What Is Basal Cell Carcinoma?
Basal cell carcinoma is a cancer that grows on parts of your skin that get a lot of sun. It's natural to feel worried when your doctor tells you that you have it, but keep in mind that it's the least risky type of skin cancer. As long as you catch it early, you can be cured.
This cancer is unlikely to spread from your skin to other parts of your body, but it can move nearby into bone or other tissue under your skin. Several treatments can keep that from happening and get rid of the cancer.
The tumors start off as small shiny bumps, usually on your nose or other parts of your face. But you can get them on any part of your body, including your trunk, legs, and arms. If you've got fair skin, you're more likely to get this skin cancer.
Basal cell carcinoma usually grows very slowly and often doesn't show up for many years after intense or long-term exposure to the sun. You can get it at a younger age if you're exposed to a lot of sun or use tanning beds.
Ultraviolet (UV) rays from the sun or from a tanning bed are the main cause of basal cell carcinoma.
When UV rays hit your skin, over time, they can damage the DNA in your skin cells. The DNA holds the code for the way these cells grow. Over time, damage to the DNA can cause cancer to form. The process takes many years.
Basal cell carcinoma can look different. You may notice a skin growth in a dome shape that has blood vessels in it. It can be pink, brown, or black.
At first, a basal cell carcinoma comes up like a small "pearly" bump that looks like a flesh-colored mole or a pimple that doesn’t go away. Sometimes these growths can look dark. Or you may also see shiny pink or red patches that are slightly scaly.
Another symptom to watch out for is a waxy, hard skin growth.
Basal cell carcinomas are also fragile and can bleed easily.
Getting a Diagnosis
Your doctor will look at your skin for growths. He may also ask you questions such as:
- Did you spend a lot of time in the sun while you were growing up?
- Have you had blistering sunburns?
- Do you use sunscreen?
- Have you ever used tanning beds?
- Have you had unusual bleeding spots on your skin that don't heal?
Your doctor will take a sample, or biopsy, of the growth. He'll will numb the area and remove some of the skin. Then he sends it to a lab, where it will be tested for cancer cells.
Questions for Your Doctor
- What kind of treatments do you suggest?
- Can drugs help treat my condition?
- Will I need surgery?
- How can I keep from getting skin cancer again?
The goal is to get rid of the cancer while leaving as small a scar as possible. To choose the best treatment, your doctor will consider the size and place of the cancer, and how long you've had it. He'll also take into account the chance of scarring, as well as your overall health.
These are some of the treatment options your doctor may suggest:
Cutting out the tumor. Your doctor may call this an "excision." First he'll numb the tumor and the skin around it. Then he'll scrape the tumor with a spoon-shaped device. Next he'll cut out the tumor and a small surrounding area of normal-appearing skin and send it to a lab.
If the lab results show there are cancer cells in the area around your tumor, your doctor may need to remove more of your skin.
Scraping the tumor away and using electricity to kill cancer cells. You may hear your doctor call this "curettage and desiccation." First your doctor numbs your skin. Then he uses a curette, a tool that has spoon-like shape to scrape off the tumor. Your doctor controls your bleeding and kills any other cancer cells with an electric needle.
Freezing your cancer cells. This is known as "cryosurgery." Your doctor kills your cancer cells by freezing them with liquid nitrogen.
Radiation therapy . This treatment uses X-rays to destroy your cancer cells. It's done over several weeks.
Mohs surgery. This is a technique that's named after the doctor who came up with it. Your surgeon removes your tumor layer by layer. He takes out some tissue, then looks at it under a microscope to see if it has cancer cells, before moving on to the next layer.
Your doctor may recommend this surgery if your tumor is:
- In a sensitive area of your body
- Has been there for a long time
- Came back after you had other treatments
Creams and pills. Your doctor may suggest some medicine that can treat your basal cell carcinoma. Two creams that you put on your skin are:
You may need to apply these creams for several weeks. Your doctor will check you regularly to see how well they are working.
There is also a pill that your doctor might prescribe called Erivedge (vismodegib). You're most likely to get this drug if your basal cell carcinoma has spread to other parts of your body.
Taking Care of Yourself
After you've been treated for basal cell carcinoma, you'll need to take some steps to lower your chance of getting cancer again.
Check your skin. Keep an eye out for new growths. Some signs of cancer include areas of skin that are growing, changing, or bleeding. Check your skin regularly with a hand-held mirror and a full-length mirror so that you can get a good view of all parts of your body.
Avoid too much sun. Stay out of sunlight between 10 a.m. and 2 p.m., when the sun's UVB burning rays are strongest.
Use sunscreen. The sun’s UVA rays are present all day long -- that’s why you need daily sunscreen. Make sure you apply sunscreen with at least a sun protection factor of 30 to all parts of the skin that aren't covered up with clothes every day. You also need to reapply it every 1 to 2 hours when outside.
Dress right. Wear a broad-brimmed hat and cover up as much as possible, such as long-sleeved shirts and long pants.
What to Expect
Basal cell carcinoma rarely spreads to other parts of the body, and the treatment is almost always successful, especially if it's caught early.
Sometimes new carcinomas can grow, so it's important to check your skin for any unusual-looking growths and get them checked by your doctor.
Learn more about basal cell carcinoma, including pictures of skin tumors, on the web site of the American Cancer Society.