What Is Skin Cancer
Cancer can start any place in the body. Skin cancer starts when cells in the skin grow out of control.
Skin cancer cells can sometimes spread to other parts of the body, but this is not common. When cancer cells do this, its called metastasis. To doctors, the cancer cells in the new place look just like the ones from the skin.
Cancer is always named based on the place where it starts. So if skin cancer spreads to another part of the body, its still called skin cancer.
Ask your doctor to use this picture to show you where your cancer is
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What Is A Basal Cell Carcinoma
Basal cell carcinoma is a type of skin cancer that occurs when there is damage to the DNA of basal cells in the top layer, or epidermis, of the skin. They are called basal cells because they are the deepest cells in the epidermis. In normal skin, the basal cells are less than one one-hundredth of an inch deep, but once a cancer has developed, it will spread deeper.
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How Do You Prevent Basal Cell Skin Cancer
The best way to prevent basal cell carcinoma and other skin cancers is to protect the skin from the sun.
- Wear sunscreen with an SPF of at least 30. Apply sunscreen at least 30 minutes prior to sun exposure, and reapply every 2 hours or more frequently if swimming or sweating.
- Wear protective clothing and a wide-brimmed hat.
- Avoid the midday sun, between the hours of 10 a.m. to 4 p.m., when the sunâs rays are the strongest.
- Avoid tanning beds.
- Examine your skin regularly for new moles, spots, bumps, or growths, and inform your doctor of any skin changes.
In patients who are at higher risk for recurrence of basal cell carcinoma, certain medications may be used, however, studies on the effectiveness of these medications have had mixed results.
- Celecoxib , a type of nonsteroidal anti-inflammatory drug , may offer modest risk reduction, but studies on its effectiveness for preventing tumors are mixed.
- Oral nicotinamide is a vitamin supplement available over the counter. Additional studies are needed to determine its effectiveness in preventing skin cancers. Consult your doctor before taking any supplements because of possible side effects or drug interactions.
- Topical fluorouracil has been shown to help prevent other skin conditions and precursors to basal cell carcinoma, however, the data are mixed on whether it may help prevent BCC.
Different Kinds Of Skin Cancer
There are many types of skin cancer. Some are very rare. Your doctor can tell you more about the type you have.
The two most common kinds of skin cancers are:
- Basal cell cancer, which starts in the lowest layer of the skin
- Squamous cell cancer, which starts in the top layer of the skin
Another kind of skin cancer is called melanoma. These cancers start from the color-making cells of the skin . You can read about melanoma in If You Have Melanoma Skin Cancer.
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Merkel Cell Carcinoma: A Rare Skin Cancer On The Rise
Merkel cell carcinoma is a rare type of skin cancer that affects about 2,000 people in the United States each year.
Though its an uncommon skin cancer, cases of Merkel cell carcinoma have increased rapidly in the last couple of decades.
This type of cancer starts when cells in the skin, called Merkel cells, start to grow out of control.
Merkel cell carcinomas typically grow quickly and can be difficult to treat if they spread.
They can start anywhere on the body, but Merkel cell carcinomas commonly affect areas exposed to the sun, such as the face, neck, and arms.
They may look like pink, red, or purple lumps that are firm when you touch them. Sometimes, they can open up as ulcers or sores.
Risk factors include:
Actinic Keratosis Signs And Symptoms
Many people have actinic keratosis , also called solar keratosis, on their skin. It shows that youÃ¢ve had enough sun to develop skin cancer, and it is considered a precursor of cancer, or a precancerous condition.
Usually AK shows up on the parts of your body that have received the most lifetime sun exposure, like the face, ears, scalp, neck, backs of the hands, forearms, shoulders and lips.
Some of the same treatments used for nonmelanoma skin cancers are used for AK to ensure it does not develop into a cancerous lesion.
This abnormality develops slowly. The lesions are usually small, about an eighth of an inch to a quarter of an inch in size. You may see a few at a time. They can disappear and later return.
- AK is a scaly or crusty bump on the skinÃ¢s surface and is usually dry and rough. It can be flat. An actinic keratosis is often noticed more by touch than sight.
- It may be the same color as your skin, or it may be light, dark, tan, pink, red or a combination of colors.
- It can itch or produce a prickling or tender sensation.
- These skin abnormalities can become inflamed and be encircled with redness. Rarely, they bleed.
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Prevention Of Basal Cell Carcinoma
Because basal cell carcinoma is often caused by sun exposure, people can help prevent this cancer by doing the following:
Avoiding the sun: For example, seeking shade, minimizing outdoor activities between 10 AM and 4 PM , and avoiding sunbathing and the use of tanning beds
Wearing protective clothing: For example, long-sleeved shirts, pants, and broad-brimmed hats
Using sunscreen: At least sun protection factor 30 with UVA and UVB protection used as directed and reapplied every 2 hours and after swimming or sweating but not used to prolong sun exposure
In addition, any skin change that lasts for more than a few weeks should be evaluated by a doctor.
What Causes Basal Cell Carcinoma
BCC develops from exposure to damaging ultraviolet sunlight and tanning beds. This cancer starts in the basal cell layer of the skin and grows very slowly. It develops mainly on the areas exposed to the sun, such as the:
- Head and face
Risk factors for basal cell carcinoma include:
- Exposure to UV radiation
- Older age
- Long-term skin inflammation or injury
- Treatment for psoriasis using psoralens and ultraviolet light treatments
- History of skin cancer
- Basal cell nevus syndrome, a rare inherited disorder
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What Are The Risk Factors For Basal Cell Carcinoma
Basal cell carcinoma, squamous cell carcinoma and melanoma are all skin cancers caused by exposure to damaging ultraviolet raysfrom natural and artificial sunlight. There’s also a genetic condition called basal cell nevus or Gorlin syndrome, which can cause people to develop hundreds of basal cell skin cancers, but it’s extremely rare, says Dr. Christensen.
People at the highest risk for basal cell carcinoma tend to have fair or light-colored skin, a history of sun exposure and a tendency to sunburn quickly. Fair-skinned people have a 50 percent risk of developing basal skin cancer at some point in their lives, Dr. Christensen says. The cancer is the result of cumulative damage of years spent in the sun, and may take 20 years to manifest.
Although it’s often more common in older people, it can occur in younger adults, too.
Basal cell carcinoma spreads very slowly and very rarely will metastasize, Dr. Christensen says. But if it’s not treated, basal cell carcinoma can continue to grow deeper under the skin and cause significant destruction to surrounding tissues. It can even become fatal. For example, an untreated basal cell carcinoma on the face can grow into the bones and, over time, directly into the brain, Dr. Christensen says.
What Does Basal Cell Carcinoma Look Like
When the DNA in the basal cells is damaged and a basal cell carcinoma develops, it will appear as a change in the skin, such as a growth or sore that wont heal. The lesion will have one of the following characteristics. It will look like
- A pearly white, skin-colored, or pink bump on the skin. It will be translucent, meaning you can see through it slightly, and you can often see blood vessels in it.
- A brown, black, or blue lesion or a lesion with dark spots. It will have a slightly raised, translucent border.
- A flat, scaly, reddish patch of skin with a raised edge. These will occur more commonly on the back or chest.
- A white, waxy, scar-like lesion without a clearly defined border. This morpheaform basal cell carcinoma is the least common.
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What Does Stage One Melanoma Look Like
Stage 1: The cancer is up to 2 millimeters thick. It has not yet spread to lymph nodes or other sites, and it may or may not be ulcerated. Stage 2: The cancer is at least 1 mm thick but may be thicker than 4 mm. It may or may not be ulcerated, and it has not yet spread to lymph nodes or other sites.
Complementary And Alternative Treatments
It’s common for people with cancer to seek out complementary or alternative treatments. When used alongside your conventional cancer treatment, some of these therapies can make you feel better and improve your quality of life. Others may not be so helpful and in some cases may be harmful.;It is important to tell all your healthcare professionals about any complementary medicines you are taking. Never stop taking your conventional treatment without consulting your doctor first.All treatments can have side effects. These days, new treatments are available that can help to make many side effects much less severe than they were in the past.;
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Basal Cell Carcinomas Topical Treatment
Topical treatments can be successful on superficial basal cell carcinomas with little depth. These drugs work by inflaming the area where they are applied. The body responds by sending white blood cells to attack the inflammation. These white blood cells go after the mutated basal cells. Aldara, Efudex, and Fluoroplex are three of the most used drugs.
Diagnosing Squamous Cell Carcinoma
The main way to diagnose squamous cell carcinoma is with a biopsy. This involves having a small piece of tissue removed from the suspicious area and examined in a laboratory.
In the laboratory, a pathologist will examine the tissue under a microscope to determine if it is a skin cancer. He or she will also stage the cancer by the number of abnormal cells, their thickness, and the depth of penetration into the skin. The higher the stage of the tumor, the greater the chance it could spread to other parts of the body.
Squamous cell carcinoma on sun-exposed areas of skin usually does not spread. However, squamous cell carcinoma of the lip, vulva, and penis are more likely to spread. Contact your doctor about any sore in these areas that does not go away after several weeks.
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Survival Statistics For Non
Most cancer registries do not collect information about non-melanoma skin cancers. These cancers are difficult to keep track of. The information often doesnt get reported because non-melanoma skin cancer is usually diagnosed and treated easily in a doctors office.
In Canada, a few provinces do collect information on new cases of non-melanoma skin cancer. Canadian statistics for non-melanoma skin cancer, including survival statistics, are based on the information gathered by these provinces.
Survival statistics for non-melanoma skin cancer are general estimates and must be interpreted carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival.
There are many different ways to measure and report cancer survival statistics. Your doctor can explain the statistics for non-melanoma skin cancer and what they mean to you.
What Is The Prognosis Of Basal Cell Carcinoma
The prognosis for patients with BCC is excellent, with a 100% survival rate for cases that have not spread to other sites. Nevertheless, if BCC is allowed to progress, it can result in significant morbidity, and cosmetic disfigurement is not uncommon.
Typically, basal cell tumors enlarge slowly, relentlessly and tend to be locally destructive. Periorbital tumors can invade the orbit, leading to blindness, if diagnosis and treatment are delayed. BCC arising in the medial canthus tends to be deep and invasive and more difficult to manage; this type of BCC can result in perineural extension and loss of nerve function.
Although BCC is a malignant neoplasm, it rarely metastasizes. The incidence of metastatic BCC is estimated to be less than 0.1%. The most common sites of metastasis are the lymph nodes, lungs, and bones.
Although treatment is curative in more than 95% of cases, BCC may recur, especially in the first year, or develop in new sites. Therefore, regular skin screenings are recommended.
Cameron MC, Lee E, Hibler BP, Barker CA, Mori S, Cordova M, et al. Basal cell carcinoma: Epidemiology; pathophysiology; clinical and histological subtypes; and disease associations. J Am Acad Dermatol. 2019 Feb. 80 :303-317. .
Cameron MC, Lee E, Hibler BP, Giordano CN, Barker CA, Mori S, et al. Basal cell carcinoma: Contemporary approaches to diagnosis, treatment, and prevention. J Am Acad Dermatol. 2019 Feb. 80 :321-339. .
Aldara cream 5% . Graceway Pharmaceuticals. 2007.
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What Are The Symptoms Of Basal Cell Carcinoma
BCCs usually develop on parts of the body that are often exposed to the sun, like the head, face, shoulders, arms and lower legs.
They often start with a subtle change in the skin, like a small bump or a flat red patch.
Signs of a BCC to look for include:
- a pearly spot or lump
- a scaly, dry area that is shiny and pale or bright pink in colour
- a sore that doesnt heal
- a sore that bleeds
See your doctor if you notice any new spots or an existing spot that changes size, shape or colour. Visit the Cancer Councils website for tips on how to check your skin.
Skin_condition_infomation Mohs Micrographic Surgery
This surgical procedure is used to treat more complex BCCs such as those;present at difficult anatomical sites or recurrent BCCs. The procedure involves excision of the affected skin and examination of the skin removed under the microscope straight away to see if all of the BCC has been removed. If any residual BCC is left at the edge of the excision further skin is excised from that area and examined under the microscope and this process is continued until all of the BCC is removed. The site is then often closed with a skin graft. This is a time consuming process and is only undertaken when simple surgery may not be suitable.
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What Happens When Skin Cancer Goes Untreated
If you notice an abnormality on your skin you may be tempted to ignore it. However, if it is skin cancer you could be putting your health at risk by waiting to get a skin and mole check. There are three main types of skin cancer in Australia with melanoma, basal cell carcinoma and squamous cell carcinoma, and they each have their own set of unique characteristics. The most important thing to remember is that if you delay treatment of skin cancer it could have life threatening consequences:
Types Of Basal Cell Carcinoma
There are several types of basal cell carcinoma, including:
- Nodular basal cell carcinoma:;Approximately 60-80% of all basal cell carcinomas that present on the face or head are nodular. It is the most common subtype, and it is also known as nodulocystic carcinoma.;It presents as a shiny, smooth nodule. It may have a dip in the center, with rolled edges, and blood vessels are often seen to cross its surface.
- Superficial spreading basal cell carcinoma:;Most commonly seen on the upper body, back, and shoulders, this type is more common in younger adults. It presents as shallow, scaly, irregular plaques that are pink or a similar color to the skin itself. Almost all superficial spreading basal cell carcinomas are secondary to sun damage.
- Sclerosing basal cell carcinoma :;This type can be challenging to diagnose. Most commonly seen on the face, it can look like a small, waxy, white scar that expands over time. It can be more dangerous or disfiguring because it is often not recognized as skin cancer until it has grown.
- Pigmented basal cell carcinoma:;Most commonly occurs in people with a darker skin tone, particularly Asians. The pigmentation can be found in the different basal cell carcinoma subtypes and it can appear dark blue, dark brown, or black.
It is possible that you can get more than one type of basal cell carcinoma simultaneously. If you have one type, it increases your risk of getting another. Basal cell carcinoma rarely spreads to other parts of the body.
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