Surgery For Basal Cell Carcinoma
Our dermatologic surgeons remove as little tissue as possible when treating your skin cancer, with the goal of preserving your appearance and minimizing scarring.
- Mohs surgery. Tumors in delicate areas like the face might require Mohs surgery, a technique performed by our highly trained doctors. During Mohs surgery, the tumor is removed layer by layer and microscopically examined each time during the procedure to ensure elimination of cancer while preserving as much healthy skin as possible.
- Curettage. Small superficial basal cell cancers can be scraped off using a curette , using local anesthesia. Your doctor then “dessicates” the tumor site with an electrocautery needle. This technique is best reserved for parts of the body where you wouldn’t mind having a scar since it typically leaves a depressed whitish scar at the tumor site.
- Skin cancer excision. Basal cell carcinomas can be excised by a surgical excision right in the doctors office using local anesthesia. Each surgery is tailored specifically to each patient, depending on the site of the skin cancer, specific physical demands of the patient and personal preferences.
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:
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Surgery to remove the tumor
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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:
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Returns after surgery or radiation treatments
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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:
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Sonidegib
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Vismodegib
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.
Where Can You Get It
Any kind of skin cancer is more likely to show up on areas exposed to the sun. Most of the time, advanced BCC affects you from the neck up. But itâs possible to get it other places, like your genitals.
Advanced BCC more commonly affects these areas:
- Eye or eyelid
- Chemotherapy
- Targeted therapy
Thereâs ongoing research into what works best for advanced BCC. Your doctor might suggest joining a clinical trial if other treatments arenât successful. Thatâs a study that looks at new kinds of drugs or treatment methods.
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What Is Mohs Surgery
Mohs surgery is considered the most effective technique for treating many basal cell carcinomas and squamous cell carcinomas, the two most common types of skin cancer. Sometimes called Mohs micrographic surgery, the procedure is done in stages, including lab work, in the dermatologist office in one visit. The procedure is done by shaving off a very thin layer of skin, then testing it to make sure there are no cancer cells around the edges. If cancer cells are detected, the doctor will shave additional thin layers until a clean margin is detected. This allows the removal of all cancerous cells for the highest cure rate while sparing healthy tissue and leaving the smallest possible scar.
What Is The Treatment For Primary Basal Cell Carcinoma
The treatment for a BCC depends on its type, size and location, the number to be treated, patient factors, and the preference or expertise of the doctor. Most BCCs are treated surgically. Long-term follow-up is recommended to check for new lesions and recurrence the latter may be unnecessary if histology has reported wide clear margins.
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Bcc Screening Diagnosis And Beyond
Regular screening for basal cell carcinoma is not usually recommended, but if you find something on your skin that concerns you, you should make an appointment with your provider right away. During a skin exam, your provider will look for any growths, spots, moles or bumps that might be cancerous or precancerous. If something abnormal is found, your provider may do a biopsy, which will reveal whether you have skin cancer and, if so, what type. Being proactive about examining your skin and getting anything abnormal checked promptly means greatly reducing your risk of developing BCC.
BCC can almost always be cured when caught and treated early. While this type of cancer rarely spreads beyond the original tumor site, the lesions can become dangerous and grow deep into the skin, invading soft tissues, bones or nerves when left untreated. It is very rare that a BCC spreads to lymph nodes or metastasizes, and it almost never endangers life.
Basal Cell Carcinoma Squamous Cell Carcinoma Of The Skin And Actinic Keratosis Often Appear As A Change In The Skin
Not all changes in the skin are a sign of basal cell carcinoma, squamous cell carcinoma of the skin, or actinic keratosis. Check with your doctor if you notice any changes in your skin.
Signs of basal cell carcinoma and squamous cell carcinoma of the skin include the following:
- A sore that does not heal.
- Areas of the skin that are:
- Raised, smooth, shiny, and look pearly.
- Firm and look like a scar, and may be white, yellow, or waxy.
- Raised and red or reddish-brown.
- Scaly, bleeding, or crusty.
Basal cell carcinoma and squamous cell carcinoma of the skin occur most often in areas of the skin exposed to the sun, such as the nose, ears, lower lip, or top of the hands.
Signs of actinic keratosis include the following:
- A rough, red, pink, or brown, scaly patch on the skin that may be flat or raised.
- Cracking or peeling of the lower lip that is not helped by lip balm or petroleum jelly.
Actinic keratosis occurs most commonly on the face or the top of the hands.
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Oral Medications For Advanced Bcc
It is rare for skin cancer to reach advanced stages, but when it does, oral medications may help. In addition to chemotherapy, targeted drugs may be used to treat advanced skin cancer. Targeted therapy means that the medication is able to directly target the cancer cells without destroying healthy cells. This can help to reduce side effects from treatment.
Vismodegib and sonidegib are hedgehog pathway inhibitors that work to prevent cancer cells from growing and spreading. The capsules are taken once per day and may be considered after surgery and other treatments. These medications come with several possible side effects and should never be taken during pregnancy since they can affect fetal growth.
Cetuximab is an EGFR inhibitor that can help to stop the spread of cancerous squamous cells. Its possible side effects include skin infections, diarrhea, mouth sores, and loss of appetite.
Treatments For Basal Cell Carcinoma
The following are treatment options for basal cell carcinoma of the skin. Your healthcare team will suggest treatments based on the . They will work with you to develop a treatment plan.
BCC is most often treated with local therapy. This means that only the cancer on the skin and the area around it are treated.
But if BCC has spread to other parts of the body, systemic therapy may be used. Systemic therapy travels through the bloodstream to reach and destroy cancer cells all over the body.
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Staging For Basal Cell Carcinoma And Squamous Cell Carcinoma Of The Skin Depends On Where The Cancer Formed
Staging for basal cell carcinoma and squamous cell carcinoma of the eyelid is different from staging for basal cell carcinoma and squamous cell carcinoma found on other areas of the head or neck. There is no staging system for basal cell carcinoma or squamous cell carcinoma that is not found on the head or neck.
Surgery to remove the primary tumor and abnormal lymph nodes is done so that tissue samples can be studied under a microscope. This is called pathologic staging and the findings are used for staging as described below. If staging is done before surgery to remove the tumor, it is called clinical staging. The clinical stage may be different from the pathologic stage.
Mohs May Be Your Best Treatment Option
Because of its ability to invade the surrounding area, typical location in high-risk areas, and high risk of recurrence, your doctor may recommend Mohs surgery for treating morpheaform basal cell carcinoma. It is possible that excision alone would not remove all the cancer. Removing all the cancer with excision would also remove a large amount of healthy tissue.2-4
Have you or someone you know been diagnosed with morpheaform basal cell carcinoma?
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After Squamous Cell Cancer Of The Skin Has Been Diagnosed Tests Are Done To Find Out If Cancer Cells Have Spread Within The Skin Or To Other Parts Of The Body
The process used to find out if cancer has spread within the skin or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment for squamous cell carcinoma of the skin.
Basal cell carcinoma of the skin rarely spreads to other parts of the body. Staging tests to check whether basal cell carcinoma of the skin has spread are usually not needed.
The following tests and procedures may be used in the staging process for squamous cell carcinoma of the skin:
Is Mohs Right For Me
Mohs surgery is the gold standard for treating many basal cell carcinomas and squamous cell carcinomas , including those in cosmetically and functionally important areas around the eyes, nose, lips, ears, scalp, fingers, toes or genitals. Mohs is also recommended for BCCs or SCCs that are large, aggressive or growing rapidly, that have indistinct edges, or have recurred after previous treatment. Some surgeons are also successfully using Mohs surgery on certain cases of melanoma.
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How Is Basal Cell Carcinoma Diagnosed
BCC is diagnosed clinically by the presence of a slowly enlarging skin lesion with typical appearance. The diagnosis and histological subtype is usually confirmed pathologically by a diagnostic biopsy or following excision.
Some typical superficial BCCs on trunk and limbs are clinically diagnosed and have non-surgical treatment without histology.
Contact Us With Questions About Superficial Radiation Therapy
If you think IG-SRT is right for you but have questions about non-melanoma skin cancer facts you would like to ask, we welcome you to call us at 312-987-6543 to speak with one of our skin cancer specialists. If youve already decided to pursue IG-SRT as a treatment option but are having difficulty locating a dermatology and skin cancer center near you that offers IG-SRT radiation therapy, give us a call. We also encourage you to take a moment to browse our blog, where you will find comprehensive posts detailing common topics and helpful advice surrounding non-melanoma skin cancer. No matter where youre at in your Superficial Radiation Therapy journey, GentleCure is here for you.
Non-Melanoma Skin Cancer impacts the lives of 4 million Americans each year. GentleCure is committed to raising awareness of IG-SRT and is a trademark owned by SkinCure Oncology, LLC.
The information on this website is provided without any representations or warranties. You should not rely on this website as an alternative to medical advice from your doctor or healthcare provider. The information on this site, as well as any information provided by the skin cancer information specialists on our educational hotline, is intended to help you make a better-informed treatment decision in conjunction with trained and licensed medical professionals.
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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 Are The Clinical Features Of Basal Cell Carcinoma
BCC is a locally invasive skin tumour. The main characteristics are:
- Slowly growing plaque or nodule
- Skin coloured, pink or pigmented
- Varies in size from a few millimetres to several centimetres in diameter
- Spontaneous bleeding or ulceration
BCC is very rarely a threat to life. A tiny proportion of BCCs grow rapidly, invade deeply, and/or metastasise to local lymph nodes.
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Effective Options For Early And Advanced Bcc
When detected early, most basal cell carcinomas can be treated and cured. Prompt treatment is vital, because as the tumor grows, it becomes more dangerous and potentially disfiguring, requiring more extensive treatment. Certain rare, aggressive forms can be fatal if not treated promptly.
If youve been diagnosed with a small or early BCC, a number of effective treatments can usually be performed on an outpatient basis, using a local anesthetic with minimal pain. Afterwards, most wounds can heal naturally, leaving minimal scarring.
Options include:
What Doctors And Specialists Treat Skin Cancer
Skin cancer treatment may require a team approach.
Simple skin cancers can usually be handled by a dermatologist in an office setting. More complex cases, however, may require the expertise of several health professionals to both diagnose and treat the cancer.
The experts on your healthcare team can answer important questions and provide valuable information about your diagnosis. The number of providers youll see will depend on the type of skin cancer you have and how advanced it is.
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What Are The Symptoms Of Basal Cell Carcinoma
Almost all BCCs develop on parts of the body frequently exposed to the sun. Tumors can develop on the face, ears, shoulders, neck, scalp, and arms. In very rare cases, tumors develop on areas not often exposed to sunlight.
BCCs are typically painless. The only symptom is the growth or change in the appearance of the skin. There are different types of BCC. Each has a different appearance:
Skin cancers, including BCC, are primarily caused by long-term sun or ultraviolet light exposure. These cancers can also be caused by intense occasional exposure often resulting in sunburn.
In rarer cases, other factors can cause BCC. These include:
- exposure to radiation
Physical Findingsbasal Cell Carcinomas
The hallmark of basal cell carcinoma is a waxy, translucent, or pearly appearance. Commonly, these lesions have central ulceration and a raised pale border . The border may be highlighted by applying traction on the skin around the lesion . Telangiectasias are common and lead to friability, poor healing, and frequent bleeding. Atrophy is possible , and the borders can be indistinct.
Basal cell carcinoma with atrophy and friability.
Figure 5
Basal cell carcinoma with atrophy and friability.
Pigmented basal cell carcinomas are less common and are easily confused with melanoma. They are caused by the presence of melanin within the lesion.23 These lesions have the same structural features described above but, because of the pigmentation, can be mistaken for melanoma. In melanoma or pigmented basal cell carcinomas, treatment is based on tissue diagnosis.
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Diagnosis Of Basal Cell Carcinoma
You can be diagnosed by your family doctor or by a skin doctor . The doctor will ask questions about your exposure to the sun, your family history of skin cancer and how long you’ve had the growth.
An examination of your skin is next, checking for any other sores. If the sore or sores look suspicious, your doctor will remove a sample of it and have it tested for cancer, also know as a biopsy.
Basal Cell Carcinoma Diagnosis
If youre concerned about a mark on your skin, schedule a visit with your dermatologist. Its always better to be safe than sorry. Your doctor will examine the spot and if he or she is concerned, a biopsy is the next step. This involves taking a sample of the lesion and sending it off to a lab for analysis. The process can take around a week or more to get results.
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Organisation Of The Study
In this study, we looked at all cases of skin cancer removed by maxillofacial surgery for the period of JanuaryDecember 2009 undertaken by one surgeon. During this time, not all the cases were sent to the same histopathology laboratory, and so the study was reduced to include only those sent to the Surrey & Sussex Histopathology Department, and which were histologically proven to be BCCs.
The patients were identified from the database by the surgeon’s name and then by the histopathological diagnosis BCC. The pathology reports were then reviewed retrospectively.
Of the 792 patients operated on by the surgeon, only 247 BCCs were studied. These cases were only selected on the basis that the histopathological examination was carried out at the Surrey & Sussex Pathology Department. There was no clinical bias, which would affect the referral to this department. All the surgery was undertaken by one surgeon, regardless of where the histology was finally reviewed.