Tests Or Procedures That Examine The Skin Are Used To Diagnose Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin
The following procedures may be used:
- Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patients health habits and past illnesses and treatments will also be taken.
- Skin exam: An exam of the skin for bumps or spots that look abnormal in color, size, shape, or texture.
- Skin biopsy: All or part of the abnormal-looking growth is cut from the skin and viewed under a microscope by a pathologist to check for signs of cancer. There are four main types of skin biopsies:
- Shave biopsy: A sterile razor blade is used to shave-off the abnormal-looking growth.
- Punch biopsy: A special instrument called a punch or a trephine is used to remove a circle of tissue from the abnormal-looking growth. Enlarge Punch biopsy. A hollow, circular scalpel is used to cut into a lesion on the skin. The instrument is turned clockwise and counterclockwise to cut down about 4 millimeters to the layer of fatty tissue below the dermis. A small sample of tissue is removed to be checked under a microscope. Skin thickness is different on different parts of the body.
- Incisional biopsy: A scalpel is used to remove part of a growth.
- Excisional biopsy: A scalpel is used to remove the entire growth.
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Radiation And Immunologic Origins
Radiation has proven to be tumorigenic by two mechanisms. The first entails the initiations of prolonged cellular proliferation, thereby increasing the likelihood of transcription errors that can lead to cellular transformation. The second mechanism is direct damage of DNA replication, leading to cellular mutation that may activate proto-oncogenes or deactivate tumor suppressor genes.
Immunologically, the mechanism by which prolonged ultraviolet radiation exposure leads to the development of BCC includes suppression of the cutaneous immune system and immunologic unresponsiveness to cutaneous tumors. This local effect includes a decrease in Langerhans cells, dendritic epidermal T cells, and Thy1+ cells. Furthermore, systemic proliferation of suppressor T cells and the release of immunosuppressive factors are believed to be pathogenic to the development of BCC.
Basal Cell Carcinoma Types And Symptoms
A basal cell lesion is often described as a pearly papule because it has a slight shine. These papules are elevated above the surface of the skin and are generally the same color or slightly lighter than the surrounding skin.
Different symptoms and features may develop in some cases, including:
- Telangiectasias: These small dilated blood vessels can form in areas affected by BCC. These lesions appear pink, red, or purplish.
- Discoloration: The cancerous areas on the skin can appear dark or brownish due to the presence of dead cells.
- Itchiness around the lesion
- Lesion that looks like a persistent, non-healing wound
BCC lesions can appear suddenly. They may start at a size of 1 centimeter and continue to grow in size after they initially appear, becoming more noticeable with time.
Basal cell carcinoma lesions usually appear on areas of the body that have been exposed to sunlight, especially high levels of sunlight, including the face, ears, arms, legs, back, and abdomen. BCC can also occur in areas that aren’t exposed to UV at all, such as the scalp, though this is not common.
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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.
- Radiotherapy
- Targeted therapy
Targeted therapy refers to the hedgehog signalling pathway inhibitors, vismodegib and sonidegib. These drugs have some important risks and side effects.
What Should I Do If I Think I Have A Basal Cell Carcinoma
If you notice a change to or growth on your skin, make an appointment to see your doctor straight away. Your doctor will assess the size, location and look of the growth. They will also ask you how long you have had it, whether it bleeds or itches, etc.
If your doctor thinks the growth may be cancer, they may take a small sample of tissue . The tissue sample will be sent to a laboratory and examined under a microscope. Your doctor will let you know whether the sample showed any cancer cells, and will recommend appropriate treatment if necessary.
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What Does Basal Cell Carcinoma Look Like
Basal cell carcinoma is sneaky because it can appear in many ways, such as a patch of skin that doesnt heal for several months, bleeds from time to time, forms a scab, looks like a pimple that doesnt go away, or looks like eczema but doesnt go away after a few months. If an area of your skin continues to become irritated, break open, or bleed over the course of several months, it is smart to have it checked out by a dermatologist.
What Are The Signs And Symptoms Of Basal Cell Carcinoma
Basal cell carcinoma is a type of skin cancer that can show up on the skin in many ways. Also known as BCC, this skin cancer tends to grow slowly and can be mistaken for a harmless pimple, scar, or sore.
Common signs and symptoms of basal cell carcinoma
This skin cancer often develops on the head or neck and looks like a shiny, raised, and round growth.
To help you spot BCC before it grows deep into your skin, dermatologists share these 7 warning signs that could be easily missed.
If you find any of the following signs on your skin, see a board-certified dermatologist.
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Who Gets Basal Cell Carcinoma
Risk factors for BCC include:
- Age and sex: BCCs are particularly prevalent in elderly males. However, they also affect females and younger adults
- Repeated prior episodes of sunburn
- Fair skin, blue eyes and blond or red hairnote BCC can also affect darker skin types
- Previous cutaneous injury, thermal burn, disease
- Inherited syndromes: BCC is a particular problem for families with basal cell naevus syndrome , Bazex-Dupré-Christol syndrome, Rombo syndrome, Oley syndrome and xeroderma pigmentosum
- Other risk factors include ionising radiation, exposure to arsenic, and immune suppression due to disease or medicines
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 :
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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.
What Is A Basal Cell
One of three main types of cells in the top layer of the skin, basal cells shed as new ones form. BCC most often occurs when DNA damage from exposure to ultraviolet radiation from the sun or indoor tanning triggers changes in basal cells in the outermost layer of skin , resulting in uncontrolled growth.
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How Basal Cell Carcinoma Forms
Basal cell carcinoma forms in the basal cells of the skin. Basal cells are located in the lowest layer of the epidermis . These cells are responsible for producing new skin cells as old ones die and are discarded.
Basal cell carcinoma usually occurs on areas of the skin that are frequently exposed to the sun, such as the head and neck. It rarely metastasizes to other areas of the body, typically spreading out and damaging surrounding tissues and bone instead. However, when it does metastasize to distant sites, it is often deadly.
What Causes Skin Cancer
Before answering, Can skin cancer heal on its own? its important that you first understand its underlying causes. In most cases, skin cancer is caused by excessive sun exposure. This exposure to ultraviolet and UV radiation can cause damage to the DNA of the cells. Once your immune system has been compromised, these skin cells can mutate and lead to cancerous cell growth.
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Causes Of Basal Cell Carcinoma
Chronic sun exposure is one of the primary causes of basal cell carcinoma. Repeated exposure to ultraviolet light including UV rays from commercial tanning beds can cause genetic mutations in a persons skin cells. In the case of basal cell carcinoma, these mutations occur in the basal cells, which are responsible for producing new skin cells as old cells are shed away.
The exact DNA mutations that lead to basal cell carcinoma are still being studied. However, researchers generally understand that:
- When these DNA mutations occur, they program the basal cells to multiply at a faster rate than normal. And, while healthy cells ordinarily die when its time for them to be replaced by new ones, DNA mutations can also prevent the basal cells from dying when they should.
- Over time, the rapidly multiplying basal cells can start to accumulate and form a tumor.
- With basal cell carcinoma, the abnormal cells typically do not spread throughout the rest of the body, but the tumor can eventually get larger and grow deeper through multiple layers of skin.
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.
Continued
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Whats The Outlook For Stage 4 Melanoma
Once the cancer spreads, locating and treating the cancerous cells becomes more and more difficult. You and your doctor can develop a plan that balances your needs. The treatment should make you comfortable, but it should also seek to remove or slow cancer growth. The expected rate for deaths related to melanoma is 10,130 people per year. The outlook for stage 4 melanoma depends on how the cancer has spread. Its usually better if the cancer has only spread to distant parts of the skin and lymph nodes instead of other organs.
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Answer: Basal Cell Carcinoma Growth Rate Difficult To Generalize
Well, typically BCCs grow very slowly, but there are occasions when they grow fast. If a person’s immune system is compromised , BCC can grow faster. If the cancer has been there for 5 years, typically it’s bigger than a dime, but again it’s hard to say. Each person’s BCC grow as different rates. I’m a Mohs surgeon and have seen thousands of BCCs.
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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.
Skin biopsy
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.
How Can You Prevent Basal Cell Carcinoma
Being safe in the sun is the best way to prevent BCC and other skin cancers. Here are some tips:
- Avoid being in the sun from 10 am to 4 pm.
- Avoid tanning beds.
- Use a broad spectrum sunscreen with an SPF of 15 or higher each day. If you will be outside for longer periods of time, use a broad spectrum sunscreen that is water-resistant and has an SPF of 30 or higher. Put the sunscreen on 30 minutes before going outside. Put sunscreen on again every two hours, or more frequently if you have been swimming or sweating a lot.
- Use protective clothing that has built-in sun protection, which is measured in UPF. Also, use broad-brimmed hats and sunglasses.
- Do your own skin self-exam about once per month and see a dermatologist about one time per year for a professional skin exam.
- Have any skin changes examined as soon as possible by a healthcare provider.
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Can Basal Cell Carcinomas Be Cured
Yes, BCCs can be cured in almost every case, although treatment can be more complicated if the BCC has been neglected for a long time, or if it occurs in an awkward place, such as close to the eye or on the nose or ear.
BCCs rarely spread to other parts of the body. Therefore, although it is a type of skin cancer it is almost never a danger to life.
How Dangerous Is Bcc
While BCCs rarely spread beyond the original tumor site, if allowed to grow, these lesions can be disfiguring and dangerous. Untreated BCCs can become locally invasive, grow wide and deep into the skin and destroy skin, tissue and bone. The longer you wait to have a BCC treated, the more likely it is to recur, sometimes repeatedly.
There are some highly unusual, aggressive cases when BCC spreads to other parts of the body. In even rarer instances, this type of BCC can become life-threatening.
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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.
Rarer Types Of Non Melanoma Skin Cancer
There are other less common types of skin cancer. These include:
- Merkel cell carcinoma
These are all treated differently from basal cell and squamous cell skin cancers.
Merkel cell carcinoma
Merkel cell carcinoma is very rare. Treatment is with surgery or radiotherapy, or both. This usually works well, but sometimes the cancer can come back in the same place. And sometimes it spreads to nearby lymph nodes.
Sebaceous gland cancer
Sebaceous gland cancer is another rare type of skin cancer affecting the glands that produce the skinâs natural oils. Treatment is usually surgery for this type of cancer.
Kaposiâs sarcoma
Kaposis sarcoma is a rare condition. Itâs often associated with HIV but also occurs in people who donât have HIV. Itâs a cancer that starts in the cells that form the lining of lymph nodes and the lining of blood vessels in the skin. Treatment is surgery or radiotherapy, and sometimes chemotherapy.
T cell lymphoma of the skin
T cell lymphoma of the skin can also be called primary cutaneous lymphoma. Itâs a type of non Hodgkin lymphoma. There are a number of different types of treatment for this type of cancer.
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