Basal Cell Carcinoma
Basal Cell Carcinoma is the most common skin cancer occurring in the USA, and other countries with a large population of white, fair skinned individuals. The tumor occurs on sun exposed parts of the body namely the face, ears, scalp, chest, and back. The tumor can have multiple forms appearing as a pink, translucent papule or nodule with a rolled border, central depression or ulceration. The surface is often associated with superficial telangiectasia and crust. They can also appear as open sores, sclerotic patches, and shiny patches. Though rare, the tumor can metastasize.
Risk factors for developing Basal cell carcinoma include prolonged exposure to ultraviolet radiation, fair skin, blond or red headed individuals, multiple blistering sun burns or intermittent sunburns in the past, family history of basal cell cancer, immunosuppression from disease or medication, radiation therapy, or tanning bed exposure.
Ultraviolet radiation comes from the sun, tanning beds, sun lamps and tanning booths. People with fair skin that freckles and burns easily, light colored eyes are more at risk for sun burns. Dark skinned individuals can also get skin cancer, but are much less likely. People who live in areas closer to the equator (Texas and Florida) are more exposed to ultraviolet light and are at increased risk for skin cancer, compared to the northern states like Minnesota. It is important to keep in mind higher altitudes and people who ski can burn at these altitudes and are also at increased risk for skin cancer. Ultraviolet radiation is present in cold climates, on rainy days, and snowy days. It is important to wear sun protection daily, to sun exposed skin, when going outdoors in daylight hours. Photo protection can also be obtained by wearing photo protective clothing such as hats, tops and pants. You can look for specific fabrics that have a UPF 50 designation on it which means there is an adequate amount of protection in the clothing.The diagnosis of Basal cell carcinoma is made after your dermatologist takes a sample of your skin and sends it for pathological examination.
Treatment of skin cancer can be done using many modalities. Factors that influence the method of removal include the location of the tumor, the size of the tumor, the depth of penetration of the tumor, and the general health of the patient. Surgery is the usual mode of removal. This can be done with a simple elliptical excision. Cure rates are generally above 95%. A repeat excision may be necessary if the tissue removed is returned with tumor present at the margin of resection. Mohs micrographic surgery offers the highest cure rate of 99%. This method is indicated if the tumor is located on the central face, have indistinct borders, is a recurrent tumor, is a large tumor in a cosmetically important area or are in critical areas around the eyes, ears, nose and lips. Curettage and electrodessication has the same cure rate as elliptical excisional surgery and is usually reserved for smaller lesions. Other treatment methods include oral or topical chemotherapy, or radiation therapy.
