Basal cell carcinoma (BCC) is a type of skin cancer that begins in the basal cells — cells within the skin that produce new skin cells as old ones die off. It’s the most commonly diagnosed skin cancer. BCC lesions often look like a waxy bump. They tend to appear on the areas of your skin that are most often exposed to the sun, including your face and neck. As with most skin cancers, BCC is thought to be caused largely by long-term exposure to ultraviolet (UV) radiation from sunlight and tanning beds.
BCC Symptoms
As in most skin cancers, a key symptom of BCC is a sore that won’t heal, or that repeatedly bleeds and develops into a scab. BCC can also appear as:
A pearly white or waxy bump (brown or black in darker-skinned people) with visible blood vessels that may bleed and develop a crustA flat, scaly, brown- or flesh-colored patch on your back or chestA white, waxy scar, which may be a sign of a particularly invasive and disfiguring cancer called morpheaform basal cell carcinoma
Talk to your doctor at your earliest convenience if you have any signs or symptoms that concern you.
BCC Treatment
There are several available treatments for BCC. The best approach for you will depend on the type, location, and severity of your cancer. Commonly used treatments include:
Electrodesiccation and curettage (ED&C)Surgical excisionFreezingMohs surgeryTopical treatmentsMedication for advanced cancer
In ED&C, a surgeon removes the surface of the skin cancer with a scraping instrument (curette) and then sears the base of the cancer with an electric needle. ED&C is typically used for small lesions on the legs and ears. In surgical excision, the surgeon cuts out the cancerous tissue and a surrounding area of healthy skin. This procedure is usually recommended for larger BCCs, and may result in scarring. For BCCs that are very thin or near the surface of your skin, your doctor may recommend killing the BCC cells by freezing them with liquid nitrogen. This is sometimes called cryosurgery. In Mohs surgery, surgeons remove cancer cells layer by layer. They examine each layer under a microscope to verify that no abnormal cells remain, which enables them to remove the entire growth without taking excessive amounts of surrounding healthy tissue. Mohs surgery is most often used in cases of recurring BCC, or when lesions are large, deep, fast-growing, on your face, or of the morpheaform type. Topical ointments may be used to treat BCCs on the surface that don’t extend deep into the skin. Drugs used as topical treatments include:
Aldara (imiquimod)Carac, Fluoroplex, Efudex (fluorouracil)
Treatments using topical ointments may last for several weeks. Finally, the drug Erivedge (vismodegib) may be used to treat BCC that has spread to other areas of the body (metastasized) or that hasn’t responded to other treatments. Vismodegib blocks chemical signals that allow basal cell carcinomas to continue growing.
