Basal Cell Carcinoma (BCC)

Basal cell carcinoma (BCC) often appears as a small, skin-colored bump or nodule on the skin that is pearly or translucent.

Other symptoms of BCC include:

• A reddish patch that may crust, itch, hurt or be painless
• An open sore that intermittently bleeds, does not heal or heals and then returns
• A flat, scar-like area that is white or yellowish in color, is shiny and taut
• A small pink raised growth with a depression or ulceration in the center
• A growth with visible blood vessels on the surface
• A growth that looks like a scar or a mole
• In people of color the lesion may be brown in color

A basal cell carcinoma (BCC) can recur after removal, although the likelihood of recurrence depends on various factors such as the size, location, depth of the original tumor, and the type of treatment used to remove it.

It’s important to have any suspicious skin lesions evaluated by Dr. Stees, especially if they are new, changing, or persist for more than 4 weeks. Early detection and treatment of BCC can prevent it from growing larger and causing more extensive damage to the skin and surrounding tissues.

Basal cell carcinoma (BCC) is usually diagnosed by Dr. Stees with a skin exam. He may use dermatoscope, a handheld device that allows him to see the skin lesion in more detail.

If he suspects a BCC, he will perform a biopsy. The biopsy can be performed with a local anesthetic and a small, sharp blade or a biopsy punch. He will take a small sample of the tissue and send it to a laboratory for diagnosis. When the diagnosis is BCC is he will recommend treatment based on the size, location, and type of BCC.

Treatment options for basal cell carcinoma (BCC) depend on the size, location, and type of the tumor, as well as the individual’s overall health and medical history. Most BCCs are treated on an outpatient basis using local anesthetic. The primary treatment options for BCCs include:

1. Mohs surgery: This is a specialized surgical technique that involves removing the tumor layer by layer and examining each layer under a microscope until no cancer cells are found. Mohs surgery is often used for BCCs that are larger, located in cosmetically sensitive areas, or have a high risk of recurrence. Mohs surgery has the highest cure rate and is the gold standard of treatment.
2. Excisional Surgery: This involves surgically removing the tumor and a margin of healthy skin around it. The skin is then typically sutured closed. With this method, the removed tissue is sent to an outside laboratory to determine if the tissue margins are clear of cancer. That laboratory result typically takes 7-10 days.
3. Electrodessication and curettage (ED&C): This involves using an electric current to destroy the lesion and then scraping out the remaining tissue with a surgical tool called a curette. The wound is left to heal on its own, and the removed tissue is sent to a lab for analysis.
4. Radiation therapy: This involves using high-energy radiation to kill cancer cells. Radiation therapy may be used for BCCs that cannot be treated with surgery or for people who are not good candidates for surgery.
5. Topical medications: These chemotherapy creams are applied directly to the skin and contain a medication that kills cancer cells. Topical medications may be used for BCCs that are smaller, thin and confined to the uppermost layer of the skin.
6. Cryosurgery: This involves freezing the tumor with liquid nitrogen to kill the cancer cells. Cryotherapy may be used for small, superficial BCCs. It is not advised for use on BCCs that are deeper or have ‘roots’ to them.

When discovered and treated early, most BCCs can be cured. In some cases, a combination of treatments may be used. It’s important to discuss the benefits and risks of each treatment option with Dr. Stees to determine the best approach for your specific situation. After treatment, regular follow-up appointments are important to monitor for recurrence or the development of new skin cancers.