Basal cell carcinoma is a kind of skin malignancy that influences the cells of basal, which are found in the external layer of the skin These cells are round in shape. It is the most typical form of cancer.
Although basal cell carcinoma is less aggressive than melanoma, it can still be dangerous. If not treated, it can develop into nearby bones and tissues.
This type of skin cancer often appears as a flesh-colored lump, a scaly or waxy part, or a skin-colored development. These changes can be subtle and may involve multiple areas of the skin.
Basal cell carcinoma is the most typical kind of skin cancer, also with squamous cell carcinoma. In the United States, doctors find about 5.4 million people affected by these 2 types of cancers each year. Few individuals have both types of cancer
About one in five individuals in the United States will get skin cancer at some point in their lives. But most people survive it. The American Cancer Society (ACS) says that about 3.3 million Americans get squamous cell carcinoma, basal cell carcinoma, or two every year. However, only around 2,000 cases are died. Typically, these deaths happen in old people who waited too long to get treatment or individuals with a weak immune system.
Types
Basal cell carcinoma comes in different types. Doctors have found around 26 kinds.
Most of them are amelanotic, they don’t involve the colored melanocytes in the skin, apart from some other skin cancers. Melanocytes are cells that make melanin, the pigment in our skin. So, basal cell carcinoma doesn’t usually look like a spot or cause discoloration to the skin.
The most typical kinds include:
Nodular
It is the most typical one. It usually makes raised spots or bumps on the skin. The bumps might be the color of your skin.
Micronodular
This type looks like the nodular one but creates many small bumps instead of one big bump.
Superficial
In this type, there are many cancer cells, however, they stay on the surface layer of the skin and don’t go deeper.
Morpheaform
This one is not as common, but it’s more aggressive. It’s more possible to spread to other parts.
Infiltrative
It spreads deeper into the skin and can even go to other parts. It’s the most serious kind and can be deadly.
Symptoms
Symptoms of basal cell cancer are often subtle, with many people not experiencing any noticeable signs aside from an abnormal development on the skin. Unlike certain other skin cancers, basal cell cancer usually doesn’t involve melanocytes, the cells responsible for skin pigmentation, so it doesn’t typically cause changes in skin coloration, making it less conspicuous.
However, there are some indicators to be aware of, such as nodules or development of the skin, particularly in areas exposed to the sun. Additionally, wounds that don’t seem to heal or keep recurring could be a sign of basal cell carcinoma. Another potential symptom is the presence of a flesh-colored lump or development on the skin, which may vary in size and texture. These signs may vary from person to person, so it’s essential to pay attention to any changes in your skin and seek medical attention if you notice anything unusual or concerning.
Causes
Basal cell carcinoma can arise from non-mature cells located in the hair cavity, as indicated by research. Several factors contribute to its development:
UV Light
Chronic exposure to UV radiation, primarily from the sun, is a significant cause of basal cell cancer. UV light, both UVA and UVB, damages DNA in skin cells. Skin’s melanin consumes UVA, generating free extremities that harm DNA. UVB directly damages the RNA and DNA of cells. Prolonged UV exposure can also weaken the skin’s immune system, making it less effective at detecting and eliminating abnormal cells.
Genetic Mutations
As same as all cancers, basal cell cancer results from cells growing uncontrollably due to genetic mutations. DNA damage triggers changes in the genetics of cells, leading to abnormal growth. Around 70% of individuals with basal cell cancer carry a change in the gene named PTCH1. Changes in the gene named P53, liable for controlling the division of cells and death, are also common. These mutations can cause unrestricted cell growth, allowing cancer cells to transmit to other areas.
Risk factors
Risk factors for basal cell carcinoma are things that can develop the chances of getting sunburned or damaging your skin from the sun. Being exposed to substances that can change human cells can also raise the risk.
A few main risk factors involve:
- Having fair skin, especially if you have red hair.
- Getting sunburned easily or having a previous serious sunburn.
- Being exposed to UV light a lot, like from the sun or tanning beds.
- Being exposed to radiation, either from treatments or from the environment.
- Having a weak immune system can make it harder for your body to fight off cancer cells.
- Having specific genetic conditions, like Rombo syndrome, Bazex-Dupre-Christol syndrome, or Gorlin syndrome, can make you more likely to develop basal cell carcinoma.
- Being in contact with toxic chemicals, like arsenic, can increase your chance of developing skin cancer.
- Having actinic keratosis are increase that can lead to skin changes that might become cancerous.
Diagnosis
The diagnosis of basal cell cancer starts with the epidermis check by a doctor. They look at the skin to see if there are any unusual growths or changes.
To be sure someone has cancer, the doctor might need to do a biopsy. This means they take a tiny piece of skin and look at a microscope to check for cancer cells. Sometimes, if there’s a worry that the cancer has spread, the doctor might do other tests like checking lymph vessels or using imaging tests to see if it’s gone to other areas of the body. These tests help the doctor figure out the best way to treat the cancer.
Appearance
Basal cell cancer can have various appearances depending on the individual. It might show up shiny growths, fleshy growths that may bleed or don’t seem to heal, skin-colored nodules, crusty developments, or growths with visible blood vessels. Darkly pigmented growths are more common in basal cell skin cancer, especially on darker skin tones.
People are more possibly to spot basal cell cancer on parts of their skin that get a lot of sun exposure, like the neck, face, and shoulders. Keeping an eye on these areas and noticing any unusual changes can help catch basal cell carcinoma early.
Treatment
Treatment options for basal cell carcinoma vary depending on the individual case.
In many instances, doctors recommend Mohs surgery, a procedure involving the elimination of thin tissue layers until all traces of cancer are healed. The surgical procedure provides the best chance of healing the carcinoma and preventing its return.
However, some individuals may not be suitable candidates for surgical procedures and can require radiation therapy instead. While radiation therapy can effectively target cancer cells, it also affects healthy cells, leading to potential side effects.
Recurrence rates
Recurrence rates for basal cell carcinoma vary depending on the treatment method. Mohs surgery has the lowest recurrence rate at 1%, indicating a high success rate in completely removing the cancerous cells. Surgical excision follows with a recurrence rate of 10.1%, while curettage and electrodesiccation have a rate of 7.7%. And then radiation therapy and cryosurgery both have recurrence rates of 8.7% and 7.5%, respectively. These rates highlight the effectiveness of each treatment approach in reducing the likelihood of cancer returning after initial removal.
Other treatment options
In cases of surface exterior basal cell cancer, other treatment options may involve cryotherapy, topical chemotherapy, or IRMs.
For more advanced cases where the cancer has extended, targeted drugs like vismodegib (Erivedge) may be used to slow or shrink the cancer’s growth. If targeted drugs are not effective, healthcare providers may contemplate immunotherapy help stimulate the immune system to fight with the cancer. For instance, an immunotherapy medicine is cemiplimab (Libtayo).
Complications
Problems from basal cell cancer are rare when treated, meaning there’s a very low chance of something going wrong.
But the main worry is that the malignance might return after treatment. If it’s not treated, basal cell cancer could transfer to other parts. Though this is uncommon, in an uncommon case, it can even lead to death.
While the cancer is left untreated for a long period, it might leave scars on the epidermis, particularly after it’s removed. So, it’s essential to get treatment early to avoid these problems.
Summary
Basal cell carcinoma is a common type of skin cancer that often appears as unusual growths on the skin. It can have various appearances and is more likely to occur in areas with high sun exposure. Diagnosing it involves a skin exam and possibly a biopsy. Treatment options include surgery, radiation therapy, and targeted drugs. While complications are rare with treatment, the main concern is cancer recurrence. Without treatment, basal cell carcinoma can spread and, in rare cases, become fatal.
