Basal Cell Carcinoma
I. Definition:
A basal cell carcinoma is a form of skin cancer.
Basal cell carcinomas are the result of sun damage to the skin. Basal cell carcinomas
enlarge slowly and steadily and can invade neighboring tissue, like the eye, but they
usually do not spread to distant parts of the body (metastasize). The only way to tell for
sure if a skin growth is cancerous is to biopsy it. This involves removing a small piece
of the skin and having a pathologist look at it under the microscope in a medical
laboratory. A biopsy does not remove the cancer, it only takes off the very top (like the
tip of an iceberg). Sometimes the skin will heal after the biopsy because it grows over
the cancer. This does not mean the cancer is gone, it means the cancer is now covered with
a blanket of skin. If the cancer is not removed completely it can go deep into the skin
and cause great harm.
II. Causes:
- Repeated, prolonged sun exposure causes skin
damage which may develop into basal cell carcinoma.
- The sun damage
responsible for a basal cell carcinoma usually occurred years before the cancer begins.
- Basal cell carcinomas are most common on the face
because the face receives more sunlight than other parts of the body.
- Fair-skinned individuals are more prone to skin
cancer than darker persons, since skin pigment protects the skin. Persons of African
ancestry with very dark skin practically never get basal cell carcinoma.
- People who get one basal cell carcinoma are likely
to develop more. Often people will develop a second basal cell carcinoma close to the spot
were one has been treated because the surrounding skin is just as damaged by the sun as
the skin where the first basal cell carcinoma grew.
III. Prevention:
- Sun exposure and sunbathing produce gradual skin
damage even if sunburn is avoided. Ten to forty years can pass between the time of sun
exposure and the development of skin cancer.
- Sun damage is permanent and irreversible. You
should put on sun-screen or moisturizer with an SPF of 15 or
higher everyday before leaving the house. Don't go overboard and try to avoid the sun
completely. The damage is already done; a little more sun will not make much difference.
- People who have had a basal cell carcinoma should
have a skin exam every six months to one year.
IV. Treatment:
- We cannot be sure whether a suspicious growth is a
basal cell carcinoma just by looking at it. In order to be sure, we must take a small
piece of the growth and send it for microscopic analysis (biopsy). The skin will often
heal after a biopsy. This is because the skin grows over the cancer like a blanket
- After a biopsy has been done and a basal cell
carcinoma is found by the pathologist, the tumor needs to be removed. Basal cell
carcinomas are not cured by doing a biopsy - further
surgery is required. Surgery always leaves a scar. There is no way to remove a basal
cell carcinoma without leaving a scar. Often the scar can be hidden in the skin folds.
Basal cell carcinomas are often much bigger under the skin then they appear on the
surface. What one can see on the surface is only the tip of the iceberg. That is why the
hole left after removing a basal cell cancer is often much larger than what can be seen
before surgery.
- The most important point about skin cancer is it
needs to be completely removed. Many people have lost body parts because of these tumors
and some people have lost their lives.
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