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  • Basal Cell Carcinoma

    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.

    Basal cell carcinoma is the most common type of skin cancer. Although rarely fatal, it can cause severe scarring or other permanent skin disfigurement. Most cases of basal cell carcinoma appear on the head and neck, but in recent years, more cases have been appearing on the trunk (torso) of the body.

    Basal cell carcinomas are classified into many sub-categories based on their location on the body. These categories typically fit into one of three groups:

    • Superficial: These carcinomas usually respond well to topical chemotherapy.
    • Infiltrative: More difficult to treat; usually calls for more aggressive forms of chemotherapy or curettage (cutting out the affected area)
    • Nodular: Any of the remaining types of basal-cell carcinomas that do not fit the above categories

    Basal Cell Carcinoma 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.
    Basal Cell Carcinoma 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.

    Basal Cell Carcinoma 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.

    Basal Cell Carcinoma 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.

    Basal Cell Carcinoma 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.

    Basal Cell Carcinoma Risk Factors

    • Sun exposure: Approximately two-thirds of basal cell carcinomas appear on sun-exposed areas of the skin. Doctors recommend using sunscreen with an SPF (sun protection factor) of 30 or higher.
    • Family history: People with ahistory of skin cancers are at high risk for developing it themselves, especially those with fair skin.
    • Medical history: Some forms of basal cell carcinoma have been known to reappear. Some patients are prescribed a chemotherapeutic medication to help prevent a recurrence of certain types of skin cancers.

    Basal Cell Carcinoma Outlook

    The outlook or prognosis for patients with basal cell carcinomas is generally good if caught early and treated appropriately. These cancers rarely metastasize, but it can grow and destroy local tissue.

    • Wear sunscreen: If you are fair-skinned or spend a lot of time outdoors, wear sunscreen regularly.
    • Cover up: Wear long-sleeved tops, long pants, and wide-brimmed hats for prolonged exposure to the sun. Try to sit in the shade or under an umbrella or some other type of covering as much as possible.
    • Follow your treatment plan: If you have a history of basal cell carcinoma, work with your doctor to create an effective treatment plan to keep recurrences to a minimum.