Basal Cell Cancer - Patients ask, Dr. Ringpfeil answers
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Philadelphia and Mainline Center of Dermatology and Cosmetic Surgery
Basal Cell Cancer
Basal Cell Cancer - Overview
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.
Diagnosis
Basal cell carcinoma can be only slightly different than normal skin. Cancer may appear as a 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 the first sign 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.
Management
Complete removal of 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, the occurrence of basal cancer can signal that you had sufficient exposure to radiation throughout your life, 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.
Treatment and Medication
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, electrodesiccation 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.
Coping
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 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.
Prevention
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.
When my brother got skin cancer, I was very concerned. Thank you for the information about the risk factors about the cells of the skin continually exposed to UV radiation and how it can do damage to the cell’s DNA and life cycle. It is nice to know that it is easy to protect against developing skin cancer by administering sunscreen.
Hello! I was wondering if you treat Basal cell Ca with Mohs surgery in the office? or who would you recommend in the area of Mainline.Thank you very much
Our office does not currently offer Mohs microscopic surgery. We work with the most talented Mohs and dermatological surgeons on the Main Line and in Philadelphia when Mohs surgery is indicated to treat a basal cell carcinoma. Most of the time, it is performed about 6 weeks after biopsy, so that the biopsy site can sufficiently heal and the procedure is not complicated by undue inflammation. I recommend that you obtain a recommendation from your dermatologist who biopsied your basal cell carcinoma. If for any reason, you are uneasy about the recommendation from your dermatologist, our office would be happy to provide a short notice second opinion or on-line consultation to you as a new patient. You will need your pathology report for this purpose.
do you do body checks for skin cancers? Who is the best doctor to see for mole checks on body and to see if they need to be biopsied?
Our office provides full body skin checks for skin cancer screening. All of our dermatologists and our physician assistant provide this service. They will examine you “head to toe and in all creases”, and they are well trained to determine if a biopsy is necessary.