Basal Cell Carcinoma
What is Basal Cell Carcinoma?
Basal Cell Carcinoma (BCC) or ‘rodent ulcer’ is a non-melanoma skin cancer that starts in the cells lining the bottom of the epidermis (upper skin layer). It’s the most common type of skin cancer, with more than 75% of skin cancers diagnosed as Basal Cell Carcinoma.
Who gets Basal Cell Carcinoma?
This type of cancer usually presents itself in patients with fair skin, light eyes and hair colour and those with a history of childhood burn.
There are many more groups of patients who are prone to this condition. This includes patients with Gorlin syndrome or those with a suppressed immune system.
What causes Basal Cell Carcinoma?
As with many skin cancers, the most common cause is overexposure to ultraviolet (UV) light from the sun, or from sun beds and sun lamps.
Other risk factors include:
- Previous non-melanoma skin cancer
- A family history of skin cancer
- Pale skin that burns easily
- Having blonde or red hair
- A large number of moles or freckles
- Medications that suppress the immune system
- Co-existing medical conditions that suppress the immune system.
- Exposure to certain chemicals, such as arsenic
What are the symptoms?
Basal Cell Carcinoma usually grows quite slowly and often isn’t visible for many years.
Whilst it’s possible to get Basal Cell Carcinoma at a young age, the risk increases with age due to the cumulative sun exposure over the years.
Basal Cell Carcinoma is most commonly found on the face, however; they can appear on any part of the body.
What does it look like?
The appearance of Basal Cell Carcinoma varies depending upon the subtype of Basal Cell Carcinoma and location on the body.
You may notice at first small shiny bumps, often with a pearl-like appearance. They are often flesh-coloured and look like a mole, red patch, ulcer or a pimple that doesn’t go away.
Sometimes, these growths can grow quite dark, or you may see shiny pink or red patches that have a scaly like appearance to them. Occasionally they can present itself is a waxy, hard skin growth.
The growths with this type of cancer are often fragile and can bleed easily.
Does Basal Cell Carcinoma spread to other organs?
When you hear the ‘C’ word, it’s completely natural to feel worried, but please keep in mind that when caught early, Basal Cell Carcinoma can be rather straightforward to treat.
This type of cancer is unlikely to spread from your skin to other parts of your body. However, it can move into bones nearby especially if neglected for many years.
Getting a diagnosis
If you come across a mole or blemish or non-healing sore that you’re worried about, or if its appearance has changed, it’s important to see your doctor.
Your GP or dermatologist can examine your skin for any signs of skin cancer. Our expert Dermatologists use handheld illuminated magnifiers — dermatoscopes. These highlight specific signs of melanoma which may not be apparent to the untrained eyes.
At Everything Skin Clinic, we can diagnose and treat skin cancer all under one roof. This is important for people who don’t want referrals to different places, or want it removing as soon as possible.
We offer fast-track appointments to ensure immediate diagnosis and treatment of skin cancers.
What treatments are available?
There are various treatments available to remove the skin cancer. The aim of treatment is to get rid of the cancer completely. The treatment options available are:
Cutting out the tumour
Cutting out the tumour or ‘excision’ is one of the methods used by doctors to remove skin cancer.
Excision means the removal of skin cancer with 4-5mm of normal skin. This technique is most commonly used for Basal Cell Carcinomas on the trunk and limbs. For facial Basal Cell Carcinoma, we offer Mohs micrographic surgery
Named after the doctor who invented it, ‘Mohs Micrographic Surgery’ is a revolutionary treatment for this condition.
In Mohs micrographic surgery, which is also undertaken using local anaesthetic. First your doctor will numb the tumour and the skin around it, then your doctor will scrape the tumour with a spoon-shaped device called a ‘curette’
Following this, your doctor will cut the tumour and a small surrounding area of normal appearing skin and sent to a lab for examination.
Your dermatologist will then examine this tissue for presence or absence of Basal Cell Carcinoma cells.
These lab results will reveal if there are cancer cells in the area around the tumour. If there are, your doctor will remove more of the skin, which is then checked again. This means that you get the best chance of cure with Mohs micrographic surgery.
Your doctor may suggest some medicine that can treat your skin cancer. Prescribed creams that you apply directly to the affected area.
You may need to apply these creams for several weeks, in the meantime, your doctor will check regularly to see if these are working. Creams are usually only of benefit in treating superficial Basal Cell Carcinoma
Radiation treatment uses x-rays to destroy cancer cells. This treatment is often done for patients who do not like to undergo surgery or for very frail patients. This should not be the first choice of treatment as risk of recurrence following radiotherapy is higher than with surgery
Photodynamic Therapy (PDT)
This treatment involves the use of light-sensitive medication and a light source to destroy abnormal cells.
On their own, the light source and medication are harmless. But when used together, the medication once exposed to light activates and causes a reaction that damages nearby cells.
Curettage and Cautery
This method may also be referred to as ‘curettage and desiccation’. Your doctor will numb the skin and surrounding tissue and then use a curette- a tool that has a spoon-like shape to scrape off the tumour.
Your doctor controls the bleeding with a cautery an electric needle.
Are there any long-term effects?
All Surgical treatments result in scarring. The advantage of having surgical treatment in the hands of a fellowship trained dermatological surgeon is that they will give you the best cosmetic outcome.
Other risks with surgery include, bleeding, infection, numbness of treated area and recurrence of tumour.
Who will carry out my treatment?
At Everything Skin Clinic™, we have a team of highly trained Consultant dermatologists, who have completed specialist training in Dermatology and are on the specialist register of the General Medical Council. All our consultants hold substantive contracts with the best Dermatology centres in leading NHS hospitals. Therefore, you can be certain of the highest quality private dermatology acne care.
Treatments at Everything Skin Clinic
At Everything Skin Clinic, we treat Basal Cell Carcinoma with Mohs Surgery, Excision, Curettage, Creams and Photodynamic Therapy.
The choice of treatment depends on the type of Basal Cell Carcinoma, its location and patient preference.
Mohs Micrographic Surgery is different from other forms of surgery. It allows the immediate and complete microscope examination of the specimen. It is not possible for a surgeon to see the roots of a skin cancer under the skin surface without a microscope
Mohs surgery gives the best chance of cure for non-melanoma skin cancers compared to all other treatments. This even applies if the skin cancer has grown back following previous treatment.
It is also very valuable for preserving normal skin around important sites such as the nose, lips, eyes or ears and keeping the wound as small as possible.