Basal Cell Cancer - Patients ask Dr. Ringpfeil answers
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Basal cell carcinoma is the most common malignant skin tumor. It is a painless, slow-growing form of non-melanoma skin cancer. Basal cell carcinoma initiates in the top layer of the skin called the epidermis. Increased risk of disease is associated with light-colored skin, blue or green eyes, blond or red hair and over-exposure to UV rays, x-rays or other forms of radiation. Basal cell carcinoma almost never spreads inside the body. But, if left untreated, it may grow into surrounding areas and nearby tissues and bone. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation.
Basal cell carcinoma can be only slightly different than normal skin. The cancer may appear as bump or growth that is pearly or waxy, white or light pink, flesh-colored or brown. In some cases the skin may be just slightly raised or even flat. A new skin growth that bleeds easily or does not heal well may be first signs of basal cell carcinoma. Diagnosis requires a complete medical history and evaluation of the affected area of skin (size, shape, color, and texture of any suspicious areas), and often includes biopsy for examination by a pathologist.
Complete removal of a basal cell cancer is the most important primary step. The rate of basal cell skin cancer locally returning is about 1-10% depending on the form of treatment. Untreated, basal cell cancer can spread to nearby tissues or structures, causing damage. This is most worrisome around the nose, eyes, and ears. Basal cell carcinoma rarely spreads to other parts of the body. However, occurrence of a basal cancer can signal that you had sufficient exposure to radiation over your lifetime making it more likely to grow additional basal cell carcinomas. Monthly self-examination of your skin is a critical process to notice any suspicious skin changes. Meticulous follow-up with your doctor twice a year is highly recommended.
A number of therapies exist for treating basal cell carcinoma. The most appropriate one depends on the type, location and severity of the tumor. The most common basal cell carcinoma treatments are surgical excision including Mohs' surgery where necessary, electrodessication and curettage, freezing, laser surgery and topical treatments such as Tazarotene (Tazorac), imiquimod (Aldara) and 5-fluorouracil. Prescription medications require careful supervision for severe skin irritation as well as systemic side effects.
Primary aspects of coping with basal cell carcinoma relate to restrictions to sun exposure (leisure time and outdoor work) as further sun exposure will increase your chance to form basal cell carcinoma elsewhere on your exposed skin. In addition, one must adjust to the change in skin from the primary cancer as well as from the scar after removal of it. Depending on the severity, an important psychological aspect may be the sense of illness (cancer). Emotional reactions include worry, fear, irritation, doubt, guilt, and anxiety. The ideal approach to the disease is to understand the causes and implement preventative behavioral measures.
The optimal way to prevent most basal cell carcinomas is to reduce your exposure to natural or artificial sunlight. Protect your skin by wearing a hat, long-sleeved shirts, long skirts, or pants. Always use sunscreen. Apply high-quality sunscreens that block both UVA and UVB light. Apply sunscreen at least 30 minutes before going outside, and reapply it at least every 2 hours. Use sunscreen on exposed areas all year round.