Definition Basal cell cancer occurs when skin cells undergo cancerous changes.
What is going on in the body? Basal cell carcinoma is the most common but least dangerous type of skin cancer, making up about 75% of skin cancers in Australia. Basal cell cancer arises from cells that have been damaged by exposure to the sun over many years. That is why most of these cancers occur on the head or neck. Middle-aged or older persons and those people who work outside are the most likely to develop these cancers. Skin that has been damaged by sunburn over and over again can cause skin cells to lose their ability to repair themselves. Cancer develops when the damage causes the cells to grow and divide abnormally. These cancerous cells can become tumours and will damage the skin around them.
What are the signs and symptoms of the disease? Basal cell cancer may start as a well-defined area of the skin that changes colour. These areas may appear and then grow. The colouration and shape of the basal cell carcinoma can vary considerably. It may be hard to tell if a spot on the skin is basal cell cancer, another kind of skin cancer, or a normal mole. Sometimes an area of basal cell cancer looks like a scar or a red scaly rash.
What are the causes and risks of the disease? Exposure to the sun over many years is the major cause of basal cell cancer. The more often a person is exposed to the sun, the more likely it is that later in life an area of basal cell cancer will develop.
What can be done to prevent the disease? Avoiding exposure to the sun is very important. Spending less time in the sun will greatly lower a person's chances of developing basal cell cancer. When exposure to the sun can't be avoided, a person should use protective sunscreens. However, sometimes people spend more time in the sun when they are using sunscreen. It is important not to spend too much time in the sun whether the skin is protected or not.
How is the disease diagnosed? A person notices an unusual spot or bump on the skin. This area may grow, change colours, itch, or otherwise make the person suspect that there is a problem. A doctor must remove the area and have it examined to confirm that it is basal cell cancer. The following changes in an area of skin should be checked by a doctor:
change in colour
change in size
change in shape
change in elevation
change in surface
change in surrounding skin
change in sensation
change in consistency
What are the long-term effects of the disease? If basal cell cancer is not treated, it will destroy the skin around it. It can destroy underlying tissue as well. Basal cell cancer generally only affects the tissue and structures around it. It doesn't usually spread through the blood to other areas of the body. As with any cancer, early detection is important.
What are the risks to others? There are no risks to others from those who have basal cell cancer. It cannot be spread from one person to another.
What are the treatments for the disease? Basal cell cancer is treated generally with simple surgery. All of the cancerous tissue and a small amount of surrounding tissue are removed. Most of the time this cures the cancer completely. The affected area can also be frozen with substances such as liquid nitrogen. Freezing the basal cell cancer will kill it. Sometimes medication, such as Efudex (fluoruoracil) can be applied, or the lesion can be given injections (e.g.interferon) to kill cancer. Occasionally radiotherapy is used. Many times though, surgery will be used to treat basal cell cancer that comes back. Also if the cancer comes back particularly on the face or head then MOHS (microscopically controlled surgery should be used).
What are the side effects of the treatments? If the cancer is small a person usually recovers from surgery without any complications. A person usually has only minor discomfort as the skin heals.
What happens after treatment for the disease? Someone who has had one basal cell cancer is likely to develop more in the future. A person should watch for any new skin lesions that may develop. A person should also monitor any area where basal cell cancer has been removed. Any new lesions or changes in the treated area should be reported to a doctor.
How is the disease monitored? The treated area will be followed closely for any signs of regrowth of the cancer. A doctor or dermatologist will do this. The person should also check the area often and report any problems.
Author: Miriam P. Rogers, EdD, RN, AOCN, CNS Reviewer: HealthAnswers Australia Medical Review Panel Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia Last Updated: 1/10/2001 Contributors Potential conflict of interest information for reviewers available on request
