Surgery is a common treatment for basal cell carcinoma (BCC), a type of skin cancer that forms on the skin’s top layer. The type of surgery used depends on the risk of the BCC and where it’s located on the body.
Diagnosis
In order to assess any growths or changes in your skin, your doctor or a specialist in skin conditions (dermatologist) will conduct a medical history and exam.
History and general exam
Your doctor will conduct a general physical exam and ask you questions about your medical history, changes in your skin, or any other signs or symptoms you’ve experienced.
Questions may include:
Questions may include:
- When did you first notice this skin growth or lesion?
- Has it changed since you first noticed it?
- Is the growth or lesion painful?
- Do you have any other growths or lesions that concern you?
- Have you had a previous skin cancer?
- Has anyone in your family had skin cancer? What kind?
- Do you take precautions to stay safe in the sun, such as avoiding midday sun and using sunscreen?
- Do you examine your own skin on a regular basis?
Skin exam
Your doctor will examine not only the suspicious area on your skin but also the rest of your body for other lesions.
Skin sample for testing
Your doctor may do a skin biopsy, which involves removing a small sample of a lesion for testing in a laboratory. This will reveal whether you have skin cancer and, if so, what type of skin cancer. The type of skin biopsy you undergo will depend on the type and size of the lesion.
Treatment
The aim of basal cell carcinoma treatment is to completely eliminate the cancer. The ideal treatment for you depends on factors including the cancer’s type, size, location, your personal preferences, and your ability to attend follow-up appointments.
Surgery
Basal cell carcinoma is typically treated with surgery to remove the cancer and surrounding healthy tissue. Treatment options include surgical excision, where the cancerous lesion and a margin of healthy skin are removed and examined for cancer cells. This method is often recommended for low-risk basal cell carcinomas. Another option is Mohs surgery, a layer-by-layer removal of cancer cells, examined under a microscope to ensure complete removal. This method is often recommended for higher-risk basal cell carcinomas, such as larger or deeper lesions, or those located on the face.
Other treatments
Sometimes other treatments might be recommended in certain situations, such as if you’re unable to undergo surgery or if you don’t want to have surgery.
Other treatments include:
Other treatments include:
- Curettage and electrodessication (C&E) is a treatment method that involves removing the surface of the skin cancer with a scraping instrument, followed by searing the base of the cancer with an electric needle. This approach is often suitable for treating small, low-risk basal cell carcinomas, typically those located on the back, chest, hands, or feet, which are less likely to recur.
- Radiation therapy employs high-energy beams, including X-rays and protons, to destroy cancer cells. This treatment is often used in conjunction with surgery, particularly when there's a higher risk of cancer recurrence. Additionally, radiation therapy may be considered when surgery is not a viable option.
- Cryosurgery, or freezing, is a treatment that involves using liquid nitrogen to destroy cancer cells. This method is often suitable for treating superficial skin lesions and may be used in conjunction with curettage, where the surface of the skin cancer is scraped away. Cryosurgery is typically considered for small, thin basal cell carcinomas, particularly when surgery is not a viable option.
- Topical treatments, in the form of prescription creams or ointments, may be considered for treating small, thin basal cell carcinomas, especially when surgery is not a viable option.
- Photodynamic therapy is a treatment that combines a light-sensitive medication with a specialized light to target and destroy superficial skin cancer cells. The process involves applying a liquid medication to the affected area, making the cancer cells sensitive to light, and then exposing the area to a specific light that kills the cancer cells. This treatment option may be considered when surgery is not a viable option.
Treatment for cancer that spreads
In the rare event that basal cell carcinoma spreads to nearby lymph nodes or other parts of the body, additional treatment options may be considered, including targeted therapies, chemotherapy, or radiation therapy.
- Targeted drug therapy is a treatment approach that exploits specific vulnerabilities in cancer cells, causing them to die. In the case of basal cell carcinoma, targeted therapy drugs work by blocking molecular signals that enable the cancer cells to continue growing. This treatment option is often considered when other treatments have been unsuccessful or are not feasible.
- Chemotherapy is a treatment that utilizes potent drugs to destroy cancer cells. It is typically considered a viable option when other treatments have been ineffective.
Preparing for your appointment
The following information can help you prepare for an appointment.
- Write down your medical history, including other conditions for which you've been treated. Be sure to include any radiation therapy you may have received, even years ago.
- Disclose any personal history of excessive ultraviolet (UV) light exposure, including prolonged time spent outdoors, use of tanning beds, or occupations that involve extensive outdoor work.
- Compile a comprehensive list of your medications and natural remedies, including prescription and over-the-counter medications, as well as vitamins, supplements, and herbal remedies that you are currently taking.
- Compile a list of immediate family members who have been diagnosed with skin cancer, including parents, grandparents, aunts, uncles, and siblings, to share with your doctor.
- Prepare for your doctor's visit by writing down a list of questions to ask in advance, ensuring you make the most of your consultation and address all your concerns.
- Consider bringing a trusted family member or friend to your appointment for emotional support and to help absorb the information discussed with your doctor.
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