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About Basal Cell Skin Cancer |
Most skin cancer can be prevented, yet one
in five Americans will develop some form of skin cancer during their
lifetime(1). Basal
cell carcinoma (BCC) is the most common type of skin cancer and appears
most often on sun-exposed areas of the body. BCC usually
develops slowly, and as a result can often be detected and treated
early. Both basal cell carcinoma and squamous cell carcinoma have a
better than 95 percent cure rate if detected and treated early.(1)
If left untreated, however, it can be locally invasive,
aggressive, and destructive of surrounding and underlying tissue,
such as muscles and bones. Fortunately it is rare that basal cell
carcinoma metastasizes (spreads) to other parts of the body.(3)
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Photos of Basal Cell Skin Cancer |
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Nodular Basal Cell |
Pigmented Basal Cell |
Basal Cell |
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Key Warning Signs of Skin Cancer |
- New growth,
- A spot or bump that’s changing in character (i.e. getting larger,
changing in color, getting darker, causing symptoms such as itching) or
- A sore that
doesn’t heal within 3 months.(4)
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What factors
increase the risk of developing basal cell carcinoma? |
- Heavy sun exposure
- Especially
in childhood: 80 percent of a
person’s lifetime sun damage occurs before the age of 18
- Five or more sunburns double your
risk of developing skin cancer. (1)
- Working outside without
using protection from the sun
- Living close to the
equator
- Light skin color
- Poor tanning capacity
- Freckling in childhood
- Blond or red hair
- Blue or light-colored eyes
- Celtic ancestry, such
as Irish or Scottish
- Age over 40
- Family history or a personal history of
skin cancer
- History of infection
with the human papillomavirus.
- History of therapy with x-rays for
facial acne
- History of ingestion of Arsenic (1,3)
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Prevention and Detection |
- Wear a broad-spectrum sunscreen with a
sun protection factor (SPF) of at least 15, ideally 30 or
more
- Use sunscreens every day if you are
going to be in the sun for more than 20 minutes.
- Apply sunscreens to dry skin 15 to 30
minutes before going outdoors.
- When applying sunscreen,
generously coat the skin
that is not covered by clothing and
pay particular
attention to the face, ears, hands and arms, back of the neck,
and exposed areas of the scalp.
- Reapply sunscreens every two hours
or immediately after swimming or strenuous activity
- Avoid outdoor activities between 10
a.m. and 4 p.m. when the sun’s rays are the strongest;
Follow the “Shadow Rule” –
if your shadow is shorter than you are, the sun’s damaging rays
are at their strongest and you are likely to sunburn;
- Seek shade whenever possible;
- Wear sun-protective clothing and
accessories, such as wide-brimmed hats.
- Wear sunglasses that are UV
protective
- Avoid tanning beds
(2)
-
Regular skin exams are important: The American Cancer
Society recommends a cancer-related checkup, including a skin exam
when you have your regular health exams. You should also check you
own skin once a month. This is best done in front of a full-length
mirror. A hand-held mirror can be used for areas that are hard to
see. You should know the pattern of moles, freckles, and other marks
on your skin so that you’ll notice any changes.
Be sure to show your
doctor any area that concerns you. The key warning signs are:
- a
new growth,
- a spot or bump that’s changing in character (i.e. getting larger,
changing in color, getting darker, causing symptoms such as itching) or
- a sore that
doesn’t heal within 3 months.(4)
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Diagnosis and Treatment |
A skin
biopsy, performed in the doctor's office, is required to confirm the
diagnosis and to further identify the histologic subtype.
(To read more details about a skin biopsy,
click here.)
Additional workup is rarely necessary, unless a genetic disorder is
suspected. If the lesion turns out to be BCC, surgical
treatment is essential so that malignant tissue cannot proliferate
further. Although it rarely metastasizes,
it can be locally
invasive and destructive of surrounding and underlying tissue.
Most common surgical methods are
curettage, excision with margin examination, and Mohs micrographic
surgery. Treatments that are effective for most nonaggressive BCCs
include radiotherapy and cryotherapy.(5)
(To read about these procedures in detail,
click here.)
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After Treatment |
After the skin cancer has been removed, it will either be allowed to
heal naturally, or reconstructive surgery using a skin flap or skin
graft may need to be performed.
It's very important to
follow the above
preventive measures and keep your physician's follow-up
appointments because:
1) Skin cancer often recurs even after it has been completely
removed and thought to be cured.
2) If the cancer does recur, it is most likely to recur within 5
years of treatment.
3) If you have had one skin cancer, you are at high risk for
developing another one.
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Videotutorial |
Educational Video Tutorial about Skin Cancer from Medline Plus Locate the "Interactive Tutorials"
button in the upper R hand column. This will take you to
an extensive list of available videos; scroll down to "Skin Cancer" and
follow the directions. Medline
Plus is a service of the National Library of Medicine and the National
Institute of Health.
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References for Basal Cell Skin Cancer |
(1) American Academy of Dermatology, Skin Cancer Fact Sheet at www.aad.org
(2) American Academy of Dermatology Timothy M. Johnson, MD, chair of the American Academy of
Dermatology's Melanoma/Skin Cancer Committee and Associate
Professor, Department of Dermatology, University of Michigan, Ann
Arbor, Mich
(3) Leffell DJ, Fitzgerald DA (1999). Basal cell carcinoma. In IM
Freedberg et al., eds., Fitzpatrick's Dermatology in General
Medicine, 5th ed., pp. 857–864. New York: McGraw-Hill.
(4) American Cancer Society How is nonmelanoma skin cancer found? Cancer Reference
Information at www.cancer.org
(5) Basal Cell Carcinoma from emedicine.com
Read more at:
US National Library of Medicine & Nat'l Institute of Health
This site provides extensive information and links to the latest
news, overview of the basics, treatment, disease management,
nutrition, emotional coping, clinical trials, research, and
national
organizations skin cancer |
| --Written by N Thompson, ARNP
in collaboration with M Thompson, MD, Internal Medicine, Last updated January 2009 |
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