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.
Nevoid Basal Cell Carcinoma Syndrome
In addition to basal cell carcinoma, this autosomal dominant disorder can result in the early formation of multiple odontogenic keratocysts, palmoplantar pitting, intracranial calcification, and rib anomalies. Various tumors such as medulloblastomas, meningioma, fetal rhabdomyoma, and ameloblastoma also can occur.
Odontogenic keratocysts, palmoplantar pitting, intracranial calcification, and rib anomalies may be seen. Mutations in the hedgehog signaling pathway, particularly the patched gene, are causative.
Go to Nevoid Basal Cell Carcinoma Syndrome to see more complete information on this topic.
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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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 donât 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.
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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How Is Basal Cell Skin Cancer Treated When It Grows Deep Or Spreads
While this skin cancer tends to grow slowly, early treatment is recommended. Without treatment, BCC can grow deep, destroying what lies in its way. This can be disfiguring. The medical term for this is advanced basal cell carcinoma.
Its also possible for BCC to spread to other parts of your body, but this is rare. When the cancer spreads, it typically travels first to the lymph nodes closest to the tumor. From there, it tends to spread through the blood to bones, the lungs, and other parts of the skin. When this skin cancer spreads, it is called metastatic basal cell carcinoma.
For cancer that has grown deep or spread to the closest lymph nodes, treatment may involve:
Surgery to remove the tumor
Follow-up treatment with radiation to kill any remaining cancer cells
For some patients, medication that works throughout the body may be an option. Medication may also be used to treat cancer that:
Returns after surgery or radiation treatments
Has spread to another part of the body
Two such medications have been approved by the U.S. Food and Drug Administration . Both come in pill form and are taken every day. A patient only stops taking the medication if the cancer starts to grow, or the side effects become too severe.
The two medications are:
In clinical trials, these medications have been shown to stop or slow down the spread of the cancer and shrink the cancerous tumors in some patients.
How Serious Is Basal Cell Skin Cancer
Basal Cell Carcinoma Skin Cancer Treatment Ocala, Florida
Cancer is always serious and never to be taken lightly, but if you develop non-melanoma basal cell carcinoma skin cancer in Ocala, FL, know that world class skin cancer doctors are nearby and that you are not alone in your skin cancer diagnosis. Given the population of some 60,000-plus residents in Ocala, FL skin cancer is an issue you and a good 15,000 of your neighbors will have to face at some point, because non-melanoma skin cancer is the most common type of cancer in America and affects about one quarter of the population overall.
Identified early and with prompt basal cell carcinoma removal thanks to a great skin cancer dermatologist, you can expect an almost 100% survival rate of basal cell carcinoma skin cancer, and with a 98% cure rate on the first round of interventions depending on which course of treatment you and your Ocala, FL skin cancer specialists choose. But you can only hope for such successful skin cancer treatment in Ocala if you act fast as soon as you think you identify basal cell carcinoma symptoms on your skin.
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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.
When Should I See A Healthcare Provider About Basal Cell Carcinoma
It is important to contact a healthcare provider any time you have a skin problem that does not resolve. This means developing any new or larger mole, lump or sore, or new symptoms such as pain or itchiness. If you have had BCC or another type of skin cancer, you will probably be given a recommended schedule of needed appointments. You should follow up on these appointments as directed.
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How To Identify Types Of Skin Cancer
Skin cancer comes in three forms: Basal cell carcinoma, squamous cell carcinoma, and melanoma. While basal cell carcinoma is the most common type of skin cancer, melanoma is the most serious type of skin cancer because it is the most likely to spread to the lymph nodes and other organs. Only a doctor can tell you for sure which type of cancer you might have, but there are some differences between the types of skin cancer that you can observe on your own body. Read on to find out what those differences are.
Things Youll Need
- Standard pencil eraserCamera
Tips & Warnings
- Sunburns and exposure to sun can greatly increase your chance of getting skin cancer, so be sure to protect your skin with clothing and sunscreen.
- See a doctor as soon as possible if you suspect you may have skin cancer. Melanoma is treatable if caught early, but can be deadly if allowed to spread.
What Does Bcc Look Like
BCCs can look like open sores, red patches, pink growths, shiny bumps, scars or growths with slightly elevated, rolled edges and/or a central indentation. At times, BCCs may ooze, crust, itch or bleed. The lesions commonly arise in sun-exposed areas of the body. In patients with darker skin, about half of BCCs are pigmented .
Its important to note that BCCs can look quite different from one person to another. For more images and information on BCC signs, symptoms and early detection strategies, visit our BCC Warning Signs page.
Please note: Since not all BCCs have the same appearance, these photos serve as a general reference to what they can look like. If you see something new, changing or unusual on your skin, schedule an appointment with your dermatologist.
An open sore that does not heal
A shiny bump or nodule
A reddish patch or irritated area
A scar-like area;that is flat white, yellow or waxy in color
A small pink growth;with a slightly raised, rolled edge and a crusted indentation in the center
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Causes Of Basal Cell Carcinoma
BCC occurs when one of the basal cells of the epidermis develops a mutation, or change, in its DNA. The process of creating new skin cells is controlled by a basal cell’s DNA. A mutation in the DNA may cause a basal cell to multiply fast and continue growing when it would normally die. Eventually, the abnormal cells add up and may form a cancerous tumor.
What Else Could This Skin Lesion Be
Other skin conditions may look like BCC. Nodular BCC without ulceration may look similar to:3
- Molluscum contagiosum, a viral infection that causes numerous small bumps.
- Sebaceous hyperplasia, a condition characterized by small yellow bumps.
- Intradermal melanocytic nevus, a nest of melanocytes in the dermis layer of skin.
- Fibrous papule, a firm bump that may develop on the nose.
- Other skin cancers
Ulcerated BCC may be confused with squamous cell carcinoma or keratoacantoma.
Conditions that look similar to superficial BCC include:3
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Preventing Basal Cell Carcinoma
Basal cell carcinoma prevention is the same as prevention methods for all skin cancers, with the goal of protecting skin from harmful UV rays.
The number one thing people can do is to practice good sun protection and sun avoidance, meaning wear sunscreen and protect the skin from getting sun damage, says Stevenson. Its also important to get skin checks regularly for early detection.
Stevenson says if someone is prone to skin cancers for example, has very fair skin, sunburns as a child, or a history of skin cancer in the family its better to go out in the late afternoon or early morning when the sun isnt as strong, or stay primarily in the shade.
Anyone spending time in the sun, regardless of complexion, should practice sun protective behaviors, including wearing sunscreen.
The Centers for Disease Control and Prevention recommends a sunscreen with a minimum sun protection factor of 15, and UVA and UVB broad spectrum protection. It also advises people to stay in the shade as much as possible and wear protective clothing including brimmed hats and sunglasses. Stevenson suggests looking for a SPF over 30.
Lebwohl says the SPF number directly correlates with the amount of protection it gives you. He says to divide the amount of time in the sun by the SPF number. For example, if someone is in the sun for 60 minutes, and wearing SPF 30, its as if they were exposed to two minutes of damaging rays rather than the full 60 minutes.
Cutaneous Squamous Cell Carcinoma
After BCC, it’s cutaneous squamous cell carcinoma that is the second most common kind of skin cancer. Both are of the keratinocyte type. Though cSCC occurs less often, it may have more serious outcomes, including death.
As with other skin cancers, cases are on the rise in aging populations. It’s thought that early exposure to UV light, in childhood and youth, contributes to the development of BCC and cSCC.
Annual screenings are important if you’ve had a previous diagnosis of either type of skin cancer. Be sure to tell your doctor because some dietary supplements, like retinoids or selenium, should not be given to people with a history of cSCC. Tell your doctor about any family history of skin cancer too.
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What Is Basal Cell Carcinoma Skin Cancer
Mark Lebwohl, MD, a professor and the chairman at the Kimberly and Eric J. Waldman Department of Dermatology at Mount Sinai and a spokesperson for the Skin Cancer Foundation, recalls once running into a doctor colleague at work with a scab on his lip.
Crossing paths again weeks later, his colleague had the same scab.
I looked at him and said, You really should have that looked at, and he said, Oh, its just a scab, I keep hitting it when I shave, says Dr. Lebwohl. Ultimately, his colleague did get it looked at by a dermatologist. It was skin cancer, more specifically basal cell carcinoma .
Skin cancer is the most common type of cancer in the United states, and BCC is the most frequently occurring of all forms of cancer, according to the;Skin Cancer Foundation. Basal cell carcinoma, which can appear, as in the case of Lebwohls colleague, as a minor irritation, has more than 4 million cases diagnosed annually.;And like Lewohl’s colleague, a wound that wont heal is just one possible manifestation of basal cell carcinoma.
What Are The Complications/side Effects Of The Treatments For Basal Cell Carcinoma
Most of the complications related to BCC treatments other than the hedgehog inhibitors are cosmetic, such as scarring or redness.
People who use sonidegib or vismodegib should make sure to use effective birth control to avoid pregnancy due to the risk of birth defects. In addition, sonidegib has other potential risks, including problems with nerves and muscles.
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What Causes Basal Cell Carcinomas
The main cause of damage leading to BCC is sun exposure. This is usually a combination of:
- long-term, everyday sun exposure, and
- occasional intense exposure, usually leading to sunburn.;
In some cases, they are the result of damage caused by things such as burns, scars, infections, vaccinations or tattoos.
Squamous And Basal Cell Carcinoma Causes And Precautions
The main cause of basal and squamous cell carcinoma skin cancer is sun damage. Every time you expose your skin to too much UV light which is really just radiation your skin gets damaged and the cells rememberer the exposure in the form of damaged DNA. Later on, this damage often presents itself in the form of skin cancer. While a family history of skin cancer and having pale skin can put you at higher risk for non-melanoma skin caner, far and away the main cause of skin cancer is exposure to UV light from the sun .
To prevent skin cancer later in life, you need to break vigilant about wearing sunblock and hats and covering yourself as much as possible with clothing. Sure, the sun in Ocala, FL is lovely, but enjoy it safely.
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How Dermatologists Diagnose Basal Cell Carcinoma
When you see a board-certified dermatologist, your dermatologist will:
Examine your skin carefully
Ask questions about your health, medications, and symptoms
If your dermatologist finds a spot on your skin that could be any type of skin cancer, your dermatologist will first numb the area and then remove all of it. This can be done during an office visit and is called a skin biopsy. This is a simple procedure, which a dermatologist can quickly, safely, and easily perform.
Having a skin biopsy is the only way to know for sure whether you have any type of skin cancer. After your dermatologist removes the spot, a doctor, such as your dermatologist or a dermatopathologist, will examine it under a high-powered microscope. The doctor is looking for cancer cells.
If the doctor sees cancerous basal cells, the diagnosis is BCC.
After the doctor examines the removed skin under a microscope, the doctor writes a report. Called a biopsy report or a pathology report, this document explains in medical terms what was seen under the microscope.
If the diagnosis is any type of skin cancer, the information in this report will tell your dermatologist the key facts needed to treat the cancer, including:
The type of BCC you have
How deeply the cancer has grown
Your dermatologist will carefully consider your health and the findings in the report before choosing how to treat the cancer.