Basal cell carcinoma (BCC) is the commonest skin cancer type and the commonest cancer of any type in the world. BCCs are particularly common in Australia. Over 50% of Australian men will develop a skin cancer over their lifetime. The main risk for developing a BCC is high cumulative sun exposure, hence they tend to affect middle-aged or older individuals. However, they may also be seen in young adults with high sun exposure or with certain genetic conditions.
BCCs frequently occur in sun exposed sites such as the face, ears and forearms, though can appear anywhere on the body. BCCs often present as shiny, pink-red bumps that may slowly grow and easily bleed. They may also appear brown or black in colour, be flat or crusted. An ulcerated area of skin that fails to heal over months is suspicious for a BCC.
People who have had one BCC are likely to develop more, so it is advisable to have regular skin checks. BCCs usually grow slowly over months to years and rarely spread to other areas of the body. In most cases treatment cures BCCs, there is an excellent prognosis with appropriate treatment. If treated inadequately or left untreated, BCCs can become problematic, as they can increase in size and invade local structures.
Treatment at The Skin Hospital
The best treatment option depends on factors such as the specific type of BCC, location of the tumour and also your general health and lifestyle factors.
- Biopsyunder local anaesthetic may be needed to confirm the diagnosis, but is not required in every case.
- Cryotherapy (liquid nitrogen) is used for the superficial types of BCC. The treated area might be left a lighter colour (hypopigmentation).
- Imiquimod (aldara) cream can only be used for the superficial type of BCCs. This must be applied to the area 5 times a week for a number of weeks.
- Photodynamic therapy (PDT)involves a cream being applied to the skin. This cream is activated by a light source (laser or non-laser light).
- Surgical options: BCCs can be treated by a variety of surgical techniques including curette & cautery (scraping it off), excision (cutting it out) or using a special surgical technique called Mohs surgery, which is very useful for BCCs that are large, recurrent, or affecting difficult sites such as the nose and central face.
- Radiotherapy: is an effective treatment that can be used if surgery is not appropriate. The Skin Hospital can refer to an appropriate specialist if this is considered the best course of action.
Prevention is better than cure.Careful life-long sun protection measures can reduce the risk of developing BCCs.
All specialists at The Skin Hospital are able to perform a skin check and discuss your treatment options. Individuals will be referred to a specialist surgeon at The Skin Hospital if that is considered to be the best option. The Skin Hospital is involved in clinical trials for treatment of some skin cancers. If you are interested in taking part in a clinical trial or hearing more, contact our clinical trials team.
Here are links to trusted sites for further information:
Authors: Dr Charlotte Thomas & Dr Nicholas Stewart