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Basal Cell Cancer

Alternate Names

  • basal cell cancer
  • skin cancer (basal cell)
  • Basal cell carcinoma

Definition

Basal cell cancer occurs when skin cells undergo cancerous changes.

What is going on in the body?

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.

Risks

What are the causes and risks of the disease?

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.

Prevention

What can be done to prevent the disease?

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.

Diagnosed

How is the disease diagnosed?

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 color
  • change in size
  • change in shape
  • change in elevation
  • change in surface
  • change in surrounding skin
  • change in sensation
  • change in consistency

Long Term Effects

What are the long-term effects of the disease?

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.

Other Risks

What are the risks to others?

There are no risks to others from those who have basal cell cancer. It cannot be spread from one person to another.

Treatments

What are the treatments for the disease?

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.

Side Effects

What are the side effects of the treatments?

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.

After Treatment

What happens after treatment for the disease?

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.

Monitor

How is the disease monitored?

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.

Sources

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

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