How Long Can I Wait To Have My Basal Cell Carcinoma Treated
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Health & Wellnesshow To Avoid Squamous Cell Carcinoma This Summer
This type of cancer is much more common in people who have light skin. One of the things thats tricky about basal cell carcinoma is that it can show up as skin-colored or pink, said Dr. Ivy Lee, a board-certified dermatologist with Pasadena Premier Dermatology in California and a member of the American Academy of Dermatology. A lot of patients mistake them as warts or witchs moles.
According to the ACS, you should watch for:
- Scar-like flat, firm areas
What Does Recurrent Basal Cell Carcinoma Look Like
At first, a basal cell carcinoma comes up like a small pearly bump that looks like a flesh-colored mole or a pimple that doesnt go away. Sometimes these growths can look dark. Or you may also see shiny pink or red patches that are slightly scaly. Another symptom to watch out for is a waxy, hard skin growth.
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How Do People Find Bcc On Their Skin
Many people find it when they notice a spot, lump, or scaly patch on their skin that is growing or feels different from the rest of their skin. If you notice any spot on your skin that is growing, bleeding, or changing in any way, see a board-certified dermatologist. These doctors have the most training and experience in diagnosing skin cancer.
To find skin cancer early, dermatologists recommend that everyone check their own skin with a skin self-exam. This is especially important for people who have a higher risk of developing BCC. Youll find out what can increase your risk of getting this skin cancer at, Basal cell carcinoma: Who gets and causes.
Images used with permission of:
The American Academy of Dermatology National Library of Dermatologic Teaching Slides.
J Am Acad Dermatol. 2019 80:303-17.
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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Who Is At Risk
Anyone who has been exposed to the sun is at risk. While that category includes all of us, some are more susceptible than others. Light-skinned individuals with blonde hair and colored eyes have the highest risk since they have little pigment protection. The lack of melanin leaves their cells DNA more vulnerable to sun damage. A tanning history and radiation therapy also increases your risk of skin cancer.
Skin damage is cumulative, adding up over the years. Imagine an empty tank under a leaky faucet that slowly releases water droplets. In the beginning, the drops are barely noticeable, but as the years pass by, the tank starts to fill up. At some point, the tank will overflow enough skin damage has accumulated in the skins DNA, leading to a skin cancer. It is never too late to start using sunscreen and protecting yourself from the adverse effects of ultraviolet radiation.
Basal Cell Carcinoma Stages
There are certain features that are considered to make the cancer at higher risk for spreading or recurrence, and these may also be used to stage basal cell carcinomas. These include:
- Greater than 2 mm in thickness
- Invasion into the lower dermis or subcutis layers of the skin
- Invasion into the tiny nerves in the skin
- Location on the ear or on a hair-bearing lip
After the TNM components and risk factors have been established, the cancer is given a stage. For basal cell carcinoma staging, the factors are grouped and labeled 0 to 4. The characteristics and stages of basal cell carcinoma are:
Stage 0: Also called carcinoma in situ, cancer discovered in this stage is only present in the epidermis and has not spread deeper to the dermis.
Stage 1 basal cell carcinoma: The cancer is less than 2 centimeters, about 4/5 of an inch across, has not spread to nearby lymph nodes or organs, and has one or fewer high-risk features.
Stage 2 basal cell carcinoma: The cancer is larger than 2 centimeters across, and has not spread to nearby organs or lymph nodes, or a tumor of any size with 2 or more high-risk features.
Stage 3 basal cell carcinoma: The cancer has spread into facial bones or 1 nearby lymph node, but not to other organs.
Stage 4 basal cell carcinoma: The cancer can be any size and has spread to 1 or more lymph nodes which are larger than 3 cm and may have spread to bones or other organs in the body.
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Targeted Therapy Or Immunotherapy For Advanced Basal Cell Cancers
In rare cases where basal cell cancer spreads to other parts of the body or cant be cured with surgery or radiation therapy, a targeted drug such as vismodegib or sonidegib can often shrink or slow its growth.
If these drugs are no longer working , the immunotherapy drug cemiplimab can sometimes be helpful.
Ask The Expert: Why Am I Having Surgery To Remove A Small Basal Cell Carcinoma
Although the nonmelanoma skin cancer basal cell carcinoma is rarely life-threatening, it can be troublesome, especially because 80 percent of BCCs develop on highly visible areas of the head and neck. These BCCs can have a substantial impact on a persons appearance and can even cause significant disfigurement if not treated appropriately in a timely manner.
The fact is, BCCs can appear much smaller than they are. On critical areas of the face such as the eyes, nose, ears and lips, they are more likely to grow irregularly and extensively under the skins surface, and the surgery will have a greater impact on appearance than might have been guessed. Even a small BCC on the face can be deceptively large and deep the extent of the cancer cannot be seen with the naked eye.
If such a BCC is treated nonsurgically , the chance of the cancer recurring is high. Unfortunately, treating a BCC that has returned is usually much more difficult than treating it precisely and completely when initially diagnosed.
BCCs on the trunk, arms and legs that cause concern are typically larger in size, but even a small BCC in these areas can have an irregular growth pattern under the skin if the initial biopsy shows the tumor is aggressive. In addition, a small BCC in an area previously treated with radiation may be much more aggressive than it appears on the surface. Again, treating such a tumor nonsurgically is likely to leave cancer cells behind.
About the Expert:
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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.
Basal Cell Carcinoma Symptoms
As it develops, basal cell carcinoma can cause several significant symptoms. However, basal cell carcinomas typically dont hurt, and patients rarely feel anything out of the ordinary. Instead, the warning signs are primarily visual.
When a person develops basal cell carcinoma, he or she may notice a small mole-shaped bump that doesnt go away. These lesions are typically skin colored and may have a slightly pearly appearance. Blood vessels may be visible in the lesion, which may frequently bleed and scab over.
In some cases, basal cell carcinoma can also present as:
- A small, hard and waxy skin growth
- A shiny, flat and scaly patch thats red or pink in color
- A lump that looks like a pimple
- A sore with a sunken area in the center
- A scar-like sore in an area that has not been injured
- A nondescript sore that oozes or crusts over
Most of the time, these lesions appear on parts of the body that are frequently exposed to the sun, such as the head or neck. However, they sometimes appear in locations not exposed to the sun, such as the abdomen or legs.
Because basal cell carcinoma has an excellent prognosis when caught early and properly treated, its important to discuss any of these symptoms with a dermatologist or skin cancer specialist as soon as they appear. Experienced medical professionals can help determine whether the lesion is basal cell carcinoma or if the symptoms are caused by another skin condition.
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Treatment For Basal Cell Carcinoma
With this type of skin cancer, if your dermatologist removes the tumor for biopsy, you probably wont need any further basal cell carcinoma treatments.
If your tumor is large, or is on your face , neck or ears, your doctor will probably recommend treating basal carcinoma with Mohs surgery, which is a procedure thats designed to leave the smallest possible scar.
Either way, youll need to keep a close watch on your skin McMichael said that once youve had this type of tumor, youre at higher risk of getting another one in the next three years.
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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Some Types Of Skin Cancer Are More Dangerous Than Others But If You Have A Spot
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Squamous Cell Skin Cancer
SCC is generally faster growing than basal cell cancers. About 20 out of every 100 skin cancers are SCCs. They begin in cells called keratinocytes, which are found in the epidermis.
Most SCCs develop on areas of skin exposed to the sun. These areas include parts of the head, neck, and on the back of your hands and forearms. They can also develop on scars, areas of skin that have been burnt in the past, or that have been ulcerated for a long time.
SCCs don’t often spread. If they do, it’s most often to the deeper layers of the skin. They can spread to nearby lymph nodes and other parts of the body, but this is unusual.
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What Makes Yale Medicines Approach To Basal Cell Carcinoma Unique
Yale Medicine receives referrals from community dermatologists all over the country. We receive a very high volume of referrals, so regardless of how unusual the case may be, it’s likely we’ve seen it before, says Dr. Christensen. We work closely with a team of specialized skin pathologists in our dermatopathology lab who evaluate skin samples that could be cancerous or pre-cancerous. Then, our dermatologic surgeons use their expertise to safely remove these spots.
Symptoms Of Basal Cell Carcinoma
The various types of basal cell carcinoma can take many different forms. Often, it may seem like a small bump that grows very slowly. Other symptoms are a:
- Pink, reddish spot that dips in the center
- Scaly patch, especially near the ears
- Sore that resembles a pimple, but that either doesnt heal or heals but keeps returning
- Round growth that can be pink, red, brown, tan, black, or skin-colored
- Scar-like skin that isnt from an injury
Its important to note that the color and shape of the tumor may not be uniform. The spot may be flat or raised, it can be dipped in the center or not, and it can even appear shiny. Often, BCCs do not cause pain, but the area can be numb, sensitive, or itchy. Its hard to self-diagnose a basal cell carcinoma because they can take so many different shapes. If you have a concerning spot, its best to schedule a dermatological appointment right away.
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What Is Basal Cell Carcinoma
Basal cell carcinoma is a cancer that grows on parts of your skin that get a lot of sun. It’s natural to feel worried when your doctor tells you that you have it, but keep in mind that it’s the least risky type of skin cancer. As long as you catch it early, you can be cured.
This cancer is unlikely to spread from your skin to other parts of your body, but it can move nearby into bone or other tissue under your skin. Several treatments can keep that from happening and get rid of the cancer.
The tumors start off as small shiny bumps, usually on your nose or other parts of your face. But you can get them on any part of your body, including your trunk, legs, and arms. If you’ve got fair skin, you’re more likely to get this skin cancer.
Basal cell carcinoma usually grows very slowly and often doesn’t show up for many years after intense or long-term exposure to the sun. You can get it at a younger age if you’re exposed to a lot of sun or use tanning beds.
What Is The Treatment For Advanced Or Metastatic Basal Cell Carcinoma
Locally advanced primary, recurrent or metastatic BCC requires multidisciplinary consultation. Often a combination of treatments is used.
- Targeted therapy
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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.
I Was Diagnosed With Basal Cell Carcinoma Now What
If your biopsy confirms a basal cell carcinoma, we will discuss the options with you. Depending the size, location, and aggressiveness , we will work with you as a team to find the best option to treat it. It may be a topical cream, a surgical procedure, or radiation treatment. The good news is basal cell carcinomas are highly curable, especially when caught early. The earlier the basal cell carcinoma is treated, the more likely you can avoid larger surgical scars and local spread.
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