Definition

Basal cell carcinoma is the most common form of skin cancer. This cancer usually grows slowly and rarely spreads to other tissues in the body.

Basal cell carcinoma is rarely fatal. It is usually treated to reduce the risk of damage to nearby tissue.

Causes

Cancer occurs when cells in the body divide without control or order. Eventually these uncontrolled cells form a growth or tumor. The growths invade and take over nearby tissue. It is not clear exactly what causes these problems in the cells, but is probably a combination of genetics and environment.

Risk Factors

Areas of skin that are damaged have a higher risk of cancer. Skin that is regularly exposed to the sun is most likely to develop skin cancer. Basal cell carcinoma may also develop in skin that has scars, burns, or inflammatory skin diseases.

Factors that may increase the chances of basal cell carcinoma:

• History of radiation therapy
• A personal history of skin cancer
• Childhood sunburns, freckling, or long periods of sun exposure
• Frequent use of tanning beds
• Blonde or red hair
• Blue or green eyes
• Fair skin that rarely tans
• A family history of skin cancer
• Treatment that suppresses the immune system, such as having an organ transplant
• Certain rare genetic disorders, such as Gorlin’s syndrome

Symptoms

Symptoms of basal cell carcinoma may vary between people. Common symptoms include:

• A sore that may crust, bleed, or ooze for more than 3 weeks without healing
• A raised, red patch that may be itchy
• A shiny bump that can be pearl-like in appearance or, less often, dark in color, much like a mole
• A pink growth with a slightly raised border and dip in the middle
• A patch of skin that seems shiny and tight, much like a scar

Diagnosis

The doctor will ask about symptoms and medical history. A physical exam will be done. This includes a thorough examination of the skin and any skin lesions.

Samples of skin lesions can be biopsied and examined under a microscope for the presence of cancer. A biopsy will also help determine the stage and type of the cancer if it is present. The information will be used to guide treatment and make a prognosis.

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Treatment

Treatment options include:

• Mohs micrographic surgery —surgery to remove skin in thin layers to be examined under a microscope
• Removal of the growth with simple surgery
• Plastic surgery to repair any cosmetic problems that occur after treatment
• Curettage and electrodesiccation—treatment to destroy the lesion

Other treatments may be used based on the size or microscopic findings of the cancer. In some cases, surgery may not be an option. Other treatments may include:

• The use of liquid nitrogen to freeze the growth
• Radiation therapy
• Photodynamic therapy—a type of light therapy
• Medicated creams, especially fluorouracil or imiquimod

Prevention

To help reduce the chances of basal cell carcinoma:

• Avoid exposing your skin to the sun between 10:00 AM and 2:00 PM standard time, or 11:00 AM to 3:00 PM daylight saving time.
• Protect your skin from the sun with clothing. Wear a shirt, sunglasses, and a hat with a broad brim.
• Use broad-spectrum (UVA and UVB) sunscreens with a sun protection factor (SPF) of 30 or more on skin that will be exposed to the sun.
• Use a protective lip balm.
• Wear sunglasses with 99-100% UV absorption to protect your eyes.
• Do not use sun lamps or tanning booths.
• Get regular full-body skin exams by a dermatologist if you are at high risk for skin cancer. The doctor will check for moles, freckles, and other growths.

If you see any changes in your skin, such as new growths or changes in moles or freckles, contact your doctor for a skin exam.