What is Basal Cell Carcinoma?

Basal cell carcinoma is the most common skin cancer in the entire world. It is caused from cumulative exposure to sun over time in people who are genetically prone to it. Basal cell carcinoma rarely infiltrates or metastasizes (less than 1% of the time), but rather tends to grow slowly over time spreading over the surface of the skin. Unfortunately, areas that are more exposed to sun such as the face, the ears, the scalp, and the neck as well as arms and hands tend to get the bulk of our sun exposures, and thus are very common areas where basal cell carcinoma (BCC) can be found.

In order to diagnose this type of malignancy, a simply biopsy can be performed. Once it is deemed positive for basal cell carcinoma, it is necessary to treat in order to prevent the spread and progression of it.

The treatment for BCC is surgical removal, electrodessication and curettage, topical therapies or even radiation, depending on location and size. Surgical excision is the most common type of treatment, and can be performed under local anesthesia in a dermatology office. Recommended margins as advised by the American Academy of Dermatology are taken, and the specimen is resent to pathology to prove total removal and elimination of the malignancy.

When a BCC is in a cosmetically sensitive area such as the nose, ears, eyelids or lips, it is recommended by the American Academy of Dermatology to send these patients for a specialized surgery called Mohs surgery, named after the surgeon, Frederick Mohs. Mohs surgery involves immediate pathologic review by the surgeon while employing a specific type of section of the visualized skin cancer. Despite the appearance of the naked eye, BCC can extend well beyond the area in question, and clearance can determined by pathologic review of the specimen while the patient is in the office. Once clearance of the margin has been determined, a repair of the area can be achieved by a Mohs surgeon who is fellowship-trained.

In order to prevent skin cancers such as basal cell carcinoma, it is important to protect the skin from damaging UV radiation which induces these types of malignancies. Sunscreen should be applied daily, and then every 2 hours when patients are working or playing out of doors. If someone drives a car, he or she is being exposed to UV radiation, and the additive effect can induce skin cancers such as basal cell carcinoma over years and year of time. Tanning beds should never be used, as they have been proven to greatly increase the risk of both non-melanoma skin cancer such as BCC, as well as melanoma skin cancer, which can be lethal. Sunscreen should have a minimum SPF of 30. Additionally, sun protective clothing with built-in SPF is very helpful and easy. Sunglasses are another easy way to prevent sun exposures on the delicate eyelid skin and surrounding area.