basal cell carcinoma

Basal Cell Carcinoma Symptoms and Treatment

Basal cell carcinoma is the most common form of skin cancer. It affects over four million Americans every year.

Individuals who are at increased risk of this form of cancer have blue eyes, fair skin, and excessive sun exposure.

In this article, we’re exploring the different symptoms of basal cell carcinoma. Plus we’ll talk about the available treatments and latest research.

basal cell carcinoma - dermatologist examining skin

Symptoms of Basal Cell Carcinoma

Basal cell carcinoma skin cancer gets its name from the appearance of the cancer cells. The cells affected by cancer look like basal cells when examined under a microscope. Basal cells are cells that form the outer layer of the skin, or epidermis.

While we can’t see the cells, the naked eye can see skin lesions caused by cancer. This cancer develops on the areas of skin exposed to sunlight, especially on the head and neck.

These lesions are small bumps that are slightly transparent. They appear on the skin and gradually become bigger. While some lesions grow slowly and go unnoticed, others can grow up to one centimeter per year.

They can break open, bleed, and form scars or scabs on the skin. Usually, a dermatologist can suspect basal cell carcinoma based on a physical examination. However, a biopsy will confirm the diagnosis.

Researchers identified a few different forms of basal cell carcinomas.

Nodular Basal Cell Carcinoma

This type of skin cancer starts as a small, shiny, firm, skin-colored, raised growth. After months, or years, the skin’s surface may have visible large blood vessels. The center of the lesions may break open.

The border of the lesion becomes thicker and white. If it bleeds, it may look like a sore, covered with scabs.

Superficial Basal Cell Carcinoma

The superficial basal cell carcinoma is flat rather than raised. It also has a red-pinkish color that looks more like a scar.

Infiltrative Basal Cell Carcinoma

Another form is infiltrative basal cell carcinoma. As the name implies, this type of cancer infiltrates deeper layers of the skin.

basal cell carcinoma - increasing graph

The Stages of Basal Cell Carcinoma

Doctors use a process called staging to evaluate cancer progression. These stages determine the spread of the cancer and how to treat it.

Cancer stages take a few things into account, including:

  • Size of the growth
  • How it spread on the skin
  • How deep it spread in the skin
  • Effects on the lymph nodes
  • Effects on distant organs

There are four stages of basal cell carcinoma cancer.

Stage 0

Stage 0, or carcinoma in situ, is early cancer. It’s confined to the epidermis, the most superficial layer of the skin.

Stage I

Stage I is when the size of the tumor is two centimeters and may have spread to the second layer of the skin, the dermis. It did not spread to surrounding tissues like muscles or bones. Lymph nodes and distant organs are not affected. The tumor also does not have more than two high-risk features.

High-risk features of a growth involve a depth or invasion of more than two millimeters thick. Other features include the location of the cancer and if the cells are poorly differentiated or undifferentiated.

Stage II

In the case of Stage II, the cancerous growth is larger than two centimeters. It may have also spread to the dermis but only appears to affect the skin. It does not affect muscles or bones but can have certain high-risk. Stage II can also have more than two high-risk features.

Stage III

In Stage III, the cancer is no longer confined to the skin. It will spread to the muscles, bones, cartilages, or lymph nodes. The cancer will stay near the original growth, though.

Stage IV

Stage IV basal cell carcinomas have growths that of any size. They spread not only to the lymph nodes but to distant organs like the brain and lungs.

Basal cell carcinomas rarely spread to distant organs, but rather grow slowly into the skin. Cancer tumors that grow close to the eyes, nose, mouth, or brain can cause more complications.

basal cell carcinoma - doctors performing surgery

Current Treatment Options

There are many treatments available for this type of skin cancer. The type of treatment considers the symptoms, cancer subtype, size, location, and stage.

Types of skin cancer treatments include:

  • Surgical excision
  • Curettage
  • Electrodesiccation
  • Cryosurgery
  • Chemotherapy applied to the skin
  • Photodynamic therapy

It’s important to note that radiation is rarely used to treat this type of skin cancer.

There is a special type of surgery, Mohs, available to treat skin cancer. This microscopically controlled surgery often helps in cases of cancers that recur. Doctors may also recommend it when cancers are incompletely treated with other procedures. Large cancers or those with vague borders and infiltrative basal cell carcinoma can also benefit from it.

Vismodegib and sonidegib can help in advanced cases of cancer stages III and IV. Usually, doctors recommend these medications when surgery or radiation cannot help. The medications work by inhibiting the “hedgehog pathway,” a pathway that affects a person’s response to chemo or radiation therapy. The basal cell carcinoma can alter this pathway in some cases.

basal cell carcinoma - researcher looking into microscope

Latest Skin Cancer Research

Scientists and researchers continuously research better cancer treatment options. The American Cancer Society says more drugs that target hedgehog pathways are under research.
So far, Vismodegib decreases the number of new cancer cells and can shrink growths. Be sure to discuss both the benefits and risks in detail with your doctor.

Nicotinamide, a form of Vitamin B3, and retinoids, a Vitamin A derivative, could be beneficial in managing basal cell carcinoma. So far, they show promising results.

If you have had this form of cancer, make sure you have yearly follow-ups and examinations. One in four people with basal cell carcinoma will develop new basal cell cancer within the next five years. When detected and treated early, the prognosis is generally good.