Basal cell carcinoma (BCC) is the most common form of skin cancer.
More than 250,000 cases of BCC are diagnosed in Australia each year.
BCC skin cancer usually develops on skin that gets the most sun exposure throughout life, such as on the head, neck, and back of the hands. BCC is especially common on the face, often developing on the nose. It is possible however, to get BCC on any part of the body, including the trunk, legs, and arms.
People who visit solariums have a much higher risk of getting BCC. They also tend to get BCC earlier in life.
This type of skin cancer grows slowly and thankfully very rarely spreads internally to other parts of the body. Treatment is still very important because BCC can have a very extensive growth pattern beneath the skin (like octopus tentacles) and grow wide and deep, destroying skin tissue and if left untreated for long enough nerves, muscle and bone can also be invaded and destroyed.
What does a BCC look like?
Based on their surface appearance to the naked eye there are many different types of BCC. If you notice any of the following features on your skin, you should sea Dermatologist for a thorough full skin examination
- Nodular BCC: dome-shaped pink or skin-coloured skin growth with visible blood vessels throughout. There may be some brown or black colouration (called a pigmented nodular BCC) or central crusting and breakdown (ulcerated nodular BCC)
- Superficial BCC: appears like a shiny pink or red, slightly scaly patch, most usually on the trunk. This type is often mistaken as a patch of eczema.
- Morphoeic BCC: this is the most difficult to diagnose as it tends to lie within the skin. It has a waxy scar-like feeling, hard on touch, with a pale-white to yellow or skin-color.
Based on their surface appearance to the naked eye there are many different types of BCC. If you notice any of the following features on your skin, you should see Dermatologist for a thorough full skin examination
How do I know if I have a BCC?
BCC’s are rarely painful nor itchy, usually presenting as follows:
- Bleeds easily.
- Won’t heal, or heals and returns.
- Oozes or crusts over.
- Has a sunken center, like a crater.
- Has visible blood vessels in or around it.
How is a BCC diagnosed?
A Specialist Dermatologist can often diagnose a BCC on visual inspection alone, but at times a skin biopsy (link) is necessary. A skin biopsy is usually performed during your office consultation
How are BCC treated?
If your Dermatologist diagnosis a BCC, then a number of treatment options are available. The best treatment for you will depend on the type of BCC you have, its location, your age and skin type
Nearly every basal cell cancer can be cured, especially when the cancer is found early and treated.
Surgical excision: This is a surgical procedure that your Dermatologist will usually perform in a minor procedures theatre within South West Sydney Dermatology or in a Private Hospital if you are covered by Private Health Insurance. Surgery involves numbing the area to be treated, carefully marking out the tumour outline, adding an extra margin of normal-looking skin around the BCC to ensure all its “roots” have been removed and then repairing the defect that remains using a variety of surgical techniques (link) The removed skin is sent to a pathologist to confirm under the microscope that the BCC is completely excised
Curettage and cauterisation: Using this treatment your Dermatologist will first scrape away all the visible tumor. Then heat via an electrocautery device is used to destroy any remaining non-visible cancer cells at the base
Mohs surgery: Named after the Doctor who developed the technique, Mohs (pronounced “moes”) is a specialised surgery technique used to remove some aggressive forms of BCC often found in difficult to access sites such as the ear canal and rim of the nose or eyelid margin. Mohs surgery offers the highest cure rate for difficult-to-treat basal cell cancers and preserves as much normal tissue as possible during the process. Your Dermatologist at South West Sydney Dermatology will advise you if Mohs Surgery is right for you
Cryosurgery: This treatment uses liquid nitrogen to freeze cancer cells, causing the cells to die.
Superficial radiation therapy: This treatment usually is reserved for BCCs that cannot be cut out, or when surgery may not be the best choice. A patient may need 15 to 30 radiation treatments.
Photodynamic therapy (PDT): This treatment uses a two-step process. First, a chemical is applied to the skin. The chemical remains on the skin for some time so that it can be absorbed preferentially by the malignant skin cancer cells. Then the skin is exposed to a special light to kill the cancer cells.
Medicated creams: Creams that contain a drug, such as imiquimod or 5-fluorouracil, can be used to treat early BCC. Your Dermatologists at South West Sydney Dermatology will advise if such a treatment is suitable
Oral medicine: A medication taken internally called Vismodegib is rarely used for BCC. This is reserved for rare cases where BCC has spread to other parts of the body, or when a patient has advanced often multiple BCC’s that cannot be treated using the traditional methods above