Basal Cell Carcinoma

Skin cancers are the most common type of cancers, and there are three main types, which are divided into non-melanoma skin cancers, and melanoma.

Overview

The term ‘non-melanoma’ means cancers that develop slowly in the upper layers of the skin. These cancers are the more common types (basal and squamous cell carcinomas), whereas melanomas are rarer and can be more serious. Non-melanoma skin cancers (BCCs and SCCs) are still serious and require specialist medical attention and treatment, and this is why suspected pre-cancerous lesions should always be checked by a medical expert.

Non-melanoma skin cancers typically present in the outermost layers of the skin (also called the epidermis) and are frequently named after the type of skin cell from which they develop.

The term ‘basal’ does not always refer to skin cancer. Basal cells are present throughout the body, and are located at the bottom of the epidermis. They are constantly being shed and regenerating as part of the body’s natural processes.

In the case of basal cell carcinoma, the cancer forms in the basal cells that line the bottom of the epidermis - the thin, flat cells that make up the outermost layer of the skin.

Basal cell carcinoma is also known as a ‘rodent ulcer,’ because the cancer tends to ‘gnaw away’ at the skin, as though a rodent would. BCCs are the most common types of skin cancer - accounting for 75% of all skin cancers.



According to NHS data, around 150,000 new cases of non-melanoma skin cancer are diagnosed in the UK each year. Non-melanoma skin cancer is more likely to affect men than women, and it tends to affect older people with the rates being highest in those over the age of 75.



Symptoms of Basal Cell Carcinomas (BCC)

As non-melanoma skin cancer develops as a result of exposure to ultraviolet (UV) light, it most often presents in skin that has been regularly exposed to the sun – on the face, ears, hands, shoulders, upper chest and back. However, the popularity of unhealthy exposure to UV light – whether sunbathing on holiday, or the use of harmful tanning beds – means cancer may develop in other areas.

The first sign of a non-melanoma skin cancer is typically a lump, bump or discolouration in a small- to medium-sized patch that appears on the skin, and doesn’t resolve itself after 4 weeks of monitoring. This is known as a suspicious growth, which needs to be investigated by a doctor. Suspicious growths may also develop over time, changing shape, size or colour.

Basal cell carcinomas typically present as a small shiny pink, or pearly white lump, which may have a ‘waxy’ or translucent appearance. In roughly half of patients with darker skin tones, basal cell carcinoma will be pigmented (brown).

BCCs may also appear as scaly and red, meaning people who have other skin conditions – like eczema or psoriasis – might incorrectly self-diagnose the condition.

If non-melanoma skin cancers are not treated, it is possible that they will cause significantly worse damage. Basal cell carcinoma does not typically spread to other parts of the body, but it can have a more ‘aggressive’ form.

It is important that you visit your GP if you are worried about a lesion, and they will refer you to a dermatologist for treatment if they feel this is appropriate. It is important to self-monitor for any changes, and follow up with your GP if you have been asked to keep an eye on a lesion and have any concerns.

Causes of Basal Cell Carcinoma

The primary cause of basal cell carcinoma is overexposure to ultraviolet (UV) light either from the sun, or from harmful artificial tanning practices, such as sunbeds or sunlamps.

The exposure to ultraviolet radiation can cause the DNA of skin cells (keratinocytes) in the outer layer of the skin to change, which allows the skin cells to grow out of control, developing into BCCs.

Factors that may mean someone has an increased susceptibility to basal cell carcinomas include;

  • Previous skin cancer
  • Fair, or pale skin
  • A history of sun exposure, or historic use of indoor tanning beds
  • Chronic infections, or inflammation from burns, scars, or other skin conditions
  • Working outdoors 
  • Previous radiotherapy
  • Medications that suppress your immune system

Gender is also likely to play a role, as men are more susceptible to developing basal cell carcinomas than women.

Basal cell carcinomas can recur, and patients who have already been treated for BCCs are at increased risk of developing them again. This is because some cancer cells can be undetectable, even by skin cancer experts, and others can form ‘roots,’ extending beyond visibility. BCCs on the nose, ears and lips are most likely to recur, usually within two years.

Patients can manage their basal cell carcinoma by self-monitoring their skin for any changes, undergoing annual follow-up appointments, and being vigilant against lifestyle factors that increase risk.

While adhering to sun awareness advice – for example, staying out of the sun (especially during midday hours) and applying a broad-spectrum sunscreen - is best practice for everyone, patients who have previously had BCCs should take all precautions to avoid harmful UV rays. Staying in the shade, wearing a wide-brimmed hat and UV-blocking sunglasses outdoors are all recommended.

Treatment for Basal Cell Carcinoma at Derma

Your appointment with the dermatologist will begin with analysis of the affected area, and together you will discuss your medical history, before a course of treatment for basal cell carcinoma is recommended.

Many non-melanoma skin cancers can be treated by excision, which is a relatively painless procedure that can be performed efficiently and effectively. Depending on insurance, treatment can be carried out the same day as the consultation.

If basal cell carcinoma is recurrent, the dermatologist may recommend an alternate approach to excision, like MOHS surgery, which is a highly effective way of treating BCCs.

Please note that further tests – such as a biopsy – may be necessary. Follow-up appointments will be required to ensure that the BCC is properly treated, and your skin monitored for any changes, as having skin cancer is likely to increase susceptibility.

We see and treat more skin cancer patients than any other doctors in Reading, so you can be assured that Derma will provide the very best care, the latest research and the most effective treatments.

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For more information, or to book an appointment with Derma, please call the clinic or contact us.

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