Basal cell carcinoma – causes, symptoms, diagnosis, treatment, prognosis

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Basal cell carcinoma is a common skin cancer. It develops gradually and is usually not metastatic. This type of cancer appears more frequently on sun-exposed skin, usually in fair-skinned people. It most often affects people over 50. Check what are the symptoms of basal cell carcinoma.

Basal cell carcinoma is a malignant tumor that grows in exposed places in the body. Most often it is the head and neck, but it can also develop anywhere, and even on mucous membranes. The appearance of basal cell carcinoma is so characteristic that a dermatologist can usually recognize it after an initial examination of the skin.

Basal cell carcinoma – causes

Basal cell carcinoma usually develops in people over the age of 50. They usually have a fair complexion that is easily sunburned (UV exposure is the main contributing factor). That is why basal cell carcinoma is most common in people who work outdoors and in people who frequently use tanning beds and over-sunbathe.

Contact with various arsenic compounds or pesticides is also a risk factor for basal cell carcinoma.

People who have undergone immunosuppressive treatment or are taking medicines that suppress their immune response, and those with a family history of skin cancer (these may be at increased risk of developing basal cell carcinoma) are at risk.

Basal cell carcinoma is exposed to places on the skin that have been mechanically, chemically and thermally irritated. These are, for example, people who smoke with chronic fistulas and whose edges are irritated in a chemical and mechanical way, or people at risk of papillomavirus (papilloma) infections. Interestingly, radiation therapy may increase the risk of basal cell carcinoma at prior treatment sites on the skin.

Conditions considered predisposing to skin cancer include:

1. hyperkeratosis (senile: keratosis senilis, solar: keratosis solaris);
2. burn scars;
3. dermal horn (cornu cutaneum);
4. white keratosis (leucoplakia, leukoplakia);
5. Bowen’s disease (a pre-invasive form of squamous cell carcinoma);
6. Queyrat erythroplasia;
7. Bowenoid papulosis (changes caused by the human papillomavirus in the genital area);
8. parchment skin (xeroderma pigmentosum);
9. nevoid basal cell carcinoma syndrome.

Find out more: Mechanisms of tumor formation

Basal cell carcinoma – symptoms

Basal cell carcinoma is usually a nodule with a rolled edge. The patient’s vigilance should also be restored in the morning, which is covered with a regularly falling scab. It is formed in the morning and quickly becomes covered with a new scab.

Basal cell carcinoma comes in various forms. It can be flat or flat to the top. Most often it is also flaky and red.

Basal cell carcinoma occurs where the skin is exposed to sunlight. Therefore, it can most often be seen on the face, neck, but also legs, arms and crotch. The location of basal cell carcinoma often reduces the quality of life of patients.

The development of basal cell carcinoma is also possible on damaged skin.

Find out more: Inconspicuous symptoms of a tumor

Basal cell carcinoma – types

Basal cell carcinoma can occur in one of five forms:

1. nodular-ulcerative;
2. pigmentary (differentiation with skin melanoma);
3. sclerosing;
4. superficial;
5. fibrous-epithelial.

It is worth adding that the superficial and fibrous-epithelial forms grow quite slowly, while the scleroderma-like form is the most aggressive and grows infiltrating in the vertical (infiltration into deeper layers) and horizontal (extensive infiltration) planes.

Basal cell carcinoma – diagnosis

Diagnosing basal cell carcinoma is quite simple. After the initial examination of the lesions through the dermatoscope, the doctor may suggest a diagnosis.

However, the final diagnosis is made after the histopathological examination of the lesion after its excision.

Also read: Control tests against cancer

Basal cell carcinoma – treatment

Treatment of basal cell carcinoma depends on the advancement of the disease, but also on the cancer location, growth dynamics, health condition, age and patient expectations. Usually the lesions are excised and submitted for histopathological examination.

In the treatment of basal cell carcinoma, for example, an ointment with a chemotherapeutic agent (5-fluorouracil) or an immunomodulating drug (imiquimod) is also used. However, it should be known that the effectiveness of conservative methods does not equal the excision of the lesion.

When basal cell carcinoma is very advanced, doctors use targeted therapy that uses modern drugs. This class of drugs is designed to inhibit the hedgehog signaling pathway.

Read also: Where to treat cancer?

Basal cell carcinoma – recurrences

Basal cell carcinoma is a malignant tumor, but statistics show that the mortality rate is very low and amounts to approx. 3%. This is because the cancer does not usually spread.

Unfortunately, basal cell carcinoma tends to recur in the same placeswhich happens up to 20% of the time. Relapse may occur even several years after recovery. Basal cell carcinoma is more likely to relapse in lesions larger than 2 cm and with lesions located on the face.

Basal cell carcinoma – frequency of occurrence

It must be admitted that basal cell carcinoma is the most common skin cancer, and every year it affects 100 to 800 people per 100 white people. Interestingly, the highest incidence of basal cell carcinoma is recorded in Australia, and this is due to the main risk factor, i.e. exposure to UV radiation, especially when a person is exposed to this factor from an early childhood.

It should also be remembered that the elderly are the most vulnerable to this type of cancer. This is because in the elderly, the effects of the sun accumulate throughout their lives. Most often, men with fair-skinned skin suffer from basal cell carcinoma. It must not be forgotten that, as in the case of other cancers, also in this case the chronic weakening of immunity is of great importance, therefore people after organ transplantation are very vulnerable to cancer (they take drugs that impair the efficient functioning of the immune system for a long time).

Also check: The most common cancers among Poles

Basal cell carcinoma – what if it is left untreated?

If left untreated, basal cell carcinoma develops and begins to attack local structures. The cancer spreads to the muscles and bones, causing further damage that needs to be dealt with. If they develop open pain or ulceration, sufferers may also be at risk of infections and other complications.

Basal cell carcinoma – prognosis

As for basal cell carcinoma, this assuming that treatment is properly administered, the prognosis is very good. However, it should be remembered that basal cell carcinoma has a tendency to recur in the places where it was detected. This entails careful observation of the scar and the places around it every now and then. This is especially important for people who have already developed basal cell carcinoma, as they are at increased risk of developing it elsewhere in the body.

Interestingly, according to preliminary studies by researchers at Stanford University School of Medicine, people with abnormally frequent cases of basal cell carcinoma appear to be at much higher risk of developing other cancers, including cancer of the blood, breast, colon, and prostate.

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Basal cell carcinoma – prevention

When it comes to prophylaxis in the case of basal cell carcinoma, several rules should be followed. Namely, remember to avoid prolonged exposure to the sun’s rays, and a single session should be short. Of course, it is equally important to use creams with high filters against UVA and UVB radiation. However, it must be said at this point that UV filters cannot be regarded as perfect protection. As the US National Cancer Institute states, there is no evidence that UV filters actually prevent basal cell carcinoma or melanoma. When in the sun, it is worth wearing protective clothing. Cover your skin with dark clothing that covers the arms and legs and a wide-brimmed hat that offers better protection than a baseball cap.

You cannot forget about:

1. regular checks of lesions predisposing to cancer development (i.e. parchment skin, senile keratosis, leukoplaki, burn scars);
2. regular control of people who are at risk (e.g. people working in professions where they are exposed to chemicals such as: insecticides and fungicides, arsenic, petroleum derivatives);
3. checking birthmarks and avoiding smoking.

It is also crucial to contact your doctor immediately if you suspect skin cancer. We should pay attention to every nevus with or without dye on the skin, in the eye, developing subungual, on mucous membranes (lips, vulva, anal area), which undergo any changes. Such symptoms should be consulted with a specialist doctor and examined.

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