Basal Cell Carcinoma
Ageless Beauty

What You Should Know About Basal Cell Carcinoma

May is skin cancer awareness month. If you haven’t seen your doctor in the recent past, now is the perfect time to schedule your skin cancer screening with a Dermatologist. One form of cancer they’ll inspect you for is basal cell carcinoma (BCC), which is a skin cancer that is caused by too much sun exposure.

What is Basal Cell Carcinoma?

Basal cell carcinoma is an epidemic among Caucasian women and men in their prime (age 40 and over). 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.  

three types of skin cancer

Basal cell carcinoma is usually found on sun-exposed areas. While it is not life-threatening, it can cause severe disfigurement if left untreated when it shows up on your face. The earlier you catch this form of cancer, the easier and less invasive it will be to remove it. That’s why it’s so important to look closely at your face for any red spot, pimple, or sore that bleeds, and if it persists for longer than three months, see your dermatologist.

Basal Cell Carcinoma

Treatment Options 

Surgical removal is the most common way to treat basal cell carcinoma, but there are a variety of treatment options to consider. It’s important that you find and treat BCC early on in its development because the earlier you catch it, the smaller the scar you’ll have. Surgery isn’t the only option; your doctor might also suggest cryotherapy (freezing off the spot with liquid nitrogen), laser surgery, photodynamic therapy, topical ointments, or another treatment option that they deem appropriate for your situation. 

Biopsy and Surgery

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 BCC 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.

Your Dermatologist will counsel you about treatment. There are different options for types of surgery based on the 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 barely perceptible scar.  Two years ago, I had one near my nose (see below). A Dermatologist excised that one and sent the tissue to an outside lab to confirm margins were clear.

In the spirit of “a picture is worth a thousand words” and the courage of others to post their after-surgery pictures, I will post the images of my BCC from immediately after surgery as well as after allowing for time to heal:

Immediately after surgery:

Basal cell carcinoma after surgery

After healing: 

Basal cell carcinoma after surgery and healing

Moh’s Surgery

Another treatment option is Moh’s surgery. This is considered the gold standard when treating basal cell carcinoma, and it has a cure rate of up to 99 percent of tumors treated for the first time. This procedure also involves excising the cancer, but the tissue is evaluated in the office lab to confirm clear margins before closing the wound. The surgeon will remove the visible portion of the tumor and a minimal amount of healthy tissue around it and observe it under the microscope. If any cancer cells remain, they can remove additional tissue and continue the process until no cancer cells remain. They’ll then close the wound, and you’ll have completed the treatment in only one office visit without the need to send your sample to an outside lab. 

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.

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