Basal Cell Carcinoma (BCC): Overview, Prevention, and Treatment

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What is Basal Cell Carcinoma?

• Basal cell carcinoma is the most common type of skin cancer.

• It arises from the basal cells, located in the lowest layer of the epidermis (the outer skin layer).

• BCC grows slowly and rarely spreads to other parts of the body, but it can cause local tissue damage if untreated.

 

Causes and Risk Factors

1. UV Radiation: Prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds.

2. Fair Skin: Individuals with light skin, freckles, blue or green eyes, and blonde or red hair are at higher risk.

3. Age: More common in older adults.

4. Family History: A history of BCC or other skin cancers in the family.

5. Exposure to Certain Substances: Contact with arsenic or radiation.

6. Weakened Immune System: People on immunosuppressive therapy (e.g., after organ transplant).

7. Skin Conditions: Chronic inflammation or scars.

 

Symptoms

• Pearly or waxy bumps on the skin, often with visible blood vessels.

• Flat, flesh-colored, or brown scar-like lesions.

• Open sores that bleed, ooze, or crust and do not heal.

• A pink growth with a raised border and an indentation in the center.

 

Prevention

1. Sun Protection:

   • Avoid excessive sun exposure, especially between 10 a.m. and 4 p.m.

   • Use broad-spectrum sunscreen with SPF 30 or higher daily, even on cloudy days.

   • Wear protective clothing, hats, and sunglasses.

2. Avoid Tanning Beds:

   • Refrain from using indoor tanning devices.

3. Skin Self-Exams:

   • Regularly check your skin for new growths, sores, or changes in existing moles.

4. Dermatologist Visits:

   • Schedule regular skin checks, especially if you have a high risk of skin cancer.

5. Healthy Lifestyle:

   • Maintain a strong immune system with a balanced diet and regular exercise.

 

Treatment

Treatment depends on the size, location, and type of BCC.

1. Surgical Options:

   • Excisional Surgery: Complete removal of the tumor with a margin of healthy tissue.

   • Mohs Surgery: Precise removal of cancer layer by layer, preserving as much healthy tissue as possible.

2. Non-Surgical Options:

   • Curettage and Electrodesiccation: Scraping off the tumor and destroying remaining cancer cells with an electric needle.

   • Cryotherapy: Freezing the tumor with liquid nitrogen.

3. Radiation Therapy:

   • Used when surgery isn't possible, or for deeper or recurrent cases.

4. Topical Treatments:

   • Imiquimod Cream: Stimulates the immune system to attack cancer cells.

   • 5-Fluorouracil (5-FU) Cream: Kills cancerous cells.

5. Photodynamic Therapy (PDT):

   • A light-activated drug is applied to the skin, followed by exposure to a specific light source to destroy cancer cells.

6. Targeted Therapy:

   • For advanced or metastatic cases, drugs like vismodegib and sonidegib may be prescribed to inhibit cancer growth.

7. Chemotherapy:

   • Rarely used for BCC but may be necessary in rare, aggressive cases.

 

Prognosis

• With early detection and treatment, the prognosis for BCC is excellent.

• Untreated, it can cause significant local damage and, in very rare cases, spread to other parts of the body.