Basal Cell Carcinoma

Overview

Basal cell carcinoma is a type of skin cancer that begins in the basal cells. It most often occurs on areas of the skin that are regularly exposed to the sun, such as the head or neck. Using sunscreen daily can help reduce your risk of developing basal cell carcinoma.

This type of cancer appears as a shiny bump on the skin, a red patch or an open sore. It’s important to get treatment early before the tumor becomes locally invasive and grows deep into the skin.

Basal cell carcinoma causes

Basal cell carcinoma is caused by mutations (changes) in the DNA of basal cells of the skin. It most always occurs on parts of the body that have been repeatedly exposed to ultraviolet light.

Basal cell carcinoma risk factors

If your occupation requires you to be in the sun for long periods of time or if you spend a significant amount of time in the sun or using tanning beds your risk of developing basal cell carcinoma increases greatly. The following factors increase your risk for developing basal cell carcinoma:

• Spending a lot of time in the sun — especially without adequate sunscreen or other protection
• Using tanning beds
• Having undergone radiation therapy
• Having fair skin, light-colored hair or light-colored eyes
• Being older
• Having a personal or family history of skin cancer
• Being on immune-suppressing medication
• Being exposed to arsenic, such as through contaminated well water or on the job
• Having certain rare inherited conditions, such as nevoid basal cell carcinoma syndrome or xeroderma pigmentosum

Basal cell carcinoma symptoms

Signs and symptoms of basal cell carcinoma can include:

• A pearly white, pink or skin-colored bump that may bleed and scab over
• A blue, brown or black lesion with spots
• A scaly, red, flat patch that may grow to be quite large
• A waxy, white, scar-like lesion

Basal cell carcinoma diagnosis

Early detection and treatment are important and most basal cell carcinomas can be removed without complications. Your oncologist may use one or more of the following tests to diagnose this condition:

• Physical exam - your doctor will perform a complete physical exam, including asking questions about your health history, symptoms and related risk factors.
• Biopsy - in this test, your doctor removes a biopsy (small tissue sample) from the suspicious area of skin. This sample is sent to the laboratory, where a specialist closely checks the biopsy for abnormalities.

Basal cell carcinoma treatments

Depending on your personal health history, the extent of your basal cell carcinoma and other factors, your oncologist may recommend one or more of the following treatment options:

• Surgery - in most cases, your doctor will recommend a surgical procedure to remove the cancerous area. Your surgeon may use a procedure called Mohs surgery. During this procedure, your surgeon removes very thin layers of skin until no cancerous cells remain.
• Cryosurgery - your doctor may recommend freezing, which involves using liquid nitrogen to freeze and destroy the cancerous cells. Your doctor may recommend cryosurgery if you have small and/or thin basal cell carcinoma or if you cannot undergo surgery.
• Radiation therapy - this treatment uses high-powered energy beams to destroy cancerous cells. You may need to undergo radiation therapy to destroy any cancerous cells that couldn’t be removed surgically or if the cancer has spread beyond the skin.
• Topical treatment - if you have small and/or thin basal cell carcinoma or if you cannot undergo surgery, your doctor may recommend a topical cream or ointment to treat the cancerous area.
• Chemotherapy - if the cancer has spread beyond your basal cells, your doctor may recommend that you undergo chemotherapy. During this treatment, medication is used to destroy cancerous cells. Chemotherapy can be taken via an oral (by mouth) pill or intravenously (through a vein).

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing an oncologist for more specialized treatment.