What is Basal Cell Carcinoma?
Basal cell carcinoma (BCC) is the most common type of skin cancer. It starts in the top layer of the skin called the epidermis. Most of the time, BCC can be removed and treated. But sometimes it can grow back.
Most BCCs show up on sun-exposed areas of the body, especially the face and neck. But they can occur in other areas too.
While it is rare for BCC to spread (metastasize) to other parts of the body, if your cancer spreads to the bone, visit our bone metastases page.
Certain people are more likely to have skin cancer. For example, people with fair skin, light-colored eyes or blond or red hair are especially prone to developing basal cell carcinoma (BCC).
What Else Makes BCC More Likely?
- Spending too much time in the sun (without protection) or using tanning beds
- Frequent sunburns (especially at an early age)
- A previous BCC or other skin cancer
- Family history of skin cancer
- Certain medical conditions or medications (mostly conditions and medications that suppress your immune system)
- Radiation therapy
- Very rarely people can have genetic syndromes where they develop numerous BCCs (>25), the most well-known is called Basal Cell Carcinoma Nevus Syndrome (BCCNS).
Basal Cell Carcinoma (BCC) will look and feel different. This depends on the type it is. There are 6 types (superficial, pigmented, nodular, micronodular, infiltrative, or morpheaform).
It might appear as a:
- Smooth, shiny, pearly or waxy bump
- Firm red or flesh-colored bump
- Growth with unusual blood vessels in and around it
- Sore that might bleed and doesn’t seem to be healing
- Flat spot or patch of skin (usually red or brown) that is rough, dry, or scaly
- Area of scar-like tissue with no previous procedure done at the site
Regardless of what it looks like, if you notice something on your skin that worries you, or if an existing growth starts to change or irritate you, get it checked out. Try to do regular skin exams too. Getting comfortable with the look and feel of your skin will help you know what is normal and what’s not.
Your doctor will examine your skin. A biopsy is typically needed to confirm a diagnosis of skin cancer. A biopsy is a common procedure to remove a piece of the skin. The area will be numbed with a local anesthetic injected into the skin. Then the doctor (often a dermatologist or skin doctor) will cut a small piece of the skin to get a sample of tissue. A different doctor (called a pathologist, often a dermatopathologist) will look at this tissue under the microscope to check for cancer cells. There are several types of biopsies.
BCC usually grows slowly. In some cases, especially if it is untreated, it can invade nearby tissue. Since the majority of BCC occur on the face, if there is local invasion it may cause damage to nearby organs such as the ear or nose and surgeries to remove the cancer can be difficult. However, it is very rare for BCC to metastasize and lead to death.
How is Basal Cell Carcinoma Treated?
In the majority of cases, Basal Cell Carcinoma is easily cured using local surgery or medications applied to the skin (called topical therapies) Rarely, radiation can be used. Treatment will depend on where it is located, how big and deep the tumor is in the skin, and if local lymph nodes are involved. Additional treatment options are available for people with later stage disease.
Questions to Ask Your Doctor
- What type of biopsy am I having?
- How soon will I know the results?
- How much of the skin/tissue will be taken? Will there be a lot of scarring?
- What is the plan if it is cancerous (malignant)?
- What treatment is most likely to work?
- How likely is it that it will return?
- What should I be doing to prevent skin cancer from coming back?
What Can I Do to Protect Myself Against Basal Cell Carcinoma?
Fortunately, most BCCs are found early and cured. Still, it is very important to pay attention to sun safety. Avoid being in the sun during peak daylight hours, always apply (and reapply) sunscreen and wear protective clothing, sunglasses and wide-brimmed hats.
Talk to your family and friends about the importance of skin cancer prevention too. Be sure to see your dermatologist regularly for skin exams. Pay close attention to any sores or bumps that might develop on your skin. Try to do regular skin self-exams; make a date with your partner to check areas you can’t see like your back, scalp back of your legs or buttocks.
Often, you first notice BCC as a lesion on the skin that you think should heal in a week or two. However, one month later it is still there, getting red, raw, and irritated. If lesions do not resolve on their own, they need to be examined by a board-certified dermatologist.