ArtsAutosBooksBusinessEducationEntertainmentFamilyFashionFoodGamesGenderHealthHolidaysHomeHubPagesPersonal FinancePetsPoliticsReligionSportsTechnologyTravel

How To Detect A Skin Cancer (Part-II) ?

Updated on November 20, 2015

Basal Cell Carcinoma - What is It ?

From among the non-melanoma skin cancers, the two most common types are basal cell and squamous cell carcinoma. In this hub, I would try to put some light on self-detection of a Basal cell carcinoma.

Being a locally invasive cancer, basal cell carcinoma is made up of a cluster of cells resembling those found in the basal layer of the epidermis of the skin. It affects individuals between 4th and the 8th decades of life, of which more than 50% are males. More than 85% of these cancers occur in the head and neck region while those on the lower leg are more common in women.

The prevalence increases greatly with exposure to sunlight, but the best part of it is that despite being a tumor, it mostly remains confined to its origin and rarely metastasizes to distant locations.

The tumor develops most commonly on the eyelids, at the inner canthus (inner angle of the eye) and behind the ear. Those with fair or red hair, those who tan poorly and those who have had a history of childhood sunburns are at a greater risk while a past history of acne is protective.

Basal cell carcinomas grow slowly but become locally invasive and penetrate deeper structures, hence the name rodent ulcer.

Appearance of a Basal cell carcinoma

A typical BCC has a rolled out edge, often beaded and the floor shows scabbing at some places and breaking at others.
A typical BCC has a rolled out edge, often beaded and the floor shows scabbing at some places and breaking at others.

How to Identify A Basal Cell Carcinoma ?

Basal cell carcinoma most commonly presents as, "a pimple that does not go", or "a spot that fails to heal". The early tumors are small, translucent or pearly, raised and round areas covered by a thin layer of skin through which a few dilated superficial blood vessels show.

It can also appear as a small, pearly, red violet papule or a bulge; or as a small superficial ulcer that resembles an excoriation by a fingernail.

It may occasionally look like a small red, blood-filled balloon, pedunculated and resembling a pyogenic granuloma.

Different types of Basal Cell Carcinoma:

  • Deeply eroding ulcer or Rodent ulcer - This ulcer has a typical rolled-out edge (not everted), often beaded and the floor shows scabbing at some places and breaking at others. If left, the tumor and its following ulcer may spread deeply and cause great destruction, especially around the eye, nose or ear.
  • Nodular type - This type grows as a well marginated expanding nodule covered by skin that may periodically scale or erode and crust.
  • Cystic type - This variant presents as a large, semitransparent nodule with a dark translucent appearance, as it contains fluid filled with a network of fiery red blood vessels on the surface.
  • Pigmented nodule - This type looks like a mole and is found mostly on the face.
  • Field fire or Forest fire or Geographical variety - With an advancing edge and a healing center, this variant has an irregular, raised edge around a flat, white scar.
  • Morpheic variant - This basal cell carcinoma variant has a smooth surface that may be slightly raised above the normal level. The color is yellowish, resembling that of old ivory.
  • Superficial type - In this type, the tumor patch is bounded by a slightly raised, thread like margin which is irregular in outline.

Basal cell carcinoma is a locally invasive tumor but in rare instances it may disseminate to distant sites via blood or lymphatics.

Identify a Basal cell carcinoma

Various types of Basal cell cancer.
Various types of Basal cell cancer. | Source

Presenting Symptoms of Basal Cell Carcinoma

The most common presentation is a papule or nodule that may have a central scab or erosion. There is a waxy, pearly appearance with fine blood vessels easily visible on the surface.

The principal complaint is that of a persisting lesion - either as an ulcer or as a nodule. It is not painful in the beginning though it might frequently itch.

The lesion grows slowly and a little bleeding may be complained of. If untreated, the rodent ulcer becomes quite big and deep. It may then cause pain and bleeding and get infected.

Basal cell carcinomas are known for their multiplicity. Many small lesions may develop simultaneously, some well defined, while others in initial stages or just as dark patches of eczema.

Common signs that raise suspicion of a Basal Cell Carcinoma

  • An open sore that bleeds, oozes or crusts. A persistent non-healing ulcer.
  • A reddish patch or irritated area that crusts feels itchy or persists with no noticeable discomfort.
  • A shiny bump or a pigmented nodule that resembles a mole.
  • A pink growth with elevated rolled out border.
  • A scar-like area with poorly defined borders.

Points to Remember When Suspecting A Basal Cell Carcinoma

Site :

Though no site is exempted, yet 90% of Basal Cell Carcinomas are seen on the face above the line drawn from the angle of the mouth to the ear lobule. The sites most favored by this cancer include the following:

  • Around inner canthus of the eye.
  • Around outer canthus of the eye.
  • Nose
  • On and around nasolabial folds
  • On the forehead, more common in females.

In fact, the rodent ulcer may be seen more commonly in places on the face over which tears roll down. That is why it is aptly called a "Tear cancer".

It may also develop on the scalp, neck, arms and hands (the exposed areas of skin).

The Lesion:

The tumor always starts as a nodule. Gradually the center of the nodule breaks and an ulcer results. Such an ulcer has a rolled edge that is raised and rounded (not everted). As the growth spreads, the shape of the ulcer becomes irregular.

An irregular raised edge and a flat white scar is sometimes called a Field Fire or a Geographical basal cell carcinoma.

When the ulcer erodes deeper structures, the edge becomes more prominent but never gets everted.

The floor of the ulcer is covered with a coat of dried serum and epithelial cells. If this sheds off, the ulcer will bleed.

The base of an ulcer is formed by the structures which the tumor is eroding - either fat or muscle or bone.

Types of Basal Cell Carcinoma

Rodent ulcer
Nodular
Morpheic
Superficial
Rolled out, beaded edge
Well marginated expanding nodule
Smooth surface
Thread like margin
Spreads deeply causing great destruction
Pigmented
Scar like appearance
Irregular outline
Floor of ulcer shows scabbing
Resembles a mole
Yellowish, waxy
Flat patch

Common Modalities of Treatment for Basal Cell Carcinoma

  • Radiotherapy - The tumor is highly radiosensitive, with an overall response rate being 92%. It is reserved for elderly who are not suitable for surgery and for certain specialized anatomic sites.
  • Surgery - This mode of treatment is used when the tumor has recurred after being treated by radiotherapy and when a new lesion appears adjacent to a previously treated area. About 3-5 mm of healthy surrounding is excised with the tumor in all three dimensions.
  • Moh's micrographic surgery - This consists of removal of the tumor followed immediately by frozen section and histopathological examination of margins with subsequent re- excision of tumor-positive areas and final closure of the defect. This method gives the highest cure rates of 98%.
  • Cryosurgery
  • Local chemotherapy with 5- Fluorouracil cream.
  • LASER beam destruction

When to suspect a Basal Cell Carcinoma ?

Morpheic variant of BCC
Morpheic variant of BCC

Prognosis of a Basal Cell Carcinoma

Basal cell carcinomas can be easily treated in their early stages. The larger the tumor has grown, however, the more extensive is the treatment needed.

This cancer sometimes resembles non-cancerous skin conditions such as psoriasis or eczema that only a trained physician can decide for sure.

If you observe any of the above-mentioned signs or some other worrisome change in your skin then consult your physician immediately.

An individual who has had one basal cell cancer treated should always be followed up, not only for local recurrence but also to detect fresh tumors arising elsewhere.

Comments

    0 of 8192 characters used
    Post Comment

    • profile image

      Snakesmum 

      2 years ago

      The sun isn't always our friend, is it? Interesting article, with a lot of detail on identifying BSCs. If in doubt check with your doctor or dermatologist!

    • shraddhachawla profile imageAUTHOR

      Metreye 

      3 years ago

      Thank you for your feedback Frank Atanacio.

    • Frank Atanacio profile image

      Frank Atanacio 

      3 years ago from Shelton

      a very helpful hub my friend.. made m check all the spots I have on my body..phew.. thank you for the share :)

    • shraddhachawla profile imageAUTHOR

      Metreye 

      3 years ago

      Very well said. Sun could be very beneficial as early morning sunlight helps our skin to make endogenous vitamin-D, but excessive sun exposure, especially the mid day sun, can cause severe sunburns and increase the risk of skin cancers. Thanks for your feedback.

    • Theresa Jonathan profile image

      Theresa Jonathan 

      3 years ago from Maseru, Lesotho

      Very useful Hub. Most people are not well informed about how much sun is useful and do not use protection creams. Thanks for great information!

    working

    This website uses cookies

    As a user in the EEA, your approval is needed on a few things. To provide a better website experience, hubpages.com uses cookies (and other similar technologies) and may collect, process, and share personal data. Please choose which areas of our service you consent to our doing so.

    For more information on managing or withdrawing consents and how we handle data, visit our Privacy Policy at: https://hubpages.com/privacy-policy#gdpr

    Show Details
    Necessary
    HubPages Device IDThis is used to identify particular browsers or devices when the access the service, and is used for security reasons.
    LoginThis is necessary to sign in to the HubPages Service.
    Google RecaptchaThis is used to prevent bots and spam. (Privacy Policy)
    AkismetThis is used to detect comment spam. (Privacy Policy)
    HubPages Google AnalyticsThis is used to provide data on traffic to our website, all personally identifyable data is anonymized. (Privacy Policy)
    HubPages Traffic PixelThis is used to collect data on traffic to articles and other pages on our site. Unless you are signed in to a HubPages account, all personally identifiable information is anonymized.
    Amazon Web ServicesThis is a cloud services platform that we used to host our service. (Privacy Policy)
    CloudflareThis is a cloud CDN service that we use to efficiently deliver files required for our service to operate such as javascript, cascading style sheets, images, and videos. (Privacy Policy)
    Google Hosted LibrariesJavascript software libraries such as jQuery are loaded at endpoints on the googleapis.com or gstatic.com domains, for performance and efficiency reasons. (Privacy Policy)
    Features
    Google Custom SearchThis is feature allows you to search the site. (Privacy Policy)
    Google MapsSome articles have Google Maps embedded in them. (Privacy Policy)
    Google ChartsThis is used to display charts and graphs on articles and the author center. (Privacy Policy)
    Google AdSense Host APIThis service allows you to sign up for or associate a Google AdSense account with HubPages, so that you can earn money from ads on your articles. No data is shared unless you engage with this feature. (Privacy Policy)
    Google YouTubeSome articles have YouTube videos embedded in them. (Privacy Policy)
    VimeoSome articles have Vimeo videos embedded in them. (Privacy Policy)
    PaypalThis is used for a registered author who enrolls in the HubPages Earnings program and requests to be paid via PayPal. No data is shared with Paypal unless you engage with this feature. (Privacy Policy)
    Facebook LoginYou can use this to streamline signing up for, or signing in to your Hubpages account. No data is shared with Facebook unless you engage with this feature. (Privacy Policy)
    MavenThis supports the Maven widget and search functionality. (Privacy Policy)
    Marketing
    Google AdSenseThis is an ad network. (Privacy Policy)
    Google DoubleClickGoogle provides ad serving technology and runs an ad network. (Privacy Policy)
    Index ExchangeThis is an ad network. (Privacy Policy)
    SovrnThis is an ad network. (Privacy Policy)
    Facebook AdsThis is an ad network. (Privacy Policy)
    Amazon Unified Ad MarketplaceThis is an ad network. (Privacy Policy)
    AppNexusThis is an ad network. (Privacy Policy)
    OpenxThis is an ad network. (Privacy Policy)
    Rubicon ProjectThis is an ad network. (Privacy Policy)
    TripleLiftThis is an ad network. (Privacy Policy)
    Say MediaWe partner with Say Media to deliver ad campaigns on our sites. (Privacy Policy)
    Remarketing PixelsWe may use remarketing pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to advertise the HubPages Service to people that have visited our sites.
    Conversion Tracking PixelsWe may use conversion tracking pixels from advertising networks such as Google AdWords, Bing Ads, and Facebook in order to identify when an advertisement has successfully resulted in the desired action, such as signing up for the HubPages Service or publishing an article on the HubPages Service.
    Statistics
    Author Google AnalyticsThis is used to provide traffic data and reports to the authors of articles on the HubPages Service. (Privacy Policy)
    ComscoreComScore is a media measurement and analytics company providing marketing data and analytics to enterprises, media and advertising agencies, and publishers. Non-consent will result in ComScore only processing obfuscated personal data. (Privacy Policy)
    Amazon Tracking PixelSome articles display amazon products as part of the Amazon Affiliate program, this pixel provides traffic statistics for those products (Privacy Policy)