BASAL CELL CARCINOMA
The Most Common Skin Cancer
Basal cell carcinoma (BCC) is the most common form of skin cancer, affecting approximately two million Americans each year. In fact, it is the most common of all cancers. More than one out of every three new cancers are skin cancers, and the vast majority are basal cell carcinomas. These cancers arise in the basal cells, which line the deepest layer of the epidermis (top skin layer).
The Major Cause
Almost all basal cell carcinomas occur on parts of the body excessively exposed to the sun especially the face, ears, neck, scalp, shoulders, and back. On rare occasions, however, tumors develop on unexposed areas. In a few cases, contact with arsenic, exposure to radiation, open sores that resist healing, chronic inflammatory skin conditions, and complications of burns, scars, infections, vaccinations, or even tattoos are contributing factors.
Who Gets It?
Anyone with a history of sun exposure can develop basal cell carcinoma. However, people who are at highest risk have fair skin, blond or red hair, and blue, green, or grey eyes. Those most often affected are older people, but as the number of new cases has increased sharply each year in the last few decades, the average age of patients at onset has steadily decreased. The disease is rarely seen in children, but occasionally a teenager is affected. Dermatologists report that more and more people in their twenties and thirties are being treated for this skin cancer. Men with basal cell carcinoma have outnumbered women with the disease, but more women are getting basal cell carcinomas than in the past. Workers in occupations that require long hours outdoors and people who spend their leisure time in the sun are particularly susceptible.
Basal cell carcinomas are easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. Although this skin cancer seldom spreads, or metastasizes, to vital organs, it can damage surrounding tissue, sometimes causing considerable destruction and disfigurement and some basal cell carcinomas are more aggressive than others.
When small skin cancers are removed, the scars are usually cosmetically acceptable. If the tumors are very large, a skin graft or flap may be used to repair the wound in order to achieve the best cosmetic result and facilitate healing.
Risk of Recurrence
People who have had one basal cell carcinoma are at risk for developing others over the years, either in the same area or elsewhere on the body. Therefore, regular visits to a dermatologist should be routine so that not only the site(s) previously treated, but the entire skin surface can be examined.
Basal cell carcinomas on the scalp and nose are especially troublesome, with recurrences typically taking place within the first two years following surgery.
Should a cancer recur, the physician might recommend a different type of treatment. Some methods, such as Mohs micrographic surgery, may be highly effective for recurrences