Basal cell cancer occurs when skin cells undergo cancerous changes.
Over 500,000 people a year in the U.S. are affected by basal cell carcinoma. Basal cell cancer begins in skin cells that have been damaged by exposure to the sun over many years. That is why most of these cancers occur on the head or neck. Middle-aged or older persons and those people who work outside are the most likely to develop these cancers.
Damage by sunburn over and over again can cause skin cells to lose their ability to repair themselves. Cancer develops when the damage causes the cells to grow and divide abnormally. These cancerous cells can become tumors and will damage the skin around them.
Basal cell cancer may start as a well-defined area of the skin that appears different than the surrounding skin. The basal cell cancer may be more smooth in appearance than the surrounding skin, with loss of the normal small pits in the skin, or it may appear as a skin ulcer with heaped-up edges.
These areas may appear and then grow rapidly. The coloration and shape of the basal cell carcinoma can vary considerably. It may be hard to tell if a spot on the skin is basal cell cancer, another kind of skin cancer, or a normal mole. Sometimes an area of basal cell cancer is less well defined and looks like a flat scar.
Exposure to the sun over many years is the cause of basal cell cancer. The more often a person is exposed to the sun, the more likely it is that later in life an area of basal cell cancer will develop.
Avoiding exposure to the sun is very important. Spending less time in the sun will greatly reduce a person's chances of developing basal cell cancer. When exposure to the sun is unavoidable, a person should use protective sunscreens. However, sometimes people spend more time in the sun when they are using sunscreen. It is important not to spend too much time in the sun whether the skin is protected or not.
Sometimes the person notices an unusual thickening, bump or ulcer on the skin. This area may grow, change colors, itch, or otherwise make the person suspect that there is a problem. Other times, a healthcare professional may notice a suspicious skin lesion during a routine physical exam. In either case, the professional must remove the lesion and have it examined microscopically to confirm that it is basal cell cancer.
The following changes in an area of skin should be checked by a healthcare professional: change in colorchange in sizechange in shapechange in elevationchange in surfacechange in surrounding skinchange in sensationchange in consistency
If basal cell cancer is not treated, it will destroy the skin around it. It can destroy underlying tissue as well. Basal cell cancer generally only affects the tissue and structures around it. It does not usually spread to lymph nodes or through the blood to other areas of the body. As with any cancer, early detection is important.
There are no risks to others from those who have basal cell cancer. It cannot be spread from one person to another.
Basal cell cancer is treated with simple surgery. All of the cancerous tissue and a small amount of surrounding tissue are removed. Most of the time, this cures the cancer completely. The affected area can also be frozen with substances such as liquid nitrogen. Freezing the basal cell cancer will kill it.
Sometimes, medicine such as fluorouracil can be applied to the area to kill the cancer. If the basal cell cancer comes back, any of these methods can be used again. Many times, though, surgery will be used to treat basal cell cancer that has come back.
Radiation therapy can also treat and cure basal cell carcinoma and preserve adjacent normal tissue. Radiation therapy is especially valuable for treating basal cell carcinomas on the nose, eyelids or ear, where surgery may leave a visible deformity. Radiation treatments treat the surface of the skin, and the treatments are given daily over a few weeks.
A person usually recovers from surgery without any complications. There is usually only minor discomfort as the skin heals. Radiation therapy results in thinning of the skin in the treated area.
Someone who has had one basal cell cancer is likely to develop more in the future. A person should watch for any new skin lesions that may develop. That person should also monitor any area where basal cell cancer has been removed. Any new lesions or changes in the treated area should be reported to a healthcare professional.
The treated area will be followed closely by a healthcare professional for any signs of regrowth of the cancer. The person him- or herself should also check the area often and report any new or worsening symptoms.
Salmon, S.&Cassady, J.R (1999). Cutaneous Cancer and Malignant Melanoma in Cancer: Principles and Practice of Oncology. 5th Edition DeVita, V.T. (ed). J.B. Lippincott:Phildephia. Pp.1026-1027.
Itano, Joanne, Taoka, Karen 1998 Core Curriculum for Oncology Nursing, Third Edition W. B. Saunders Company Pp. 552-553
