Basal Cell Carcinoma (BCC) or ‘rodent ulcer’ is a non-melanoma skin cancer that starts in the cells lining the bottom of the epidermis (upper skin layer). It’s the most common type of skin cancer, with more than 75% of skin cancers diagnosed as Basal Cell Carcinoma.
This type of cancer usually presents itself in patients with fair skin, light eyes and hair colour and those with a history of childhood burn. There are many more groups of patients who are prone to this condition. This includes patients with Gorlin syndrome or those with a suppressed immune system.
As with many skin cancers, the most common cause is overexposure to ultraviolet (UV) light from the sun, or from sun beds and sun lamps. Other risk factors include
- Previous non-melanoma skin cancer
- A family history of skin cancer
- Pale skin that burns easily
- Having blonde or red hair
- A large number of moles or freckles
- Medications that suppress the immune system
- Co-existing medical conditions that suppress the immune system.
- Exposure to certain chemicals, such as arsenic
What are the symptoms of Basal Cell Carcinoma?
Basal Cell Carcinoma usually grows quite slowly and often isn’t visible for many years. Whilst it’s possible to get Basal Cell Carcinoma at a young age, the risk increases with age due to the cumulative sun exposure over the years. Basal Cell Carcinoma is most commonly found on the face, however; they can appear on any part of the body.
Basal cell carcinomas can appear anywhere on the body, but most commonly found on areas of the body which are more frequently exposed to sunlight, including the face, head, neck and ears. There are several variants of basal cell carcinoma and in all cases, the lump may slowly get bigger, become crusty, bleed or develop into a painless ulcer:
- Superficial basal cell carcinomas appear as a red, scaly plaque and might resemble psoriasis or eczema
- Nodular basal cell carcinomas appear as a slightly shiny, pink or pearly-white translucent nodule which may ulcerate centrally and have blood vessels visible on their surface.
- Infiltrative (or morphoeic) basal cell carcinomas are less well-defined plaques and can be difficult to identify.
Can Basal Cell Carcinoma spread to other organs?
When you hear the ‘Cancer’ word, it’s completely natural to feel worried, but please keep in mind that when caught early, Basal Cell Carcinoma can be rather straightforward to treat. This type of cancer is unlikely to spread from your skin to other parts of your body. However, it can move into bones nearby especially if neglected for many years. It is really important that if you suspect you have Basal Cell Carcinoma that you get it checked by a doctor.
Treating Basal Cell Carcinoma
At Everything Skin Clinic, we treat Basal Cell Carcinoma with Mohs Surgery, Excision, Curettage, Creams and Photodynamic Therapy. The choice of treatment depends on the type of Basal Cell Carcinoma, its location and patient preference.
Mohs Micrographic Surgery is different from other forms of surgery. It allows the immediate and complete microscope examination of the specimen. It is not possible for a surgeon to see the roots of the skin cancer under the skin surface without a microscope. Mohs surgery gives the best chance of cure for non-melanoma skin cancers compared to all other treatments. This even applies if the skin cancer has grown back following previous treatment. It is also very valuable for preserving normal skin around important sites such as the nose, lips, eyes or ears and keeping the wound as small as possible.
Treating Skin Cancer at Everything Skin Clinic
Cutting out the tumour or ‘excision’ is one of the methods used by doctors to remove skin cancer.
Excision means the removal of skin cancer with 4-5mm of normal skin. This technique is most commonly used for Basal Cell Carcinomas on the trunk and limbs. For facial Basal Cell Carcinoma, we offer Mohs micrographic surgery.
Your doctor may suggest some medicine that can treat your skin cancer. Prescribed creams that you apply directly to the affected area. You may need to apply these creams for several weeks, in the meantime, your doctor will check regularly to see if these are working. Creams are usually only of benefit in treating superficial Basal Cell Carcinoma.
Photodynamic Therapy involves the use of light-sensitive medication and a light source to destroy abnormal cells. On their own, the light source and medication are harmless. But when used together, the medication once exposed to light activates and causes a reaction that damages nearby cells.
Radiation treatment uses x-rays to destroy cancer cells. This treatment is often done for patients who do not like to undergo surgery or for very frail patients. This should not be the first choice of treatment as risk of recurrence following radiotherapy is higher than with surgery.
Curettage and Cautery
This method may also be referred to as ‘curettage and desiccation’. Your doctor will numb the skin and surrounding tissue and then use a curette- a tool that has a spoon-like shape to scrape off the tumour. Your doctor controls the bleeding with a cautery – an electric needle.
Named after the doctor who invented it, ‘Mohs Micrographic Surgery’ is a revolutionary treatment for basal cell carcinoma. In Mohs micrographic surgery, your doctor will numb the tumour and the skin around it with local anaesthetic, then will scrape the tumour with a spoon-shaped device called a ‘curette’. Following this, your doctor will cut the tumour and a small surrounding area of normal-appearing skin and sent to a lab for examination.
Your dermatologist will then examine this tissue for the presence or absence of Basal Cell Carcinoma cells. These lab results will reveal if there are cancer cells in the area around the tumour. If there are, your doctor will remove more of the skin, which is then checked again. This means that you get the best chance of cure with Mohs micrographic surgery.
All Surgical treatments result in scarring. The advantage of having surgical treatment in the hands of a fellowship trained dermatological surgeon is that they will give you the best cosmetic outcome. Other risks with surgery include bleeding, infection, numbness of treated area and recurrence of tumour.
Why choose Everything Skin Clinic?
At Everything Skin Clinic™, we have a team of highly trained Consultant dermatologists, who have completed specialist training in Dermatology and are on the specialist register of the General Medical Council. All our consultants hold substantive contracts with the best Dermatology centres in leading NHS hospitals. Therefore, you can be certain of the highest quality private care.
We offer a range of treatments and can offer one, or a combination of treatments to achieve the best results. Unlike many other clinics, we can offer diagnosis and treatment all under one roof by expert consultant dermatologist, so you know you’ll be in safe hands.