Basal Cell Carcinoma

What is basal cell carcinoma?

Basal cell carcinoma (BCC) is the most common type of skin cancer, and the most common type of cancer in general.  Its incidence is on the rise. About 80% of skin cancers are BCC. There are about four million new cases of BCC per year in the U.S. BCC is the least serious type of skin cancer.

While BCC is slow growing, rarely spreads and is highly treatable, left undiagnosed and untreated it can destroy local tissues like cartilage and bone and cause disfigurement. Early diagnosis and treatment are essential. Additionally, the risk of recurrence is high unless treated appropriately.

What causes BCC?

BCC is caused by repeated and unprotected exposure to ultraviolet radiation (UV) from the sun and tanning beds which damages to the DNA of the basal skin cells. The damaged DNA causes genetic mutations that cause the cancer cells to multiply rapidly and create BCC. It may take 20 years of cumulative UV damage to manifest as BCC. The use of a tanning bed increases the risk of developing BCC.

Who is at risk for BCC?

BCC is most common in fair skinned individuals over age 40 and can occur in people of any color. Lifetime risk of developing a BCC is about 20% in the U.S. BCC is especially prevalent in young women. A family history of skin cancer creates a risk. People with one BCC have about a 30-50% chance of developing another within 5 years. Moreover, a history of BCC may increase the risk of developing squamous cell carcinoma (SCC). This is why it is so important to have an annual skin cancer checkup.

What are the symptoms of BCC?

It is commonly found on areas of skin chronically exposed to the sun including the nose, eyelids, cheeks, and lips, chest, neck, arms, legs and the back of the hands; but it can occur on any area of the body that is repeatedly exposed to UV light.

A BCC may look like:

• a sore that won’t heal and may bleed, ooze or crust over
• a flesh-colored pearly white, skin – colored or red growth that may have raised and rolled edges
• a smooth shiny and waxy looking bump
• a white scar like lesion
• a scaly red patch or a pinkish or reddish patch of skin that may be slightly raised
• the lesion may have tiny blood vessels or flecks of brown or black

Importantly, BCCs can look different from the symptoms listed above. When you find anything unusual or changing on your skin, contact Dr. Sotiriou to schedule a consultation.

How is BCC diagnosed?

Dr. Sotiriou is an expert and may suspect BCC merely by its appearance. He will conduct an examination noting the size, appearance and symptoms of the lesion. He will review the patient’s health history including family history of skin cancer, and whether the individual has previously had skin cancer.

A skin biopsy is the definitive tool to diagnose BCC. It is a simple procedure where the area is numbed with a local anesthetic and part, or all of the lesion is removed and examined under a microscope.

What are the treatments for BCC?

Treatment options depend on the size, depth, location of the lesion and the patient’s health. Dr. Sotiriou will discuss with you the treatments that he recommends.

Management of BCC remains largely surgical in the form of electrodessication and curettage, surgical excision for small lesions and Mohs surgery. Topical chemotherapy medications may be offered if the lesion is small and superficial. Cryosurgery (freezing the cancer cells) may also be an option when the cancer is shallow and small. Lastly, radiation therapy can be considered when surgery is not an option.

Because BCC is typically found on areas that are aesthetically and functionally important like the face, eyes, lips and nose, standard excision can be disfiguring. Consequently, micrographic surgery called Mohs surgery can spare healthy tissues, provide a cosmetic solution and reduce the risk of recurrence.

Low risk BCC is a public health issue. The main risk is ignoring a wound that won’t heal. Prevention is the essential to avoid skin cancer. Schedule your annual skin cancer checkup with Dr. Sotiriou at Salt Lake Dermatology & Aesthetics.  If you notice a lesion that is suspicious, don’t wait, contact him to schedule a consultation.