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Basal cell carcinoma

Definition

Basal cell carcinoma is a type of skin cancer. It is the most common form of cancer in the United States. Most skin cancers are basal cell cancer.

Basal cell carcinoma is almost always a slow-growing form of skin cancer.

Other common types of skin cancer are:

Alternative Names

Basal cell skin cancer; Rodent ulcer; Skin cancer - basal cell; Cancer - skin - basal cell; Nonmelanoma skin cancer; Basal cell NMSC

Causes

Basal cell cancer starts in the top layer of the skin called the epidermis. Most basal cell cancers occur on skin that is regularly exposed to sunlight or other ultraviolet radiation.

This type of skin cancer is most common in people over age 40. But it can occur in younger people who have had extensive sun exposure.

You are more likely to get basal cell cancer if you have:

  • Light-colored or freckled skin
  • Blue, green, or grey eyes
  • Blond or red hair
  • Overexposure to x-rays or other forms of radiation
  • Many moles
  • Close relatives who have or had skin cancer
  • Many severe sunburns early in life
  • Long-term daily sun exposure (such as the sun exposure received by people who work outside)

Symptoms

Basal cell cancer grows slowly and is usually painless. It may not look that different from your normal skin. You may have a skin bump or growth that is:

  • Pearly or waxy
  • White or light pink
  • Flesh-colored or brown

In some cases, the skin is just slightly raised or even flat.

You may have:

  • A skin sore that bleeds easily
  • A sore that does not heal
  • Oozing or crusting spots in a sore
  • A scar-like sore without having injured the area
  • Irregular blood vessels in or around the spot
  • A sore with a depressed (sunken) area in the middle

Exams and Tests

Your doctor will check your skin and look at the size, shape, color, and texture of any suspicious areas.

If your doctor thinks you might have skin cancer, a piece of skin will be removed. This is called a skin biopsy. The sample is sent to a lab for examination under a microscope.

A skin biopsy must be done to confirm basal cell skin cancer or other skin cancers.

Treatment

Treatment depends on the size, depth, and location of the skin cancer, and your overall health.

Treatment may involve any of the following:

  • Excision: Cutting out the skin cancer and stitching the skin together
  • Curettage and electrodessication: Scraping away cancer cells and using electricity to kill any that remain; used to treat cancers that are not large or deep
  • Cryosurgery: Freezing the cancer cells, which kills them; used to treat cancers that are not large or deep
  • Medication: Skin creams that have medicine; used to treat cancers that are not large or deep
  • Mohs surgery: Removing a layer of skin and looking at it immediately under a microscope, then removing layers of skin until there are no signs of the cancer; usually used for skin cancers on the nose, ears, and other areas of the face
  • Photodynamic therapy: Treatment using light; used to treat cancers that are not large or deep
  • Radiation: May be used if a basal cell cancer cannot be treated with surgery
  • Chemotherapy: May be used to treat basal cell cancer that has spread to other parts of the body or that cannot be treated with surgery

Outlook (Prognosis)

Most of these cancers are cured when treated early. Some basal cell cancers return. Smaller ones are less likely to come back. Basal cell carcinoma almost never spreads to other parts of the body.

Possible Complications

Basal cell skin cancer almost never spreads. But, left untreated, it may grow (spread) into surrounding areas and nearby tissues and bone.

When to Contact a Medical Professional

Call for an appointment with your health care provider if if you have a sore or spot on your skin that changes in:

  • Appearance
  • Color
  • Size
  • Texture

Also call if a spot becomes painful or swollen or if it starts to bleed or itch.

Prevention

The American Cancer Society recommends that a health care provider examine your skin every year if you are older than 40 and every 3 years if you are 20 to 40 years old. You should also examine your own skin once a month.

The best way to prevent skin cancer is to reduce your exposure to sunlight. Always use sunscreen and learn how to protect yourself from the sun.

References

Cockerell CJ, Tran KT, Caruuci J, et al. Basal cell carcinoma. In: Rigel DS, Robinson JK, Ross M, et al., eds. Cancer of the Skin. 2nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 11.

National Cancer Institute: PDQ Skin Cancer Treatment. Bethesda, MD: National Cancer Institute. Date last modified July 20, 2012. Available at http://cancer.gov/cancertopics/pdq/treatment/skin/HealthProfessional. Accessed August 19, 2013.

National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines): Basal cell and squamous cell skin cancers. Version 2.2013. Available at http://www.nccn.org/professionals/physician_gls/pdf/nmsc.pdf. Accessed August 19, 2013.

U.S. Food and Drug Administration. FDA press release: FDA announces changes to better inform consumers about sunscreen. Available at http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm258940.htm. Accessed August 19, 2013.


Review Date: 8/9/2013
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.
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