Basal cell carcinoma is a type of skin cancer also known as rodent ulcer. It is the most common cancer amongst Caucasians and is rare among dark skinned peoples.
It accounts for three quarters of all skin cancers and unlike the other common type of skin cancer, melanoma, it very rarely spreads to other tissues. The main problem with basal cell carcinoma is its spread to the surrounding skin. Although this is generally slow, failure to get appropriate treatment can lead to a considerable area of skin being destroyed and thus requiring plastic surgery.
Nature of Basal Cell Carcinoma
Eighty per cent of tumours grow on the face, the other twenty percent can occur anywhere on the body.
The tumours vary in appearance. Commonly they appear as red nodules. Some are superficial and can resemble the skin lesions of eczema or psoriasis. A particular variety known as morphoic has an irregular outline. This is the most aggressive of the basal cell carcinomas tending to grow to large size and be more likely to recur. Very occasionally, dark pigmented tumours occur.
Risk Factors for Basal Cell Carcinoma
The risk factors for basal cell carcinoma include the following:
- Sun exposure: The major risk factor is having pale skin, particularly one which burns rather than tans. There is growing evidence that sun exposure as a child or adolescent may be important in skin cancer development.
- Age and gender are also implicated. Men are more likely to be affected than women and the risk increases with age.
- Genetics: A family history of skin cancer will increase the chances of developing the condition. This is not surprising since pale complexion is inherited.
- Viruses: It's been suggested that human papilloma virus may be implicated. This virus is responsible for the majority of genital warts and cervical cancers.
- Chemicals: Some studies have found that arsenic and coal tar compounds may be responsible for some skin cancers. As yet no causative link has been found.
Treatment of Basal Cell Carcinoma
Treatment for basal cell carcinoma involves complete removal of the tumour by one of a number of methods. It is normally carried out by a primary care physician with an interest in dermatology or a specialist dermatologist.
Here are some facts about the various treatment options for basal cell carcinoma:
- Radiation, which is around 90% effective, can leave more scarring than surgery. It is not suitable for large or recurrent tumours.
- Surgery has a higher cure rate than radiation. It involves excision of the tumour plus an area around the tumour. If a large area is excised, then skin grafting is needed.
- Moh's Surgery: This is a specialist micrographic surgery increasingly popular in the US and Australia. The excision is carried out in stages with each stage being checked microscopically. If any tumour cells are found in the excised section, then more of that particular area is removed and checked again. It leaves minimal amount of tissue damage and less scarring.
- Cautery: The soft surface part of the tumour is scraped away and the remaining is destroyed by cauterisation (heat).
- Cryotherapy: This is destroying the tumour by freezing, much in the way warts are removed. It is suitable for superficial tumours only.
- Creams can be used for superficial tumours, but relapse rates are higher.
- Photodynamic therapy is another mode of treatment suitable for superficial tumours only. It involves shining intense light on tumour cells that have been previously sensitized to light.
The overall cure rate for basal cell carcinoma is between 95%-100%
This article is for information only. If you have any skin lesions which are causing you concern, then you should consult your doctor.
Resources:
Medicine Eds. Souhami and Moxham. Pub. Churchill Livingstone 2002
Molecular Ateiology and Pathogenesis of Basal Cell Carcinoma. CMLJ Tilli et al. British J. of Dermatology 2005;152(6)
John Richard Roberts - I am a practicing osteopath and acupuncturist living and working in the UK. I hold a Master's degree in Clinical Neuroscience. I have ...
