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Basal Cell Carcinoma

Basal cell carcinoma (BCC) of the skin is the most common cancer in the world, and accounts for 80% of all skin cancer in the USA. BCC is a cancer of the top layer of the skin, and is usually caused by exposure to ultraviolet rays in the sun or in tanning salons. Basal cell skin cancers rarely spread to other parts of the body, and deaths from BCC are extremely rare. Because they occur most commonly on the face, treatments may lead to a scar in a noticeable location. After having a skin cancer, regular follow up with your dermatologist for skin cancer screening is highly recommended.

Most common locations for a BCC to develop:
◦ Face.
◦ Scalp.
◦ Neck.
◦ Hands.
◦ Ears.
◦ Can be on any part of the body.

Signs of a BCC:
◦ Small smooth pink thin growth.
◦ A pink flat scaly spot, may look irritated.
◦ A waxy looking bump.
◦ A white, clear or yellow scar-like area.
◦ A smooth bump with a central indentation.
◦ A pimple that does not heal; it may bleed.
◦ Not painful.

Treatment for basal cell skin cancer:
◦ A biopsy must be performed to confirm the diagnosis.
◦ Treatment for BCC depends on the size and location of the lesion, how deep the tumor extends, the health of the patient.
◦ Topical chemotherapy with creams may be useful for very early and thin BCCs, but the tissue is typically not biopsied after treatment to check if any cells remain.
◦ Curettage and electrodessication is a simple procedure where the skin cancer is scraped away and the base is cauterized; used most for low-risk tumors on the trunk.
◦ Surgery/Excision is a treatment where the lesion is surgically removed, stitches are placed, and the tissue is sent to the lab for confirmation that it has been completely removed.
◦ Mohs surgery is a specialized form of skin cancer removal where the tumor is removed and the tissue is examined prior to stitch placement; this is used mainly for the face, ears, scalp, hands and genitals, but may also be used if the tumor is very large.
◦ Radiation is useful for very large tumors in patients unable to undergo a large surgical procedure, or in patients where it is difficult to remove all of the tumor.

How to prevent basal cell skin cancer:
◦ Avoid excessive exposure to the sun all year.
◦ Seek the shade when outdoors.
◦ Avoid the midday sun, between the hours of 10am and 4pm.
◦ Use broad spectrum sunscreen with an SPF of 30 or higher.
◦ Reapply sunscreen every 2 hours and after getting the skin wet.
◦ Do not use tanning beds.

Am I at risk for developing a BCC? Risk factors include:
◦ Fair skin.
◦ History of excessive sun exposure and sunburns.
◦ Personal or family history of skin cancer.
◦ Weakened immune system (eg. cancer or immunosuppressive medications).
◦ Exposure to radiation, arsenic, coal tar, other industrial chemicals.