Basal Cell Carcinoma (BCC)

Basal Cell Carcinoma is the most common form of skin cancer and concerns the presence of irregular growths in the skin’s basal cells, located on the top layer of the skin. Basal Cell Cancers look distinctly different from the surrounding skin area and often resemble ulcers, reddish patches or numerous other conspicuous sores and are the result of prolonged sun exposure. Unlike melanomas, BCC’s almost never expand beyond the initial location of the cancerous tumour. Despite this, it should be noted however, that the tumour can still cause permanent disfiguration, if treatment is delayed.

Warning Signs

Early stage BCC can often appear harmless to the naked eye or similar to non-life-threatening skin diseases, which is why it’s extremely important to have your skin routinely examined by a specialist. As the cancer progresses however, there are a number of tell-tale signs that are possible indicators of Basal Cell Carcinoma.

Open Sores

a sore that bleeds and refuses to properly heal is a common indicator of early stage BCC

Reddish Patch

a small, seemingly innocuous, itchy or slightly painful, reddish coloured patch of skin, most commonly found anywhere on the body that receives frequent sun exposure, such as the face, shoulders, arms etc.

Shiny blister or nodule

a highly conspicuous growth that is sometimes confused with an ordinary mole. The appearance is usually pearly or clear and can be a whole range of colours, from red or white, to black or brown

Pinkish sore

a pinkish coloured sore with a rough surface. As the cancerous tissue expands, minute blood vessels will often appear

Scar-like tissue

a small area of skin that often resembles ordinary scar tissue. The skin around the outside of the scar may be shiny and can portend the existence of a deep-lying BCC that is bigger than it appears to be

Causes

Basal Cell Carcinoma is typically caused by prolonged sun exposure over the course of a person’s lifetime and by bouts of short-term exposure to excessive amounts of high intensity sunlight. For this reason, BCC generally occurs on areas of the body that receive frequent exposure, such as the face, neck, shoulders and back. In extremely rare cases however, the cancers can develop in areas of the body that aren’t exposed to light. Although difficult to determine the exact cause, in circumstances such as these, the cancer can often be attributed to a whole host of non UV-related factors.

Who’s at Risk?

Although anyone who has had even a moderate amount of sun exposure throughout their lives has a chance of developing BCC, those with fair skin and light eyes are at most risk. Historically, this form of skin cancer is most common amongst older generations but in recent times, the average age of BCC sufferers has been falling dramatically, with many younger people now also developing the cancerous tumours, particularly those in their 20’s and 30’s. Basal Cell Carcinoma is more prevalent in men than in women, and not surprisingly, those with outdoor occupations or those who choose to spend their recreational time in the sun, all have a greater likelihood of developing the cancer.

Recurrence

Patients who have already been treated for BCC at some point in their life, are at an increased risk of developing further cancers later on. For this reason, they are strongly urged to make regular visits to see a skin cancer specialist or doctor.

Treatment

At Skin Clinic Robina, we provide a range of effective Basal Cell Carcinoma treatments at our Skin Cancer Clinic, including:

• Surgical removal/excision – this involves numbing the skin tissue using a local anaesthetic. The cancerous and surrounding normal tissue is then removed using a surgical scalpel.
• Flap surgery – flap surgery is required when the size of the wound created by the skin cancer’s removal, is too large to stitch together. A skin flap made of healthy skin or tissue beneath the skin (subcutaneous) is removed from an area of the body, and transferred to the site of the wound where the skin cancer was extracted. This patches and covers the area of the wound.
• Graft surgery – this is similar to flap surgery, except the tissue extracted from the healthy donor site of the body, relies on the blood supply of the wound created by the skin cancer’s removal.
• Slow MOHS technique – while this treatment method concerns the surgical excision of the skin cancer, Slow Mohs surgery may require multiple treatment sessions. When the skin cancer has been removed, the extracted cancerous tissue is sent to a lab for analysis. If results indicate that the tissue contains cancer around the margins of the sample, then additional tissue will be removed, and the sample is sent to the lab once more. This is done until the margins around the sample are identified as non-cancerous.
• Curettage and cautery – the area to be treated is numbed with a local anaesthetic and the cancerous lesion is removed using a small surgical instrument known as a curette. The extracted tissue is sent to a lab for assessment. The resulting wound is then cauterised, which prevents bleeding, while eliminating any lingering cancer cells. This process is repeated twice if the cancerous lesion is malignant.
• Topical/cream treatments – skin cancer does not always require surgical intervention. Sometimes, topical treatments can be used to successfully treat the cancerous cells. This includes immunotherapy and chemotherapy creams.
• Photodynamic Therapy (PDT) – PDT is a nonsurgical method for the treatment of superficial skin cancers. Metvix (MLA) is applied to the cancerous tissue and covered for approximately 3 hours, after which the treated area is then exposed to red light to complete the treatment process. This is then followed by two additional treatments, spaced two weeks apart.
• Rhenium-SCT – a painless treatment solution that requires no anaesthesia, Rhenium-SCT is ideal for patients who are elderly, susceptible to allergies, have multiple diseases or who have a low pain threshold. In the majority of cases, Rhenium only requires a single treatment session and is non-surgical, ensuring little to no scarring. Treatment is highly precise, with no damage done to surrounding healthy tissue. Please note that we currently do not perform Rhenium-SCT at our clinic, but can provide a referral for those who wish to undergo this treatment.

Generally, when BCC’s are removed, the resulting scar is very minor. If however the cancer is considerably large, a graft or flap may be required to adequately seal the wound and ensure the best possible cosmetic outcome.

Prevention

It’s no secret that Australia is the driest continent on Earth, receiving excessive amounts of sunlight, right throughout the year. For this reason, it’s imperative that people incorporate a list of sun smart strategies when going outdoors, such as:

• Always try to minimise your sun exposure between the hottest hours of the day; 10 AM – 4 PM
• Wear a wide-brimmed hat and (ideally) sunglasses with UV-protective lenses
• Do not use tanning beds
• Use sunscreen with an SPF of at least 15 (50 is recommended)
• Always apply sun cream to your body, approximately half an hour before you head outside and again every 2 hours thereafter or immediately after you’ve been in the water
• Always keep infants out of direct sunlight
• Aim to see a skin doctor at least once a year, for a skin check. (your frequency of visits should be based on the amount of time you spend outdoors, your skin complexion and your skin cancer history)

Contact Skin Clinic Robina

Basal Cell Carcinoma can be treated effectively when detected early. If you have noticed the sudden appearance of an unusual mark or sore on your skin that refuses to heal, we strongly advise you to come in and have your skin examined by one of our trained professionals. Likewise, if it’s been a while since you last had a skin check – or if you haven’t ever had one at all, arrange for an appointment with us today.