What is Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is a non-melanocytic skin cancer (i.e., an epithelial tumour) that arises from basal cells, i.e. small, round cells foundin thelower layerof theepidermis. It is considered as the most common skin cancer, and the most common cancer of human beings. The prognosis for patients with Basal Cell Carcinoma is excellent, with almost no possibility of metastasis, but if the disease is allowed to progress, it can cause significant morbidity.

This type of skin cancer usually develops on the skin that is exposed to the sun, such as the head, neck or the back of the arms.

Basal cell carcinoma is also particularly common on the face, often appearing on the nose. It may appear on any part of the body, including the trunk, legs and arms. People using sun beds are at much greater risk of developing basal cell carcinoma.

This type of skin cancer develops slowly. Treatment is important, because it may because it may grow widely and deeply, destroying the skin tissue and the bones if untreated for a long time.

Symptoms

Basal cell carcinomas often develop, as already mentioned, on areas of the body that are exposed to the sun, especially on the head and neck. A much lower number of BCCs develop on the trunk and legs. Nevertheless, basal cell carcinomas may also develop on body parts that are rarely exposed to the sun.

Although a general warning sign for this type of skin cancer is a wound that is not healing or bleeds repeatedly, basal cell carcinoma may also look like:

  • A white, pearly or waxy bump, often with visible blood vessels on the face, ears or neck. The bump may bleed and develop a crust. In darker skinned people, this type of cancer may be brown or black.
  • A flat, scaly, brown or flesh-coloured patch on the back or chest. Over time, these patchy rashes can grow quite large.
  • More rarely, a white, waxy scar. This type of basal cell carcinoma is easy to overlook but it may be a sign of a particularly invasive and disfiguring type of cancer called morpheaform (sclerosing) basal cell carcinoma.

Treatment

The goal is to eliminate cancer, with the least possible scarring. To choose the best treatment, the size and the location of the tumour should be examined, as well as its growth rate. Of course, scarring is also taken into account, in addition to your general health status.

Below you will see some of the treatment options offered in DERMadvance and may be recommended by the doctor:

  • Surgical Excision. This is the first choice. Surgical excision is performed at the margins of the healthy skin, followed by restoration of the skin, and the tissue sample obtained is sent to the laboratory for biopsy.
  • Fractional laser and BCC Sublimation. A modern surgical approach using an invasive laser for the sublimation of the tumour or its intersection to obtain tissue for biopsy.
  • Photodynamic Therapy. A modern treatment approach using a photosensitising substance (Metvix), followed by the exposure of the lesion to a source of light energy at a specific wavelength. The aesthetic result achieved is excellent, but there are also certain limitations depending on the location, type and size of the carcinoma.
  • Electrodesiccation and curettage (Electrosurgery). Following local anaesthesia, the tumour is removed using a scraping spoon-like instrument. Then the doctor controls local bleeding.
  • Cryosurgery. This method is used less commonly today, mainly in patients who cannot undergo surgery for various reasons. The aesthetic result is not pleasant, and it is usually selected in elderly patients with low life expectancy.
  • Radiotherapy. This treatment uses X-rays to destroy the cancerous cells. It lasts several weeks.
  • Use of topical immunomodulatory substances
    • Α. Imiquimod cream. ALDARA cream is a safe option in patients with small tumours (< 0.8 cm in diameter). The cream acts by reviving the skin’s immune monitoring function in the affected area and the tumour is treated. Treatment duration is approximately 6 weeks, and it is accompanied by local irritation or even systemic (fever – influenza-like-illness, etc).
    • Β. 5-FU Cream. Treatment with fluorouracil 5-FU cream leads to comparable therapeutic effects to those of Aldara (Ιmiquimod) cream.It is applied to the tumour twice daily for three to six weeks.
  • Chemotherapy in locally extended and inoperable BCC tumours with Vismodegib.