Basal cell carcinoma is a skin cancer, caused by too much sun exposure, and is an epidemic among Caucasian women and men in their prime (age 40 and over). As a dermatologist, not a day goes by that I do not find a basal cell carcinoma on a patient.
Recently, basal cell carcinoma has been in the press as two journalists have reported their own experiences with basal cell carcinoma. Jacquielynn Floyd, Columnist for Dallas Morning News, used a picture in her article that Judy Noble Cloud had posted on her Facebook to illustrate “The ugly aftermath of surgery to remove cancerous skin spots.” The picture shows Ms. Cloud right after having multiple basal cell cancers removed from her face.
Shortly after that, I received my monthly Oprah Magazine. I saw that Beauty Editor, Valerie Monroe, had posted a picture of herself immediately after her basal cell cancer had been removed and again after the surgical site had healed.
In the spirit of “a picture is worth a thousand words” and the courage of others to post their after basal cell cancer surgery pictures, I will post my own immediately after surgery and after time has allowed it to heal:
What is Basal Cell Carcinoma?
Basal cells are one of the three main types of cells in the top layer of the skin, the epidermis. BCC is caused when our DNA is damaged from UV exposure (via direct sunlight or sunless tanning). Basal cell carcinoma is the most common type of skin cancer, and each year in the U.S. alone, an estimated 3.6 million cases are diagnosed.
Skin tumors, moles and spots, 3d section of the skin layer. Three types of skin cancer, squamous cell carcinoma, basal cell carcinoma, melanoma. 3d render
Basal cell carcinoma is usually found on sun-exposed areas. While it is not life-threatening, when it shows up on your face, it can cause severe disfigurement if left untreated. Surgical removal is the most common way to treat basal cell carcinoma. The earlier you catch basal cell carcinoma, the smaller the surgical scar to remove it. So, look closely at your face for any red spot, pimple, or sore that bleed, and if it persists for longer than three months, see your dermatologist.
There are normal growths that can mimic basal cell carcinoma, and a dermatologist can look at the spot and tell if it is suspicious enough to warrant a biopsy. After finding two basal cell cancers on myself, I recently had another biopsy that was not a basal cell carcinoma but an enlarged oil gland (thank goodness). A biopsy is performed under local anesthetic, where the spot is superficially shaved off and sent to a lab. A pathologist will look at the sample under a microscope and determine if it is a basal cell cancer or not.
Treatment Options
Your Dermatologist will counsel you about treatment. There are different options for types of surgery based on size of the cancer and location. I have had two basal cell cancers on my face. The first (twenty-one years ago) was on my temple, and I had a procedure known as an ED+C. It has not come back, and I have a scar that is barely perceptible. Two years ago, I had one near my nose (seen in the picture). That one was excised by a Dermatologist, and the tissue was sent to an outside lab to confirm margins were clear.
Moh’s Surgery
Ms. Monroe had Moh’s surgery on her basal cell carcinoma, which also involves excising the cancer, but the tissue is evaluated in the office lab to confirm clear margins before closing the wound. When appropriate, imiquimod cream can be used to treat basal cell carcinoma. The pros and cons of treatments are beyond the scope of this article and best discussed between you and your dermatologist.
Topical Treatments
When appropriate, your doctor may prescribe topical ointments to treat BCC. One option is imiquimod cream. This is used for superficial cases and basically causes the immune system to attack the cancerous cells. There are many treatment options when it comes to skin cancer, and the pros and cons are best discussed between you and your dermatologist.
We’ve finally entered into a sunny spring, and a long, hot summer is right around the corner. Before you leave the house every day, make sure to put on your sunscreen. Invest in some cute sunhats, and if you’re going to be out in the sun for an extended period of time, plan ahead and be prepared. More importantly, pay attention to your spots. And, don’t hesitate to see your dermatologist.
