What Is a Basal Cell Carcinoma?
Basal Cell Carcinoma also referred to as BCC, is the most common cancer in Australia. They account for around 80% of all non-melanoma skin cancers. In 2016 it is estimated that there were 600,000 Basal Cell Carcinomas.
When treated early the vast majority of Basal Cell Carcinomas are not life-threatening.
Basal Cell Carcinomas are malignant, abnormal, uncontrolled growths or lesions that arise in the skin’s basal cells, which line the deepest layer of the epidermis (the outermost layer of the skin).
What Does Basal Cell Carcinoma Look Like?
A Basal Cell Carcinoma can look like a small, smooth, shiny lump with a depressed center and rolled borders. The picture below is an example of a basal cell carcinoma.
Basal cell carcinomas can also appear translucent, waxy, and firm, or may bleed or crust.
Basal Cell Carcinoma Risk Factors
Anyone with a history of sun exposure can develop Basal Cell Carcinoma. However groups of people at greater risk include:
- Fair Skin Types
- people who are at highest risk have fair skin, freckles, blond or red hair, and blue, green, or grey eyes. They have a tendency to burn rather than tan
- Prior Skin Cancer
- People who have had one Basal Cell Carcinoma are at risk for developing others, in the same area or elsewhere on the body. If you’ve had a Basal Cell Carcinoma you have a 10 times higher risk of developing another skin cancer of any type and so routine reviews are advised on a 6 monthly basis.
- Family History
- The tendency to develop Basal Cell Carcinoma may also be inherited
- Older People
- Those most often affected are older people, but as the number of new cases has increased sharply each year in the last few decades, the average age of patients at onset has decreased. The disease is rarely seen in children, but occasionally a teenager is affected.
- Occupational
- Workers in occupations that require long hours outdoors
- Recreational
- People who pursue outdoor recreation activities for hours at a time
Where Are Basal Cell Carcinomas Found?
They can appear anywhere on the body but most commonly develop on parts of the body that receive high or intermittent sun exposure (head, face, neck, shoulders and back).
What Causes Basal Cell Carcinoma?
95% of Basal Cell Carcinomas in Australia are the result from skin damage caused by
- Cumulative long-term sun exposure
- Intermittent overexposure to ultraviolet (UV) radiation from the sun (typically leading to sunburn)
Most Basal Cell Carcinomas occur on parts of the body exposed to the sun — especially the face, ears, neck, scalp, shoulders, and back, but many can be found in areas that are only burned or exposed occasionally - such as the abdomen or upper thighs
It is not possible to pinpoint a precise, single cause for a specific tumour, especially tumours found on a sun-protected (un-exposed) area of the body or in an extremely young individual. Some Basal Cell Carcinoma can also result from less common causes such as:
- contact with arsenic,
- exposure to ionising radiation such as X-rays (used in radiotherapy)
- open sores that resist healing,
- chronic inflammatory skin conditions, and
- as complications of burns and scars.
Symptoms of Basal Cell Carcinoma
Basal Cell Carcinoma may have no visible symptoms and tends to grow slowly without spreading to other parts of the body, but if it has progressed to the skin’s upper layers a tumour will typically have some visible clues. A key factor used to identify it is ongoing change that persists beyond a few weeks in a lesion on the skin.
If you observe two or more of the signs below, you should consult the My Skin Clinic immediately.
- An open sore
that bleeds, oozes, or crusts and remains open for a few weeks, only to heal up and then bleed again. A persistent, non–healing sore is a very common sign of early Basal Cell Carcinoma
- A reddish patch
or irritated area, frequently occurring on the face, chest, shoulders, arms, or legs. It may develop a crust. It may itch or hurt. Mostly they produce, no discomfort and local tenderness.
- A shiny bump
or nodule that is pearly or clear and is often pink, red, or white. The bump can also be tan, black, or brown, especially in dark-haired people, and can be confused with a normal mole.
- A pink growth
with a slightly elevated rolled edge and or take on a donut shape. The growth slowly enlarges, tiny blood vessels may develop on the surface.
- A scar-like area
that is white, yellow or waxy, and often has poorly defined borders; the skin itself appears shiny and taut. This warning sign may indicate the presence of an invasive Basal Cell Carcinoma that is larger than it appears to be on the surface.
Basal Cell Carcinoma can sometimes resemble non-cancerous skin conditions such as psoriasis or eczema.
Stages of Basal Cell Carcinoma
Basal Cell Carcinomas are usually slow growing, occasionally BCCs grow in subtle ways and may be quite extensive and advanced by the time of diagnosis. Some BCC’s are aggressive and can grow and spread (metastasise) quickly.
If BCC cancer is advanced the outcome (prognosis) can vary and affect your treatment choices. A small number of Basal Cell Carcinomas cases can be fatal.
Basal Cell Carcinoma Screening
Diagnosis and management of Basal Cell Carcinoma is best performed via a Full Body Scan.
In the first incidence, this process includes
- Digitally Mapping a patient's entire body for any suspicious skin damage or lesion
- Followed by a detailed Dermoscopic Examination by a trained skin cancer doctor.
- Recording and combining all images and skin metrics (size, shape, colour, and other attributes) into the patient record
Our expert Doctors at My Skin Clinic will then clearly identify and diagnose any skin disease.
Untreated Basal Cell Carcinomas
Basal Cell Carcinomas seldom spread to vital organs and respond well to early treatment. If untreated the consequences could include:
- Disfigurement
- Nerve, or muscle injury, or other injury to nearby structures like eyelids
- Certain rare, aggressive forms can be lethal if not treated promptly.
The larger the tumour has grown, the more extensive any surgical treatment would be. This could result in increased scarring.
In 2016 it is estimated that there were 560 deaths in Australia from non-melanoma skin cancers. It is not possible to identify how many of these are Basal Cell Carcinomas as this data is not separately recorded.