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.
What Are The Symptoms Of Basal Cell Cancer Of The Head And Neck
Basal cell cancers usually present as an abnormal growth on the skin. The growth may have the appearance of a wart, crusty spot, reddish patch, mole, nodule or bump, or a sore that does not heal. It may or may not bleed and can sometimes be painful. These are usually slow-growing tumors that begin as small spots on sun-exposed areas of the face. Because they can have such a range of appearances, any new persistent skin lesion should be evaluated.
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Skin Cancer Types: Basal Cell Carcinoma Overview
All content solely developed by the American Academy of Dermatology
The American Academy of Dermatology gratefully acknowledges the support from Sanofi Genzyme and Regeneron.
Basal cell carcinoma
What is basal cell carcinoma?The most common type of skin cancer, basal cell carcinoma can show up on the skin in many ways.
Is it contagious? No;
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Basal Cell Carcinoma Treatment
There are several ways to treat, remove, and destroy basal cell skin cancers. The best option for each patient depends on factors such as tumor size and location, age, general health, and preferences.
Treatment options include one or a combination of these methods:
- Medication to shrink or slow tumor growth
Surgery is the most common treatment, and micrographic surgery is considered to be the gold standard. In that category, Mohs surgery, which allows surgeons to closely examine the margins the area surrounding the tumor to make sure no cancer cells have encroached in those areas has the highest cure rate of all therapies and is especially effective for high-risk basal cell carcinomas.
With Mohs micrographic surgery, the dermatologist is both the surgeon and the pathologist, says Rossi, explaining Mohs surgery. Youre actually examining all the margins and looking at it in real time, whereas in a traditional excision, the surgeon removes the tissue and sends it to a pathologist and they examine only a portion of the margin.
Mohs surgery is often used for large tumors, tumors where the edges are not well-defined, tumors in sensitive locations such as on the head or face, hands, or genital area, and for tumors that have come back after other treatments.
What Should I Do If I Suspect I Have Basal Cell Carcinoma
If you have a spot thats not healing or otherwise looks suspicious, get it checked out by a dermatologist. Most dermatologists can identify basal cell carcinoma very quickly due to their specialized training in skin cancers. Over 90% of basal cell carcinomas can be identified on physical exams alone.
If we visually identify a basal cell spot, we perform a skin biopsy. Skin biopsies are relatively simple procedures that only require local anesthesia. We take a sample of the bump and submit it for review to a pathologist. Under the microscope, basal cell carcinoma is very clear. With this process, dermatologists are able to diagnose basal cell carcinoma with a high sense of confidence theyre not often mistaken.
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Tests That May Be Done
The doctor will ask you questions about when the spot on your skin first showed up and if it has changed in size or the way it looks or feels. The rest of your skin will be checked. During the exam your doctor will check the size, shape, color and texture of any skin changes. If signs are pointing to skin cancer, more tests will be done.
In a biopsy, the doctor takes out a small piece of tissue to check it for cancer cells. A biopsy is the only way to tell for sure if you have skin cancer and what kind it is.
There are many types of skin biopsies. Ask your doctor what kind you will need. Each type has pros and cons. The choice of which type to use depends on your own case.
In rare cases basal and squamous cell skin cancer can spread to the nearby lymph nodes Ask your doctor if your lymph nodes will be tested.
Basal and squamous cell cancers don’t often spread to other parts of the body. But if your doctor thinks your skin cancer might spread, you might need imaging tests, such as MRI or CT scans.
Basal Cell Carcinoma: The Most Common Skin Cancer
Basal cell carcinoma, which is also called basal cell skin cancer, is the most common form of skin cancer, accounting for about 80 percent of all cases.
Rates of basal cell carcinoma have been increasing. Experts believe this is due to more sun exposure, longer lives, and better skin cancer detection methods.
This type of cancer begins in the skins basal cells, which are found in the outermost layer, the epidermis. They usually develop on areas that are exposed to the sun, like the face, head, and neck.
Basal cell carcinomas may look like:
- A flesh-colored, round growth
- A pinkish patch of skin
- A bleeding or scabbing sore that heals and then comes back
They typically grow slowly and dont spread to other areas of the body. But, if these cancers arent treated, they can expand deeper and penetrate into nerves and bones.
Though its rare, basal cell carcinoma can be life-threatening. Experts believe that about 2,000 people in the United States die each year from basal cell carcinoma or squamous cell carcinoma.
Some risk factors that increase your chances of having a basal cell carcinoma include:
- Being exposed to the sun or indoor tanning
- Having a history of skin cancer
- Being over age 50
- Having chronic infections, skin inflammation, or a weakened immune system
- Being exposed to industrial compounds, radiation, coal tar, or arsenic
- Having an inherited disorder, such as nevoid basal cell carcinoma syndrome or xeroderma pigmentosum
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There Actually Are Cases In Which Basal Cell Carcinoma Sometimes Called A Non
Youve probably read that basal cell carcinoma cant spread or doesnt spread, but does cause local destruction if not treated.
But basal cell carcinoma CAN spreadand kill.
Unlike melanomas, basal cell carcinomas usually do not metastasize but instead spread locally, says;Dr. Tess Mauricio, MD, FAAD, a leading board certified dermatologist from Stanford University Medical School and CEO of MBeautyClinic.com.
However, if BCCs are allowed to spread without treatment, there could be a chance for metastasis, warns Dr. Mauricio.
What are the chances of basal cell carcinoma metastasis?
The chances, in terms of percent, have not been determined. However, check out the following:
Metastasis of basal cell carcinoma rarely occurs. Few cases have been reported in the literature.
the occurrence of BCC metastasis is exceedingly rare, with an average rate of approximately 0.03%, typically involving a large, long-standing, locally destructive, recalcitrant tumor of the head or neck.
Cutis, July 2007
To put this in more perspective, here are intriguing excerpts from DermatologyTimes .
A search of the current literature shows that only about 350 cases of metastatic BCC have been reported.
However, with 1 million new cases of BCC every year in the United States alone, Dr. Giannelli says it is very hard to believe, and highly unlikely, that these metastases do not occur more frequently than they are actually reported.
From the Journal of the American Academy of Dermatology :
Too Much Sun Exposure
How do you know if you are at-risk for basal cell carcinoma? It normally begins with concerns around too much sun exposure. The head, face, neck, and back of the hands are areas that typically see problems with too much sun exposure. The nose in particular is one area that has increased sun exposure, leading some patients to need multiple surgeries to restore their nose after losing it to cancer.
Exposure to tanning beds also increases the risk of developing basal cell carcinoma. Tanning beds have harmful UV rays, which cause the skin to age faster. Younger people are starting to become diagnosed at younger ages, many research studies pointing to the use of tanning beds. While basal cell carcinoma is part of the skin cancer family, it is the least risky type of skin cancer according to WedMD.
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Basal Cell Carcinoma Signs And Symptoms
This type of cancer is usually found on sun-exposed areas of the skin like the scalp, forehead, face, nose, neck and back.
Basal cell carcinomas may bleed after a minor injury but then scab and heal. This can happen over and over for months or years with no visible growth, making it easy to mistake them for wounds or sores. They rarely cause pain in their earliest stages.
In addition to the bleeding and healing, these are other possible signs of a basal cell cancer:
- A persistent open sore that does not heal and bleeds, crusts or oozes.
- A reddish patch or irritated area that may crust or itch.
- A shiny bump or nodule that is pearly or translucent and often pink, red or white. It can also be tan, black or brown, especially in dark-haired people, and easy to confuse with a mole.
- A pink growth with a slightly elevated, rolled border and a crusted indentation in the center. Tiny blood vessels may appear on the surface as the growth enlarges.
- A scar-like lesion in an area that you have not injured. It may be white, yellow or waxy, often with poorly defined borders. The skin seems shiny and tight; sometimes this can be a sign of an aggressive tumor.
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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There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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Basal Cell Carcinoma Staging
Staging;is the process of determining whether cancer has spread and, if so, how far. The stage of the disease may affect the treatment plan.
The stage is based on the size of the tumor, how deeply into the skin it has grown, and whether cancer has spread beyond the tumor to the lymph nodes. Your doctor will look at the results of the biopsy to determine the stage.;In rare cases, your doctor may recommend imaging such as CT or PET-CT scan to see if the cancer has spread beyond the skin
Stages are numbered in Roman numerals between 0 and IV.
Most non-melanoma skin cancers are Stage 0 or Stage 1. Stage 3 and 4 are relatively rare. Based on the type of cancer, the stage of cancer, your overall health, and other factors, your doctor works with you to develop a treatment plan.
High risk features for primary tumor staging
- Depth/invasion: >2 mm thickness , Clark level IV, Perineural invasion
- Anatomic: Primary site ear
- Location: Primary site hair-bearing lip
- Differentiation: Poorly differentiated or undifferentiated
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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.
Taking Care Of Yourself
After you’ve been treated for basal cell carcinoma, you’ll need to take some steps to lower your chance of getting cancer again.
Check your skin. Keep an eye out for new growths. Some signs of cancer include areas of skin that are growing, changing, or bleeding. Check your skin regularly with a hand-held mirror and a full-length mirror so that you can get a good view of all parts of your body.
Avoid too much sun. Stay out of sunlight between 10 a.m. and 2 p.m., when the sun’s UVB burning rays are strongest.
Use sunscreen. The suns UVA rays are present all day long — thats why you need daily sunscreen. Make sure you apply sunscreen with at least a;6% zinc oxide and a sun;protection factor of 30 to all parts of the skin that aren’t covered up with clothes every day. You also need to reapply it every 60 to 80 minutes when outside.
Dress right. Wear a broad-brimmed hat and cover up as much as possible, such as long-sleeved shirts and long pants.
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What Is Squamous Cell Cancer
Squamous cell carcinoma of the skin is a common skin cancer that typically develops in chronic sun-exposed areas of your body. This type of skin cancer is usually not nearly as aggressive as melanoma and is uncontrolled growth of cells in the epidermis of your skin.
It can become disfiguring and sometimes deadly if allowed to grow. Squamous cell carcinomas are at least twice as frequent in men as in women. They rarely appear before age 50 and are most often seen in individuals in their 70s.
An estimated 700,000 cases of SCC are diagnosed each year in the United States, resulting in approximately 2,500 deaths.
Squamous Cell Carcinoma: Common In Sun
Squamous cell carcinoma, also called squamous cell cancer, is the second most common type of skin cancer. It accounts for about 20 percent of cases.
This type of cancer starts in flat cells in the outer part of the epidermis. It commonly crops up on sun-exposed areas, such as the face, ears, neck, lips, and hands. It can also develop on scars or chronic sores.
Squamous cell carcinomas may develop from precancerous skin spots, known as actinic keratosis .
These cancers might look like:
- A firm, red bump
- A flat lesion with a scaly, crusted surface
- A sore that heals and then reopens
People with lighter skin are more at risk for developing squamous cell carcinoma, but the skin cancer can also affect those with darker skin.
Other risk factors include:
- Having light eyes, blond or red hair, or freckles
- Being exposed to the sun or tanning beds
- Having a history of skin cancer
- Having a history of sunburns
- Having a weakened immune system
- Having the genetic disorder xeroderma pigmentosum
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