Basal cell carcinoma (BCC) is the most common cancer in the US.  Risk factors for this form of skin cancer include a fair complexion, sun exposure and a history of radiation therapy.  There are several variants of BCC, the most common being nodular type.  BCCs are generally slow-growing, indolent tumors.  They most often appear as small pearly nodules and may have a central depression.  They have a tendency to bleed with continued growth, in the absence of other symptoms.  There are a few forms including the basosquamous variant that are more locally aggressive.

Metastasis:

Metastasis of BCC is extremely rare, occurring anywhere between 0.0028% and 0.55%.

Other internal malignancies:

Patients with basal cell carcinoma were found to have higher rates of certain internal malignancies including cancers of the salivary glands, larynx (voice box), lung, breast, kidney, and lymphatics.

Immunosuppression:

Individuals with immunosuppression for a variety of reasons are at risk for the development of numerous BCCs.  Organ transplant recipients are at a 10-fold increased risk.  HIV infection and certain leukemias are also risk factors for BCC.

Treatment methods:

The selection of treatment method depends upon multiple factors including the size, location, type of BCC, as well as patient preference.  Patients should be informed of their options and the risks, benefits and alternatives associated with each treatment.  Approaches to the treatment and prevention of BCC include:

• Surgical methods
  • Excision
  • Mohs surgery (for head & neck, hands/feet locations and recurrent tumors)
  • Electrodessication & Curettage (scrape & burn)
  • Cryosurgery (freezing)
• Topical therapy for superficial BCCs
  • 5-fluorouracil chemotherapy
  • Imiquimod
  • Photodynamic therapy (photosensitizer with light)
• Sun protection and use of sunscreens are important preventative measures for all the major forms of skin cancer including BCCs.

Consult your dermatologist if you have a new, bleeding growth on a sun-exposed area.