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Basal Cell Carcinoma

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  3. Basal Cell Carcinoma

Overview of Basal Cell Carcinoma

Basal cell carcinoma results from the abnormal growth of the basal cells. These cells are located in the lining of the epidermis. It affects various areas of the skin, especially the face.

Basal cell carcinoma is a form of skin cancer resulting from abnormal growth of basal cells in the epidermis layer. These cells produce within the skin and replace the old cells with new ones. As the basal cells form a tumour that appears on the skin's surface. Tumour of basal cells produces sores, growths, bumps, scars or red patches mainly in head or neck areas.
Basal cell carcinoma does not metastasize to other areas but in rare cases, it can be possible. If it expands to other areas, then it would be life-threatening for patients.
Mostly the cancer is caused by the exposure of UV light from sunlight. Sunscreen is the best approach to reduce the incidence of basal cell carcinoma.

Prevalence of Basal Cell Carcinoma

Nearly 8 out of 10 cases are reported of basal cell cancers worldwide. Between the years of 2000-2010, the average occurrence rate of men is around 67.6% of and women is about 62.7%. The survival rate is much higher than other skin cancers that are about 85-95% without recurrence.

 

Signs and Symptoms of Basal Cell Carcinoma

Nearly, basal cell carcinoma occurs on the different parts of the body due to frequent skin exposure. Main regions of the body include the face, ears, shoulders, neck, scalp, and arms. 

These types of tumours are typically painless. The only sign of basal cell carcinoma is growth or change in the appearance of the skin. There are different types of basal cell carcinoma which are characterized by their different appearance. 

  • Pigmented Basal Cell Carcinoma: The lesions appear as brown, blue, or black coloured. Also, they have translucent and raised borders.
  • Superficial Basal Cell Carcinoma: In this type, the reddish patches appear on the skin, which is often flat and scaly. As they continue to grow, then show as a raised edge. Back or chest area is mainly affected by these lesions.
  • Nonulcerative Basal Cell Carcinoma: This type appears as a translucent white-coloured lesion on the skin. These lesions often contain blood vessels which are visible underneath the skin. This is one of the common types of Basal cell carcinoma. They appear on the neck, ears, and face that can rupture, bleed, and ooze out from them.
  • Morpheaform Basal Cell Carcinoma: This type of basal cell carcinoma is the least common among all. The white scar-like lesions with no defined border and waxy appearance forms on the different areas of the skin. This type is primarily very invasive and may be fatal for people.
  • Basosquamous Basal Cell Carcinoma: This type of carcinoma is a combination of both traits basal cell carcinoma and squamous cell carcinoma. It rarely exists but can metastasize more than other types of skin cancer.

 

Types of Basal Cell Carcinoma

Nearly, basal cell carcinoma occurs on the different parts of the body due to frequent skin exposure. Main regions of the body include the face, ears, shoulders, neck, scalp, and arms.
These types of tumours are typically painless. The only sign of basal cell carcinoma is growth or change in the appearance of the skin. There are different types of basal cell carcinoma which are characterized by their different appearance.

  • Pigmented Basal Cell Carcinoma: The lesions appear as brown, blue, or black coloured. Also, they have translucent and raised borders.
  • Superficial Basal Cell Carcinoma: In this type, the reddish patches appear on the skin, which is often flat and scaly. As they continue to grow, then show as a raised edge. Back or chest area is mainly affected by these lesions.
  • Nonulcerative Basal Cell Carcinoma: This type appears as a translucent white-coloured lesion on the skin. These lesions often contain blood vessels which are visible underneath the skin. This is one of the common types of Basal cell carcinoma. They appear on the neck, ears, and face that can rupture, bleed, and ooze out from them.
  • Morpheaform Basal Cell Carcinoma: This type of basal cell carcinoma is the least common among all. The white scar-like lesions with no defined border and waxy appearance forms on the different areas of the skin. This type is primarily very invasive and may be fatal for people.
  • Basosquamous Basal Cell Carcinoma: This type of carcinoma is a combination of both traits basal cell carcinoma and squamous cell carcinoma. It rarely exists but can metastasize more than other types of skin cancer.

 

Causes of Basal Cell Carcinoma

The UV light is the main cause of basal cell carcinoma which leads to hyperpigmentation. This ultimately causes tanning to the skin.
As the UV rays target the skin, over time, they start to damage the DNA in skin cells. The DNA contains the instructions for the growth of cells.
Frequent damage to DNA can cause cancer after years.

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Risk Factors of Basal Cell Carcinoma

Factors that may increase the risk of basal cell carcinoma include:

  • Frequent sun exposures such as the people are living in hot climatic conditions.
  • Radiation therapy for the treatment of acne or other skin conditions.
  • White skin tone people are at higher risk than the darker tone.
  • As the age increases with time, the risk of basal cell carcinoma is getting higher that's why it is more likely to occur in older people. But it affects younger people between the ages of 20 to 30 years.
  • People who have a personal or family history of skin cancer.
  • Some people are taking immune-suppressing drugs such as anti-rejection drugs used after transplant surgery may increase the risk of cancer.
  • Exposures to arsenic metal are another factor that may have a chance to increase the risk of skin cancer.
  • The certain genetic disease may cause skin cancer including nevoid basal cell carcinoma syndrome (Gorlin-Goltz syndrome) and xeroderma pigmentosum.

Health Complications of Basal Cell Carcinoma

Following are the complications of basal cell carcinoma in which includes:

 

  • Basal cell carcinomas usually have a risk of recurrence even after the successful treatment.
  • If a person had a basal cell carcinoma history then it may have a chance of producing other skin cancer types such as squamous cell carcinoma.
  • Rarely, cancer spreads to the lymph nodes area and other types of the body that cause complications of the skin.

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Prevention

In order to prevent cancer, the following steps are taken:

  • Avoid the sunlight especially during the middle of the day.
  • Apply sunscreen on the exposed skin of the body when a person goes out.
  • Wear full covered clothes in which less exposure of skin to sunlight.
  • Avoid tanning beds because it emits UV rays.

 

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Diagnosis

A Dermatologist will visually inspect the skin lesions or changes in skin through torchlight. After a doctor asks the questions regarding the symptoms, medical and family history.
Some of them are as follows:

When did you observe skin growth or lesions?
When do these lesions first develop?
Have you felt any changings in skin growth since your first day?
Have you felt any pain in the lesions?
Have you had a history of other skin cancer?
Has anyone in your family had any kind of skin cancer?
Do you take any preventive measures to reduce the lesions?
Do you examine your skin regularly?

After completion of the question session, a dermatologist will first examine the suspected areas of the skin. Then also check other areas of the body. To confirm its diagnosis, a doctor may recommend the skin biopsy test.

  • Skin Biopsy

Skin biopsy is a procedure in which a small fragment of the lesion from the skin is scraped off for testing. Then observe it under a light microscope. The test results reveal the type of cancer or any other skin abnormalities on the basis of type and size of the lesion.

 

Treatment of Basal Cell Carcinoma | When to Consult a Doctor

The treatment of basal cell carcinoma belongs to a variety of therapies such as home remedies, surgeries, chemotherapy etc. The main treatment goal is to remove cancer completely, depending on the type, location and size of cancer. 

In order to quickly relieve disease, a patient should take the Oncologist’s consultation seriously and attend follow up sessions timely.

There are multiple treatment therapies which are described below:

  1. Home Remedies

Certain types of herbs or natural products are used to prevent the formation of lesions on the skin. Some of them are as follows:

  • Black Raspberry seed oil
  • Eggplant extract
  • Myrrh oil
  • Frankincense oil
  • Apple cider vinegar
  • Baking Soda

  1. Surgery

Basal cell carcinoma is mostly treated with surgery for the removal of cancer as well as surrounding healthy tissues. It depends on the extent of cancer on the skin.

There are different kinds of surgeries available to eliminate the basal cell carcinoma include:

  • Surgical Excision- In this method, a doctor makes an incision in the cancerous lesions along with a surrounded margin of healthy tissue cells. Then examine the margin under a microscope to ensure the presence of cancerous cells. This is recommended for the conditions in which carcinomas are less risk of recurrence, including, chest, back, hands and feet.
  • Mohs Surgery- During Mohs surgery, a doctor removes the layers of cancerous tissues and examines each layer under the microscope. The removal is done until no abnormal cells appear. This helps the surgeon ensure that the entire growth of cells is removed or measures the required amount of surrounding healthy skin.

Mohs surgery might be recommended in basal cell carcinoma cases where there is a high risk of recurrence. For example: if cancer metastasizes deeper in the skin.

  1. Other treatments

Sometimes other treatments might be recommended in certain situations, such as if you're unable to undergo surgery or if you don't want to have surgery.

Other treatments of removal of basal cell carcinoma include:

  • Curettage and Electrodesiccation (C and E)-This treatment C and E treatment involves the scraping off the affected surface of the skin by using a curette instrument.  After that, cut out the base of the cancer with an electric needle.
  • C and E curettage options are used to treat the affected areas on the back, chest, hands and feet. 
  • Radiation Therapy- The powerful high energy electron beam transfers to the affected areas and kills the cancer cells. 
  • Freezing- The lesions are removed by applying the liquid nitrogen on them. It is done after the curettage. 
  • In some cases, cryosurgery is recommended for treating small and thin basal cell carcinomas.
  • Topical Treatments- Some creams or ointments are used to treat the small and thin basal cell carcinomas. It depends on the patient's condition. 

  1. Treatment for Metastatic Basal Cell Carcinoma

In rare cases, basal cell carcinoma can spread (metastasize) to nearby lymph nodes and other areas of the body. For this type of conditions, the following options are included:

  • Targeted Drug Therapy- This method targets the affected area of cancerous skin. This kills the cancer cells.
  • Chemotherapy- Powerful chemotherapeutic drugs help to kill cancer cells. It might be considered when other treatments do not respond to cancer.

After or during the treatment, timely follow-up sessions are highly required for carefully monitoring the skin.

 

 

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