Basal cell carcinoma is the most common form of skin cancer, affecting 800,000 Americans each year. In fact, it is the most common of all cancers. One out of every three new cancers is a skin cancer, and the vast majority are basal cell carcinomas, often referred to by the abbreviation, BCC. These cancers arise in the basal cells, which are at the bottom of the epidermis (outer skin layer). Until recently, those most often affected were older people, particularly men who had worked outdoors. The number of new cases has increased sharply each year in the last few decades, and the average age of onset of the disease has steadily decreased. More women are getting BCCs than in the past, but cases in men still greatly outnumber cases in women.

If found and treated early, basal cell carcinoma has a cure rate of about 95

The Major Cause

Chronic exposure to sunlight is the cause of almost all basal cell carcinomas, which occur most frequently on exposed parts of the body – the face, ears, neck, scalp, shoulders, and back. Rarely, however, tumors develop on non-exposed areas. In a few cases, contact with arsenic, exposure to radiation, and complication of burns, scars, vaccinations, or even tattoos are contributing factors.

Who gets it?

Anyone with a history of frequent sun exposure can develop basal cell carcinoma (BCC), but people who have fair skin, light hair, and blue, green, or gray eyes are at highest risk. Those whose occupations require long hours outdoors or who spend extensive leisure time in the sun are in particular jeopardy. Dark-skinned people are far less likely than fair-skinned people to develop skin cancer. More than two-thirds of the skin cancers that dark-skinned people do develop are not BCCs but squamous cell carcinomas, usually arising on the sites of preexisting inflammatory skin conditions or burn injuries.

What to look for?

Basal cell carcinoma sometimes resembles non-cancerous skin conditions such as psoriasis or eczema. Only a trained physicians, usually dermatologists as specialist in diseases of the skin, can diagnose it with certainty. The illustration here shows an advanced case.

Learn the signs of basal cell carcinoma, and examine your skin regularly – as often as once a month if you are at high risk. Include the scalp, backs of ears, neck, and other hard-to-see-areas. (A full-length mirror and hand-held mirrors can be very useful.) If you observe any of the warning signs or other change in your skin, consult your physician immediately. The Skin Cancer Foundation advises people to have a total body skin exam by a qualified skin specialist at regular intervals. The physician will suggest the correct time frame for follow-up visits, depending on your specific risk factors, such as skin type and history of sun exposure.

The Five Warning Signs of Basal Cell Carcinoma

Frequently, two or more of the five most typical features listed here are present in one BCC tumor.

• An open sore that bleeds, oozes, or crusts and remains open for three or more weeks. A persistent, non-healing sore is a very common sign of an early basal cell carcinoma.
• A reddish patch or irritated area, frequently occurring on the chest, shoulders, arms, or legs. Sometimes the patch crusts. It may also itch or hurt. At other times, it persists with no noticeable discomfort.
• A shiny bump or nodule, that is pearly or translucent and is often pink, red, or white. The bump can be also be tan, black, or brown, especially in dark-haired people, and can be confused with a mole.
• A pink growth with a slightly elevated rolled border and a crusted indentation in the center. As the growth slowly enlarges, tiny blood vessels may develop on the surface.
• A scar-like area which is white, yellow or waxy and often has poorly defined borders. The skin itself appears shiny and taut. Although a less frequent sign, it can indicate the presence of an aggressive tumor.

Image copyright: Color Atlas & Synopsis of Clinical Dermatology. All rights reserved.