Basal Cell Carcinoma Danielle Robbins Abstract This paper briefly describes basal cell carcinoma. Several scientific studies and articles are referenced to further present the causes, symptoms, tests, treatments, and prognosis of basal cell carcinoma. Also included in this paper are the different types of basal cell carcinoma and the populations that are affected. Basal cell carcinoma (BCC) is a skin cancer that starts in the epidermis (Medline Plus, 2012). The Skin Cancer Foundation defines BCC as an “abnormal, uncontrolled growth or lesion that arises in the skin’s basal cells, which line the deepest layer of the epidermis” (2012).
BCC is a significant health problem, with an estimated 2. 8 million cases diagnosed each year (Dogan, 2007). It is the most common type of cancer found in humans, and accounts for 75% of all cancers (Skelton, 2009). There are several factors that contribute to the cause of BCC. These factors include, light colored skin, light colored eyes, blonde or red hair, overexposure to x-rays or radiation, many moles, genetics, many severe sunburns early in life, and long term daily sun exposure (Medline Plus, 2012).
Individuals with light colored skin, hair, and eyes have poor tanning abilities and are more likely to have sun-damaged skin (Roewart-Hober, 2007). Radiation therapy in childhood for ringworm on a 58 year old patient caused an aggressively growing BCC that took over most of the posterior scalp (Asilian, 2005). Genetics also contribute to your likelihood of getting a BCC. A family history of skin cancer can increase your chances of having a BCC (Skelton, 2009). Also, there is several inherited and acquired skin disorders associated with BCC.
These disorders include xeroderma pigmentosum, nevoid basal cell syndrome, Bazex-syndrome, Rasmussen syndrome, Rombo syndrome, and albinism (Roewert-Hober, 2007). Although there are several contributing factors to BCC, the number one cause is sun exposure and other ultraviolet radiation like tanning beds. The depletion of the ozone layer, responsible for the restriction of carcinogenic UV ray transmission, further increases the worldwide prevalence of BCC (Roewert-Hober, 2007). Recently, the media have helped to heighten awareness and generate concern about skin cancer, and President Obama even implemented the tanning tax (Skelton, 2009).
Symptoms of BCC include bumps or growths on the skin that are pearly or waxy, white or light pink, flesh-colored or brown. The skin may be raised or flat with soreness, bleeding, or oozing. The affected area may not heal, look like a scar, or have a depressed area in the center. (Medline Plus, 2012). The most common type of BCC is nodular. Nodular BCC presents itself as a round, flesh-colored papule (Skelton, 2009). The area around the nodule may have a border with dilated blood vessels causing the skin to be red (Skelton, 2009).
Another common type of BCC is keratotic. Keratotic BCC is diagnosed by the presence of prominent keratin formations in the center of the tumor that look like horns (Skelton, 2009). Most BCC’s are easily spotted and diagnosed by dermatologists by the size, shape, color, and texture of the area. Sometimes the lesion’s appearance is questionable and may be difficult to recognize (Goldberg, 1996). In this case, a physician would perform a skin biopsy by removing a piece of the suspicious area and sending it to a lab for examination under a microscope (Medline Plus, 2012).
This test will determine if the questionable lesion is benign or malignant. After a BCC is identified, treatment is prescribed. Effective treatments of BCC include excision, curettage, cryosurgery, and topical medication. A type of procedure that involves excising the skin cancer is called Mohs surgery. Mohs surgery has come to be accepted as the single most effective technique for removing BCC (Skin Cancer Foundation, 2012). Mohs is done in stages, by taking the smallest amount of tissue possible and testing it under the microscope before closing the wound.
When examining the tissue microscopically, Mohs surgeons can tell if the margins are clear of BCC skin cancer cells (Skelton, 2009). Curettage is used when the BCC is less than 1 cm in diameter (Skelton, 2009). Curettage involves removing the tumor by scrapping and then destroying the base with a cautery (Skelton, 2009). When BCC is very superficial, cryosurgery and topical medications may be used. Cryosurgery involves the destruction of the lesion using liquid nitrogen (Skelton, 2009).
Aldara is a common topical cream that is prescribed for small superficial BCCs (Skelton, 2009). Even though BCC is a slow growing cancer, if left untreated, it may grow into surrounding areas and nearby tissues and bone. As previously mentioned in the extreme case of the 58 year patient, his neglected BCC caused hearing loss to his left ear, and paralysis to the left side of his face (Asilian, 2005). The prognosis of a patient with BCC depends on how early diagnosis and treatment occur. Most of the time, BCC is cured when treated early (Roewart-Hober, 2007).
Individuals that are predisposed to skin cancer can reduce their chances of getting a BCC by protecting their skin with sunscreen and avoiding tanning beds (Skin Cancer Foundation, 2012). Regular full body exams preformed by a dermatologist is also a preventative measure to BCC (Medline Plus, 2012). Use of a hand mirror during self examination is also helpful for hard to see places (Medline Plus, 2012). In conclusion, basal carcinoma is the most common type of skin cancer. This paper has discussed the causes, symptoms, tests, treatments, prognosis, and prevention of basal cell carcinoma.
If treated early, BCC has an excellent prognosis. If neglected and left untreated, the lesion may spread, disfiguring the face or body and comprising functions of surrounding nerves and tissues. References Asilian, A. , & Tamizifar, B. (2005). Aggressive and Neglected Basal Cell Carcinoma. Dematologic Surgery, 31(11), 1468-1471. Basal Cell Carcinoma. (N. D. ) retrieved September 28, 2012 from http:/www. nlm. nih. gov/medlineplus/ency/article/000824. htm Basal Cell Carcinoma. (N. D. ) retrieved September 28, 2012 from http:/www. skincancer. org/skin-cancer-information/basal-cell-carcinoma.
Dogan, G. (2007). Basal cell carcinoma in ourdoor versus indoor workers in Turkey. International Journal Of Dermatology, 46(1), 43-46. Doi:10. 1111/j. 1365-4632. 2006. 03042. x Goldberg, Leonard H. ( 1996). Basal Cell Carcinoma. The Lancet 347. 9002 Roewert-Huber, J. J. , Lange-Asschenfeldt, B. B. , Stockfleth, E. E. , & Kerl, H. H. (2007). Epidemiology and aetiology of basal cell carcinoma. British Journal of Dermatology, 15747-51. Skelton, L. (2009). The effective treatment of basal cell carcinoma. British Journal of Nursing, 18(16), 346-35-350.