BCCs

What is Basal Cell Carcinoma (BCC)?

• A BCC Is a keratinocyte or non-melanoma skin cancer and the most common type of skin cancer in Australia.
• BCCs occur in the ‘basal layer’ of the epidermis, the outermost layer of the skin.
• BCCs are rarely life-threatening, but they can cause problems by growing very large and very deeply if untreated
• BCC accounts for about 70% of non-melanoma skin cancers.
• These cancers can appear anywhere on the body but most commonly develop on parts of the body that receive high or intermittent sun exposure (head, face, neck, shoulders and back).

What are the symptoms of Basal Cell Carcinoma?

• BCCs often have no symptoms and tend to grow slowly without spreading to other parts of the body.
• BCCs often appear as a pearly lump, or a scaly dry area that is pale or bright pink.
• If left to become large, they may ulcerate.

What are the risk factors for Basal Cell Carcinoma?

• Repeated prior episodes of sunburn
• Fair skin, blonde or red hair, blue or green eyes, however BCC can also affect darker skin
• Gender and age – older men are particularly at risk although BCC can impact younger adults too.
• Previous BCC or other forms of skin cancer (squamous cell carcinoma, melanoma)
• Sun damage
• BCC is also problematic for families with a history of basal cell naevus syndrome (Gorlin syndrome), Rombo syndrome, Oley syndrome, Bazex-Dupré-Christol syndrome and xeroderma pigmentosum
• Comorbidities include cutaneous lupus (a sub-type of the autoimmune disease lupus) and sebaceous naevus
  (a birthmark that can become warty or bumpy in adolescence).
• Ionising radiation
• Immune suppression due to disease or medication
• Exposure to arsenic

What causes BCCs?

• Nine out of 10 BCCs are directly linked to UV exposure although there are genetic underpinnings, most often DNA mutations are in the patched (PTCH) tumour suppressor gene.

What are the treatments for BCCs?

• Most BCCs can be treated and cured when detected early.
• Although very rarely fatal, aggressive forms can be if not treated and BCCs have a tendency to become very disfiguring and require extensive treatment.

Treatments include

• Excisional surgery excision with a ‘safety margin’ of normal surrounding skin.
• Graft or flap repair – if the wound left behind from a skin cancer surgery is quite large or tight, skin may need to be used from a nearby region to help close the wound.
• Moh’s surgery – a form of staged skin cancer excision
• Radiation Therapy – using radiation therapy
• Photodynamic Therapy – chemotherapy cream activated by light.
• Cryotherapy – cold therapy
• Laser Surgery – using light therapy
• Topical medications – chemotherapeutic agents such as Aldara or Efudix applied to the skin, usually for more superficial, less advanced cancer
• Biologics

Please find out about more about skin cancer treatments here.