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.
What Does It Look Like
BCCs vary in their appearance. People often become aware of them as an area of discoloured skin, a lump, or area of skin that bleeds, scabs and then refuses to heal. Occasionally they are itchy. Usually BCCs are painless.
There are subtypes of BCC. The subtypes may have a different appearance and may require different treatment.
- Nodular BCC: Form a nodule with a pearly rim and may have a central crater. Fine blood vessels are visible within the nodule.
- Superficial BCC: Look like a scaly red patch on the skin with a thin translucent rolled border. Common on the upper trunck and shoulders.
- Morphoeic BCC: Also known as sclerosing BCC. This resembles a scar with a waxy appearance and indistinct margins it may be subtle. Often this type of BCC is much larger than it initally appears, it may invade deeply and infiltrate nerves .
- Basosqamous BCC: Mixed BCC and squamous cell carcinoma that is potentially more aggressive than other forms of BCC.
How Serious Is My Cancer
If you have skin cancer, the doctor will want to find out how far it has spread. This is called staging.
Basal and squamous cell skin cancers don’t spread as often as some other types of cancer, so the exact stage might not be too important. Still, your doctor might want to find out the stage of your cancer to help decide what type of treatment is best for you.
The stage describes the growth or spread of the cancer through the skin. It also tells if the cancer has spread to other parts of your body that are close by or farther away.
Your cancer can be stage 0, 1, 2, 3, or 4. The lower the number, the less the cancer has spread. A higher number, like stage 4, means a more serious cancer that has spread beyond the skin. Be sure to ask the doctor about the cancer stage and what it means for you.
Other things can also help you and your doctor decide how to treat your cancer, such as:
- Where the cancer is on your body
- How fast the cancer has been growing
- If the cancer is causing symptoms, such as being painful or itchy
- If the cancer is in a place that was already treated with radiation
- If you have a weakened immune system
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What Are The Symptoms
Check for basal cell carcinoma where your skin is most exposed to the sun, especially the face, ears, neck, scalp, chest, shoulders and back, but remember that they can occur anywhere on the body.
Frequently, two or more of these warning signs are visible in a tumor.
How Do People Find Signs Of Melanoma On Their Own Skin
Performing a skin self-exam as often as recommended by your dermatologist is the best way. While examining your skin, you want to look for the following:
Mole that is changing in any way
Spot that looks different from the rest of the spots on your skin
Growth or spot on your skin that itches, bleeds, or is painful
Band of color beneath or around a nail
Sore that doesnt heal or heals and returns
The ABCDEs of melanoma can help you find changes to a mole, freckle, or other spot on your skin.
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How Fast Melanoma Spreads
Some forms of melanoma can spread quickly, though the exact timeline will depend on your individual health situation. The timeline can be impacted by factors like your age, family history, any underlying medical conditions you may have, as well as what kind of melanoma you have.
During the diagnosis process, your dermatologist will determine what stage your cancer is at. The stage of your melanoma indicates what kind of treatment youll need.
Melanoma can spread quickly and be difficult to treat at later stages, so its important to seek treatment immediately after diagnosis, even if youre only at Stage 0 or Stage 1.
Protect the skin youre in.
Skincare is healthcare
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What Are The 5 Stages Of Skin Cancer
Staging is an important tool used to treat skin cancer. Your stage helps the medical team determine where the tumor is, how large it is, where it has spread, your prognosis, and the most effective treatment plan.
The five stages of squamous cell carcinoma include:
- Stage 0: Also known as carcinoma in situ, in this stage cancer is present in the epidermis. It has not spread to deeper layers.
- Stage 1: The tumor is smaller than 2 centimeters and has not spread to nearby lymph nodes or other organs. The individual has one or fewer risk factors for spread.
- Stage 2: The tumor is wider than 2 centimeters and has not spread to nearby lymph nodes or other organs. This stage also applies to any sized tumor when the individual has two or more risk factors.
- Stage 3: The tumor has spread into nearby facial bones or one lymph node. It has not spread to other organs.
- Stage 4: The tumor is of any size and has metastasized to one or more of the lymph nodes. It may have spread to the bones and other distant organs.
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Squamous Cell Skin Cancer
This is the second most common form of skin cancer, it occurs most commonly on the head and neck, and exposed arms. However, these are frequently seen on the front of the legs as well, or the shin area. This form of skin cancer grows more quickly, and though it can be confined to the top layer of skin, it frequently grows roots. Squamous cell carcinoma can be more aggressive and does have a potential to spread internally. This is more likely in cases where an individual is immunosuppressed, or the tumor is invading deeply in the second layer of skin, or tracking along nerves. These tumors need to be treated early as they are not only locally destructive, but can spread along nerves, into lymph nodes, and internally.
What Will Happen After Treatment
Youll be glad when treatment is over. Your doctor will want you to check your skin at least once a month. It will be very important to protect yourself from getting too much sun.
For years after treatment ends, you will see your skin cancer doctor. At first, your visits may be every few months. Then, the longer youre cancer-free, the less often the visits are needed. Be sure to go to all of these follow-up visits. Your doctor will ask about symptoms and check you for signs of the cancer coming back or a new skin cancer. Other exams and tests may also be done.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us at 1-800-227-2345 or talk to your cancer care team to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as good as you can.
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Mistaken For A Bruise
Many people first mistake subungual melanoma as a bruise.3,4 However, unlike a bruise, the streaks from subungual melanoma do not heal or grow out with the nail over time.4 It can also be confused with normal pigmentation of the nail bed or a fungal infection.2 While you can have a streak or bruising under the nail that isnt melanoma, you should ask a dermatologist to check your nails if you notice any changes.
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How Is Metastasis Detected
If your doctor suspects that your melanoma may have spread, there are several tools available to verify the diagnosis. These include a blood test for lactate dehydrogenase , which increases when melanoma metastasizes, and imaging studies, such as chest X-ray, computed tomography , magnetic resonance imaging , positron emission tomography and ultrasound.
The doctor may also need to take a sample of your lymph nodes, using a procedure called sentinel lymph node mapping. If confirmed, there are many treatments available, including chemotherapy, immunotherapy, radiation therapy and surgery.
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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
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.
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When To Seek Medical Care
If you have developed a new bump on sun-exposed skin, or if you have a spot that bleeds easily or does not seem to be healing, then you should make an appointment with your primary care physician or with a dermatologist.Try to remember to tell your doctor when you first noticed the lesion and what symptoms, if any, it may have . Also, be sure to ask your parents, siblings, and adult children whether or not they have ever been diagnosed with a skin cancer, and relay this information to your physician.
Our Approach To Basal Cell And Squamous Cell Carcinoma
UCSF provides superior, proven care to prevent, detect and manage basal cell and squamous cell carcinomas, and will tailor cutting-edge treatment plans to the individual patient. Our dermatologists, medical and surgical oncologists, radiation oncologists and dermatopathologists are known for providing the best treatment options and cure rates for skin cancer, while giving outstanding cosmetic results.
Some of our new diagnostic and treatment techniques include lymph node mapping to detect early occurrences of cancer, electron beam radiation and Mohs micrographic surgery, which removes the smallest amount of healthy tissue in order to minimize scarring and preserve skin function. We also offer our patients access to educational programs, resources for emotional support and opportunities to participate in experimental treatments.
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How Does Melanoma Make You Feel
For example, if it spreads to lymph nodes, they can get swollen and painful. If the melanoma goes to your lungs, you may have trouble breathing or a cough that wont go away. If it shows up in your liver, you may have indigestion, a swollen belly, or yellow skin and eyes, a condition called jaundice.
A Primer On Skin Cancer
Malignant melanoma, especially in the later stages, is serious and treatment is difficult. Early diagnosis and treatment can increase the survival rate. Nonmelanoma skin cancers include basal cell carcinoma and squamous cell carcinoma. Both are common and are almost always cured when found early and treated. People whoâve had skin cancer once are at risk for getting it again they should get a checkup at least once a year.
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What Are The Stages Of Squamous Cell Carcinoma
Squamous cell carcinoma is classified into the following stages, which are partly based on how far the cancer has spread throughout the body:
- Stage 0 Squamous cell carcinoma develops in the squamous cells, which are located in the epidermis . During Stage 0, the cancer hasnt spread beyond the epidermis.
- Stage 1 When squamous cell carcinoma progresses to Stage 1, it means that the cancer has spread deeper into the skin, but not into any lymph nodes or healthy tissues.
- Stage 2 A Stage 2 classification means that, in addition to progressing deeper into the skin, the cancer also displays at least one high-risk feature. This might include metastasizing to the lower skin layers or the nerves. However, at this stage, the cancer still hasnt spread to lymph nodes or healthy tissues.
- Stage 3 Once squamous cell carcinoma reaches Stage 3, the cancer has spread into lymph nodes but not any other tissues or organs.
- Stage 4 This is the final stage of squamous cell carcinoma, where the cancer has spread to at least one distant organ, whether that be the brain, the lungs or a separate area of skin.
If you think you might have squamous cell carcinoma, its important to seek prompt medical attention to minimize the risk of cancer spread. The specialists in Moffitt Cancer Centers Cutaneous Oncology Program can provide you with the comprehensive diagnostic and treatment services you need. Call or complete our new patient registration form online to request an appointment.
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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Can You Die From Basal Cell Carcinoma
Death from either basal cell or squamous cell cancers is quite rare. Statistics for these types of skin cancer arent tracked by cancer registries, so its difficult to have specific numbers, but its thought that less than 2,000 people in the U.S. die from both basal cell and squamous cell carcinomas each year.
These deaths are predominantly in elderly people who have not had their skin checked in a long time and cancer has grown quite large.
Considering there are over 4 million diagnosed cases of basal cell carcinoma each year in the U.S. , the risk of death from this form of skin cancer is quite low.
Alternative Treatment Options: Radiation Therapy
For Squamous and Basal cell cancer, Mohs surgery is often not the only viable treatment option. The invasive nature of Mohs surgery coupled with the possibility of scarring and the need for antibiotics following the procedure makes some patients uneasy.
If you are searching for a non-invasive alternative, youll want to learn more about Image Guided Superficial Radiotherapy . IG-SRT uses Ultrasound Imaging and Superficial Radiotherapy to treat Basal and Squamous cell cancers with a precise, measured dose of radiation delivered directly under the patients skin surface. It is completely non-invasive and has less of an effect on the patients daily life post-treatment, with no scarring, no need for antibiotics, and no requirement to stop taking certain medications prior to the procedure.
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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. Thereâs also a genetic condition called basal cell nevus or Gorlin syndrome, which can cause people to develop hundreds of basal cell skin cancers, but itâs 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 itâs 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 itâs 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.