease, called Xeroderma pigmentosum, which leads to excessive sensitivity to the sun, may increase a person’s risk of skin cancer, too.

5Diagnosis

The initial step in diagnosing BCC is through physical examination. Along with the examination and inspection from a trained doctor or dermatologist, is the interview of medical history. The doctor will check the skin for discolorations, lesions, and abnormal growths. The medical history is comprised of questions about family history of skin cancer, sun exposure history and other diseases that may be linked to the development of basal cell carcinoma.

To confirm a diagnosis, a skin sample is taken for testing. Called skin biopsy, the test involves removing a small sample of the lesion and is sent to the laboratory for examination under the microscope.

If basal cell carcinoma is found, the doctor will remove the lesion but if it’s an aggressive type, the doctor may also conduct a biopsy of the lymph nodes to check for spread to the other parts of the body or metastasis.

6Treatment

The treatment for basal cell carcinoma involves removing the lesion or growth.
The doctor will recommend various treatment options, depending on the size and location of the lesion. Here are the common treatment options used:

Mohs micrographic surgery – This type of surgery entails the removal of a thin layer of tissue containing the tumor. The layer is then frozen and mapped through the use of a microscope. This is recommended for large tumors in highly visible areas such as the neck and face.

Excision – This type of surgery involves the removal of the tumor and its surrounding borders. The doctor will use a scalpel and it may need suturing to close the surgical site. Usually, this is used for more aggressive and advanced basal cell carcinomas.

Cryosurgery – Cryosurgery is used for cancers that are too thin and do not extend far into the skin. The doctor will freeze and kill the tumor cells through the use of liquid nitrogen.

Electrodesiccation and Curettage – This procedure entails the scraping off of the lesion with a curette. The tumor is then burned with an electrocautery needle. This procedure is effective for small lesions but not for the aggressive types of BCC.

Basal cell carcinoma treatments are often minor and will need a short time for recovery. Many individuals might experience some pain at the incision site after surgery. Scarring is common but you can use scar products to remove the signs of surgery. Keep the surgical site clean and sanitized.

Keep in mind that there is a high risk of basal cell carcinoma recurrence. Thus, taking precautions to protect the skin from ultraviolet rays exposure is very important. Also, always consult with your dermatologists regularly for him to check on your skin for new growths of basal cell carcinoma, or other types of skin cancer.

7Prevention

Basal cell carcinoma risk can be reduced through the following:

  • Avoid sun exposure during the midday, especially between 10 a.m. and 4 p.m., because during this time, the sun rays are the strongest. Also, for those who live in tropical areas or those in high altitude areas, avoid exposing your skin to the sun during this period.
  • Wear protective clothing such as long-sleeved clothes and caps to protect the skin from ultraviolet rays.
  • Use sunscreen inside and outside the house, all-year-round. Choose a sunscreen that protects the sun against both UVA and UVB sun rays and has at least 15 SPF, but 30 and above SPF products are better.
  • Avoid using tanning beds and tanning lights. Tanning beds produce UV radiation which can increase the risk of skin cancer.
  • Check or assess your skin for discolorations, changes and texture changes. Aside from this, go to a dermatologist for an annual assessment.
  • If you are working in areas where there is sun exposure, make sure you take precautions to keep your skin healthy. Moisturize the skin and prevent it from being exposed to the sun for prolonged periods.