Overview
Basal cell carcinoma (BCC) is a malignant neoplasia (skin cancer) of the dermal epithelium. The cancer originates as a papule (a small, usually conical, raised lesion of the skin) and it develops into an indentation that bleeds, forms a crust, and destroys surrounding tissue.
BCC is most commonly found between the upper lip and the hairline and is responsible for more cancer diagnoses than any other type of cancer. It is also the least lethal of the cancers.
BCC Classification
Basal cell carcinoma has been divided into three classifications: nodular BCC, pigmented Lesion BCC, and the superficial type.
Nodular Basal Cell Carcinoma
Nodular BCC (the most common form of Basal Cell Carcinoma) is characterized by the appearance of a flesh-toned nodule that is covered with inflamed small blood vessels and is round in shape.
Pigmented Lesion Basal Cell Carcinoma
Pigmented lesion BCC is much darker in coloration than the nodule type. It is the blue-brown-black hue that identifies this type of BCC.
Superficial Basal Cell Carcinoma
The third, and least common type of BCC is the superficial type. It is red in coloration with a scaly texture. It can easily be confused with other skin anomalies such as eczema or psoriasis. BCC’s rarely spread and are easily treatable.
Diagnosis
A biopsy is conducted in order to properly diagnose basal cell carcinoma. With the aid of local anesthesia, a tissue sample is taken for pathological study. This will allow an oncologist to confirm malignant status and/or BCC classification. If the nodule or lesion is small, the entire growth is usually removed immediately during biopsy. If the lesion is large, a portion of the tissue is biopsied for analysis and the entire growth is surgically removed following biopsy.
Pathophysiology
Exposure to sunlight leads to a form of DNA damage known as thymine dimer. Thymine dimer indicates the bonding of two adjacent thymine residues in a DNA molecule. The catalyst for the bonding of these residues is radiation (sunlight) and is ultimately the cause of most cases of Basal Cell Carcinoma
BCC is also a result of Gorlin’s Syndrome, or Basal-Cell Syndrome. This syndrome is characterized by a mutation of the tumor-suppressor gene PTCH1 of the chromosome 9q22.3.
Treatment
The successful treatment of basal cell carcinoma depends greatly on the patient's overall health, age, and time of diagnosis.
- Mohs Surgery: This is an outpatient procedure in which the patient will have the entire tumor removed and examined under a microscope for further analysis.
- Chemotherapy: Chemotherapy is frequently applied to treat the superficial type of BCC. 70-90% of all superficial BCC’s are cured with five applications of Chemo over a six-week period. Unfortunately, this treatment usually results in severe inflammation of the skin.
- Immunotherapy: Researchers are now suggesting that implementing Euphorbia Peblus, a very common garden weed, may help cure BCC. However, there isn’t much evidence to support this suggestion.
- Radiation: Radiation is usually applied when a patient is not a candidate for surgery.
Prognosis
Basal Cell Carcinomas are common in individuals with fair complexion and a family history of BCC. The disease occurs frequently in areas close to the equator and/or at high altitudes. It is the most common of the skin cancers (and all cancers) and most cases are successfully treated before serious complications occur. If the disease is allowed to proliferate untreated, vital structures in the body will be damaged, leading to the loss of certain body functions and/or death.