What we call basal cell carcinoma is a type of skin cancer and is the most frequently observed type of skin cancer worldwide. You can find more information below.
What is basal cell carcinoma?
Basal cell carcinoma is a skin cancer caused by long and intense stays under UV radiation, such as sun or tanning light, and initially presents as nodules or hardening of the skin. Because this carcinoma is initially the same color as the rest of the skin, it is often not detected early.
If left untreated, it can develop into tumors that infiltrate other areas with crust formation that continues to spread. For this reason, basal cell cancer should always be surgically removed, even if it is not a problem and rarely becomes life-threatening.
Basal cell carcinomas, like squamous cell carcinomas , are skin cancers but are more common. Thousands of people are affected by it every year in Turkey. The average age of those who get it is 60. But things like outdoor activities, increased sunbathing during the holidays and visits to solariums, which are especially popular with young people, also trigger this condition.
What is the incidence?
According to estimates, approximately 20 to 50 thousand people in Turkey are diagnosed with this type of carcinoma. Men and women are affected approximately equally. The average age is 60, but young people are also increasingly affected. The reasons for this are leisure behavior that changes with increased sun exposure or visits to tanning salons.
What causes basal cell carcinoma?
Intense prolonged sun exposure is considered the main cause of them. This explains why carcinomas occur mostly in sun-exposed areas of the head and neck. Other risk factors include genetic predisposition, light skin colour , etc.
Excessive UV radiation damages the genetic material (DNA) of basal cells of the epidermis and some skin cells in the hair follicle. This DNA damage can cause cells to multiply uncontrollably . This is how tumors develop, which is what doctors call basal cell carcinoma.
This carcinoma usually begins as a gray-white thickening of a few millimeters of skin . Without treatment, it damages deeper tissue layers such as cartilage and bone and becomes ulcers over time.
It can also be caused by certain genetic diseases that make the skin color extremely white, such as albinism . People with this type of problem should be especially vigilant about skin cancers.
What are the symptoms of basal cell carcinoma?
There are two questions to ask yourself about this:
- Is there a reddish bump in a place that is usually exposed to UV rays?
- Do your capillaries show themselves on your skin?
These symptoms are characteristic of basal cell carcinoma. The tumor usually has a yellowish-reddish color, a pearly cord-like edge, and small blood vessels that glow on the surface. But sometimes its appearance can be very different. It is usually inconspicuous and not recognizable to the layman.
The following features are typical for basal cell carcinoma:
- Hemispherical vitreous nodules
- Tissue hardening
- Small blood vessels on the surface of the skin lesion
- small areas of red
- Scaly patches, sores and scars
- Small crusts that do not heal
- red spots
If these small cancerous tumors are not detected and treated, they can potentially grow into a large tumor. This not only expands in space, but can also penetrate deeply. These may appear smaller from the outside than they actually are.
When should you see a doctor?
If you observe some negative changes on the surface of your skin, such as a new growth, a change in a previous growth, or recurrent pain, it is a good idea to see a doctor.
How is basal cell carcinoma diagnosed?
Your family doctor or a dermatologist (dermatologist) will take your medical history and perform an examination to evaluate any growths or changes in your skin.
Health history and physical examination
Your doctor will do a general physical exam and ask you questions about your medical history, changes in your skin, or any other signs or symptoms you are experiencing.
Questions may include:
- When did you first notice this skin growth or lesion?
- Has it changed since you first noticed it?
- Is there a growth or is the lesion painful?
- Do you have any other growths or lesions that worry you?
- Have you ever had skin cancer?
- Has anyone in your family had skin cancer? What kind of?
- Do you take precautions to stay safe in the sun, such as avoiding the sun and using sunscreen?
- Do you regularly examine your own skin?
Your doctor will not only examine the suspicious area on your skin, but the rest of your body for other lesions as well, and then do some tests if necessary.
Skin sample for testing
Your doctor may perform a skin biopsy , which involves removing a small sample of the lesion to test in a lab . This will reveal whether you have skin cancer and what type of skin cancer, if any. The type of skin biopsy you do will depend on the type and size of the lesion.
How is basal cell carcinoma treated?
Specialists such as dermatologists can usually recognize this type of carcinoma as soon as they see it. To diagnose even the slightest skin changes, they use a special magnifying glass with an integrated lamp (dermatoscope). If in doubt, they take a tissue sample and examine it.
The goal of treatment is to remove all carcinomas and prevent further growth of the tumor. After that, the chance of recovery is 95%. Which treatment is appropriate depends on where the basal cell carcinoma is, how big it is, and how far it has spread.
In addition, doctors take into account the general condition of the person involved in the treatment. In principle, the decision regarding the therapeutic procedure should be made in a detailed discussion between the doctor and the patient.
In particular, surgery is the first choice for removal of this type of cancer. In the case of smaller basal cell carcinomas, the dermatologist may perform the surgery on an outpatient basis and under local anesthesia. The removed tissue is sent to a lab and it examines the cut edges to determine if microscopic tumor extensions are still hiding there. The remaining tumor tissue is then removed in a second step. In this way, the recurrence of a tumor could possibly be prevented.
Sometimes, if surgery cannot be performed or you do not want to have surgery, other treatments may be recommended in some cases. Other treatments include:
- Curettage and electrodication: This treatment involves removing the surface of the skin cancer with a scraping tool (curette) and then tearing off the base of the cancer with an electric needle. It may be an option for treating small basal cell carcinomas that are less likely to recur, such as those that form on the back, chest, hands, and feet.
- Radiation therapy: Radiation therapy uses high-energy rays such as X-rays and protons to kill cancer cells. Radiation therapy is sometimes used after surgery when the risk of the cancer returning is increased. It can also be used when surgery is not an option.
- Freezing therapy: This treatment involves freezing the cancer cells with liquid nitrogen ( cryosurgery ). It may be an option for the treatment of superficial skin lesions. Freezing can be done after using a scraping tool (curette) to remove the surface of the skin cancer. Cryosurgery may be considered to treat small and thin basal cell carcinomas when surgery is not an option.
- Topical treatments: Prescription creams or ointments may be considered to treat small and thin basal cell carcinomas when surgery is not an option.
- Photodynamic therapy: Photodynamic therapy combines photosensitive drugs and light to treat superficial skin cancers. During photodynamic therapy, a liquid drug that sensitizes cancer cells to light is applied to the skin. Then a light shines on the area, which destroys the skin cancer cells. Photodynamic therapy may be considered when surgery is not an option.
Spreading cancer treatment
Very rarely, basal cell carcinoma can spread (metastasize) to nearby lymph nodes and other parts of the body. Additional treatment options in this situation include:
- Targeted drug therapy: Targeted drug therapies focus on specific weaknesses found in cancer cells. By blocking these weaknesses, targeted drug treatments can cause cancer cells to die. Targeted therapy drugs for this type of carcinoma block the molecular signals that keep cancers from growing. It may be considered after other treatments or when other treatments are not possible.
- Chemotherapy: Chemotherapy uses powerful drugs to kill cancer cells. It may be an option when other treatments don’t help.
Can basal cell carcinoma be prevented?
To prevent this type of skin cancer, you must first stay away from sunlight or tanning sessions. Some other things you can do include:
- Avoid the midday sun.
- Avoid visiting the solarium.
- Stay in the shade in the sunlight, wear sun protection clothing and a sun hat.
- Use quality sunscreens.
- Pay special attention to sun protection for children.
- Wear protective clothing if you work outdoors.
- In addition, skin cancer screening is recommended every two years from age 35.