Basal Cell Carcinoma (Skin Cancer)

A basal cell carcinoma (or rodent ulcer) is a type of skin cancer usually caused by sun damage. The repeated and prolonged sun exposure responsible for the damage will have occurred years before the cancer actually develop; sometimes as much as 40 years previously.

Basal cell carcinomas (BCC) most commonly occur on the face and enlarge slowly and steadily. They can invade neighbouring tissue, like the eye, but they usually do not spread to distant parts of the body. In other words they do not generally metastasize. A diagnosis of this kind of skin cancer is not usually regarded as an emergency but if left untreated it may invade the subcutaneous fat, skeletal muscle and bone causing extensive damage.

Basal cell carcinomas are most common in the elderly, and fair skinned individuals are at the greatest risk as the dark melanin pigment in the skin gives some protection. People of African origin with very dark skin almost never develop BCC.

Once the first lesion appears the risk of a second one developing is very high. Often the second BCC will appear close to the spot where the first has been treated.

The only way to tell for certain whether a lesion on the skin is a basal cell carcinoma is to take a biopsy of it. This involves removing a small piece of tissue and getting a pathologist to look at it under a microscope. The abnormal cancer cells are usually obvious. Sometimes as the biopsy site heals a `blanket' of skin forms obscuring the cancer.

The only treatment for basal cell carcinoma is to completely remove it surgically. The tumours are often much larger under the skin than they appear on the surface and often a large scar remains after surgery.

Sun damage to the skin is permanent and irreversible and people who had had a basal cell carcinoma should be regularly checked for reoccurrence.

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