Basal Cell Carcinoma

What You Need to Know About Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer, responsible for the majority of skin cancer cases. This form of cancer develops in the basal cells, located in the lowest layer of the epidermis, which is the skin's outermost layer. Although basal cell carcinoma is typically known for its slow growth and non-aggressive nature, it can still lead to significant local tissue damage if not treated promptly.

Basal cell carcinomas can manifest in various ways on the skin, including as red patches, pink growths, open sores, or shiny bumps. The primary cause of BCC is prolonged exposure to ultraviolet (UV) rays. While BCCs are rarely life-threatening when treated appropriately, they require medical attention to prevent complications.

Each year, nearly three million people are diagnosed with basal cell carcinoma. The condition is most commonly found in individuals with lifestyles that involve excessive exposure to UV rays. Although the average age of BCC patients is decreasing, the condition remains most prevalent among individuals over the age of 40. People with fair skin, blond or red hair, and blue, green, or grey eyes are at higher risk, as are men.

Effective Treatment Options for Basal Cell Carcinoma

When it comes to treating basal cell carcinoma (BCC), there are several effective options available, with the choice depending on the size, location, and severity of the cancer. One of the most precise and highly regarded treatments is Mohs surgery, a procedure where layers of cancerous tissue are progressively removed and examined until only cancer-free tissue remains.

This technique is particularly beneficial for BCCs located in areas where preserving healthy tissue is crucial, such as the face. Other treatment options include standard excisional surgery, where the tumor and some surrounding tissue are removed, cryotherapy, which involves freezing the cancer cells, and topical medications that can be applied directly to the skin. Radiation therapy is also an option for cases where surgery might not be feasible.

Early diagnosis and treatment are key to achieving the best outcomes and minimizing the risk of recurrence.

While basal cell cancer is most often caused by cumulative sun exposure, many cases can be prevented or caught early with the right habits. Practicing sun protection year-round and regular skin checks can help reduce risk. Understanding what BCC looks like, especially in the early stages, is critical for catching it before it becomes severe. 

Common preventative measures include:

• Using a broad-spectrum sunscreen with SPF 30 or higher daily, even on cloudy days
• Avoiding sun exposure during peak hours (10 AM – 4 PM)
• Wearing protective clothing, wide-brimmed hats, and UV-blocking sunglasses when outdoors
• Staying in the shade whenever possible, especially during midday
• Avoiding tanning beds, which significantly increase skin cancer risk
• Performing regular self-skin checks and being aware of BCC symptoms, such as shiny bumps, open sores, or scar-like patches
• Learning to recognize what basal cell carcinoma looks like using credible resources and basal cell carcinoma pictures of the early stages
• Scheduling annual total body skin examinations with a dermatologist for professional screening

Treatment for BCC depends on several factors, including the size, depth, and location of the lesion, as well as the patient’s overall health. With various effective approaches available, from surgical options to newer non-invasive therapies, it’s crucial to tailor the treatment to each case. Early intervention can improve outcomes and minimize scarring. Whether the goal is basal skin carcinoma removal or long-term management, knowing the range of available treatments is essential.

Non-Surgical Treatments

There are several non-surgical treatment options for patients who are not candidates for surgery or prefer less invasive approaches. These include topical medications such as imiquimod or 5-fluorouracil, which can be effective for superficial BCCs. 

Basal cell carcinoma radiation treatment may be recommended for older adults or those with tumors in difficult-to-operate locations. Electrodesiccation and curettage involve numbing the area, scraping off the lesion, and cauterizing it to destroy remaining tumor cells and control bleeding. Cryotherapy is another option, which freezes the lesion with liquid nitrogen. Additionally, superficial radiation therapy (SRT) treatment for skin cancer is emerging as a non-invasive alternative for certain patients, particularly for low-risk lesions.

Surgical Procedures

Surgery remains the most common and effective option for basal cell carcinoma treatment. Excisional surgery involves cutting out the cancerous lesion along with a small margin of healthy tissue to ensure complete removal. Another highly effective technique is Mohs surgery for basal cell carcinoma, especially used for facial areas or lesions with a high risk of recurrence. 

This precise method involves removing the cancer layer by layer while examining each layer under a microscope, ensuring minimal damage to surrounding healthy skin. Mohs surgery offers the highest cure rates, around 98% for primary, non-recurrent BCC, while preserving healthy tissue and delivering excellent cosmetic outcomes. 

New and Emerging Treatments

Advancements in skin cancer treatment have led to promising new therapies for basal cell carcinoma. Targeted drugs such as hedgehog pathway inhibitors are used for advanced or recurrent cases that don’t respond well to conventional treatment. Immunotherapy and photodynamic therapy are also being explored in clinical settings for patients who need alternatives to traditional basal cell carcinoma surgery.

Topical therapeutic options, including certain creams or ointments, may also be considered for specific lesions. Your dermatologist will discuss these based on the characteristics of your basal cell carcinoma.