Basal cell carcinoma is a type of skin cancer. It is a malignant epithelial cell tumor that begins as a papule (a small, circumscribed, solid elevation of the skin) and enlarges peripherally, developing into a crater that erodes, crusts and bleeds. Metastasis is rare, but local invasion destroys underlying and adjacent tissue. In 90 percent of all cases, the lesion is seen between the hairline and the upper lip.
Basal cell carcinoma (BCC) is the most common form of skin cancer. It also is the most common cancer in the world, and the number of cases continues to rise. The reason for this rise might be that people are receiving more unprotected exposure to the harmful ultraviolet (UV) rays of the sun.
The likelihood of developing BCC also increases when you have one or more of the following risk factors: -
Blond or red hair.
Blue or green eyes.
Family history of skin cancer.
Weakened immune system.
Received radiation therapy.
Exposure to coal tar, pitch, creosote, or arsenic.
Age is another risk factor. BCC can occur at any age, but the risk of developing this skin cancer increases significantly with age.
A biopsy is required to diagnose skin cancer. A dermatologist can perform this simple procedure in the office by numbing the area and then removing the suspicious lesion (or a portion of it). The removed tissue is examined under a microscope to see if cancer is present.
When the diagnosis is BCC, the dermatologist has a number of surgical and non-surgical options. The appropriate treatment depends on the size, location, and characteristics of the tumor, as well as the overall health and needs of the patient.
Most BCCs are treated with one of the following: -
SIMPLE SURGICAL EXCISION : - The dermatologist cuts out the tumor and some of the surrounding healthy tissue. The removed tissue is examined under a microscope to see if all of the skin cancer has been removed.
MOHS MICROGRAPHIC SURGERY : - Performed by a specially trained dermatologic surgeon, Mohs involves removing the visible tumor and then successive layers of skin one at a time until cancer cells are no longer found.
ELECTRODESICCATION AND CURETTAGE : - The dermatologist removes the tumor by scraping or 'curetting' it, and then burning the base with an electric needle. The latter is 'electrodessication.'
CRYOSURGERY : - The dermatologist destroys the tumor by freezing it with liquid nitrogen.
RADIATION THERAPY : - High energy x-rays are used to damage/kill the cancer cells and prevent the growth of new cancer cells.
LASER SURGERY : - High-intensity focused light waves are used to destroy the cancerous tissue.
TOPICAL THERAPY : - The dermatologist prescribes a cancer-fighting medication, such as imiquimod or 5-fluorouracil, which the patient can apply to the skin cancer at home.
PHOTODYNAMIC THERAPY ; - A medication is applied to the skin, and light is used to activate the medication.
Treatment varies depending on the size, depth, and location of the basal cell cancer. It will be removed using one of the following procedures: -
Excision cuts the tumor out and uses stitches to place the skin back together.
Curettage and electrodesiccation scrapes away the cancer and uses electricity to kill any remaining cancer cells.
Surgery, including Mohs surgery, in which skin is cut out and immediately looked at under a microscope to check for cancer. The process is repeated until the skin sample is free of cancer.
Cryosurgery freezes and kills the cancer cells.
Radiation may be used if the cancer has spread to organs or lymph nodes or for tumors that can't be treated with surgery.
Skin creams with the medications imiquimod or 5-fluorouracil may be used to treat superficial basal cell carcinoma.
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