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Basal Cell Carcinoma

What is a basal cell carcinoma?

A basal cell carcinoma (BCC) is a common type of skin cancer that develops in the head and neck area. It tends to grow gradually. These cancers occur more commonly in fair-skinned people with excessive sun exposure. BCC at an early stage can appear subtle, just like a scaly patch that does not go away or a skin-coloured bump. As it advances, it becomes more prominent and may even bleed or crust and grow into a larger lump.

What causes basal cell carcinoma?

Basal cell carcinoma occurs when one of the cells in the skin’s basal cell layer suffers a mutation in its DNA. Mutated DNA prompts the basal cell to multiply fast and continue its growth when it is supposed to die normally. This results in accumulating abnormal, cancerous cells that eventually develop into a tumour.

Damage to basal cell DNA results from ultraviolet radiation exposure from sunlight or solariums. BCC is most common in people above 40 years of age. But it may also occur in younger people who have had extensive exposure to the sun.

How is BCC treated?

Treatment of BCC is based on the type, size, location and depth of the tumour as well as the patient’s age and general health. The options for treatment are as follows:

Basal Cell Carcinoma

Skin surgery

Most surgical excisions of BCC, including skin grafts, are undertaken in the procedure room at Kew Dermatology. If there is a very large skin cancer, we may refer you to a plastic surgeon for the procedure.

Skin surgery involves numbing the area with local anaesthetic medication. Your surgeon removes the entire lesion along with a small area of normal surrounding skin as a safety margin. The area is then closed using stitches, and the excised tissue is sent to a pathology laboratory to be examined under a microscope.

The stitches may be removed 1–2 weeks after your surgery, and then regular followup skin checks are scheduled to detect skin cancers that may develop further, as early as possible.

Photodynamic therapy

Photodynamic therapy (PDT) is recommended in patients with small early BCCs or superficial lesions. During this procedure, a topical photosensitizing agent is applied
to the site to be treated, which is then absorbed by the abnormal cells. After the cream
stays there for several hours, it is activated by a special light, which can destroy the
cancerous cells. The treatment claims to selectively destroy only the skin cancer cells
while causing minimal damage to the normal cells. The treatment is repeated after 2
weeks to ensure the highest chance of cure.

PDT can achieve outstanding cosmetic results with a minimal amount of skin scarring. It can only be used as a treatment for low-risk skin cancers. Your dermatologist will guide you through this process and advise the most appropriate treatment for you. You will also be quoted the out-ofpocket costs as Medicare offers no rebate for PDT.

Radiation therapy

This involves the use of X-ray beams directed to the tumour site. This is useful in conditions that are difficult to manage by surgical treatment, in elderly people and in patients with poor general health.

Cryosurgery

In this procedure, the tumour tissue is destroyed through freezing. Total destruction of
cells may require repeated sessions of treatment. It is useful in treating superficial
BCC, patients with bleeding problems and intolerance to anaesthesia medications.

  • curettage and cautery