Basal Cell Carcinoma
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Basal Cell Carcinoma

(Nonmelanoma Skin Cancer)

En Español (Spanish Version)

Definition

Basal cell carcinoma is the most common form of skin cancer. It is named for basal cells, which lie at the base of the outer layer of skin. This cancer grows slowly and usually does not spread to other tissues in the body. It is rarely fatal, but can be locally destructive and requires treatment or removal.

Basal Cell Carcinoma

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Causes

Exposure to ultraviolet (UV) light through time spent in the sun—particularly as a child—is recognized as the primary cause of basal cell carcinoma. However, the growth results from a combination of sun exposure and genes that make developing the cancer more likely.

Risk Factors

A risk factor is something that increases your chance of getting a disease or condition.

The following factors increase your chance of developing basal cell carcinoma:

  • Childhood sunburns, freckling, or long periods of sun exposure
  • Fair skin that rarely tans
  • Blue or green eyes
  • Blonde or red hair
  • A family history of skin cancer
  • A personal history of skin cancer
  • Treatment that suppresses the immune system, such as that prescribed for people who have had an organ transplant
  • History of radiation treatment
  • Swallowing arsenic
  • Certain rare genetic disorders, such as Gorlin’s syndrome—an inherited group of multiple defects involving the skin, nervous system, eyes, endocrine glands, and bones
  • Frequent use of tanning beds

Symptoms

Symptoms include:

  • A sore that may crust, bleed, or ooze for three weeks without healing
  • A raised, red patch that might or might not 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 diagnosis will probably be made by a doctor who specializes in skin care, called a dermatologist. The dermatologist will look at the skin growth and take a sample, called a biopsy, to test for cancerous cells. The doctor will then decide on a treatment plan based on the size, subtype, and location of the tumor.

Treatment

A doctor may recommend any of the following treatments:

  • Mohs Micrographic Surgery—microscopically controlled surgery the offers the best cure rate for basal cell carcinoma
  • Removing the growth with simple surgery
  • Freezing the growth off with liquid nitrogen
  • Electrodesiccation and Curettage—treatment with a curette (a sharp, spoon-shaped tool, and an electric current)
  • Radiotherapy, also known as radiation therapy
  • Photodynamic therapy in which the cells absorb an acid that causes them to die when exposed to light
  • Creams, especially fluorouracil (5-FU) or imiquimod
  • Plastic surgery to repair any cosmetic problems that occur after treatment

Prevention

The following are ways to decrease your chance of developing basal cell carcinoma:

  • Reduce sun exposure especially by wearing sunscreen, long sleeves and slacks, and hats.
  • Stay out of the sun during midday hours.
  • People who ski and enjoy other winter sports should be aware that UV light is stronger at higher elevations, and should take precautions (eg, wearing sunscreen).
  • At-risk adults should examine themselves monthly and get an annual full-body exam by a dermatologist to check for moles, freckles, and other growths.
  • Limit sun exposure/tanning for children and teens.
  • Learn to recognize early basal cell carcinoma and seek treatment.
  • Some patients can take a retinoid (eg, vitamin A1) to help prevent a return of the cancer.

RESOURCES:

American Academy of Dermatology
http://www.aad.org

American College of Mohs Micrographic Surgery
http://www.mohscollege.org/AboutMMS.html

The Skin Cancer Foundation
http://www.skincancer.org

CANADIAN RESOURCES:

Canadian Dermatology Association
http://www.dermatology.ca

The Canadian Skin Cancer Foundation
http://www.canadianskincancer.com

References:

Basal cell carcinoma. DynaMed website. Available at: http://dynamed102.ebscohost.com/Detail.aspx?id=113813. Accessed June 15, 2007.

Wong C. Strange R. Lear J. Basal cell carcinoma. BMJ . 2003;327:794-798. Available at: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=214105. Accessed June 15, 2007.



Last reviewed April 2008 by Ross Zeltser, MD, FAAD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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