Basal Cell Carcinoma
What types of basal cell carcinoma exist? Information on the causes, symptoms, and treatments for this disease.
Symptoms and Causes
Basal cell carcinoma is one of the most common types of skin cancer. It originates in basal cells, which are responsible for creating new cells when old ones die. It primarily appears in areas frequently exposed to the sun, as one of its main causes is excessive ultraviolet radiation exposure.
Based on its characteristics and behavior, basal cell carcinomas are classified into four types:
- Nodular basal cell carcinoma: The most common type. It appears as small, firm nodules that may be pink or translucent, often accompanied by dilation of nearby blood vessels. Crusting or ulceration is also frequent.
- Pigmented basal cell carcinoma: Manifests as black, brown, or blue papules with a smooth and shiny surface.
- Sclerodermiform basal cell carcinoma: Resembles a scar with poorly defined borders.
- Ulcerated basal cell carcinoma: Characterized by ulcers, often with raised, pearly-colored crusts and a firm consistency.
Due to its slow growth and low likelihood of metastasis, basal cell carcinoma has a favorable prognosis, and patients typically recover after cancerous cells are removed and appropriate treatment is administered.
Symptoms
The most characteristic symptoms of basal cell carcinoma include:
- Skin lumps: Depending on the subtype, the lesion may appear brown, black, blue, white, or shiny.
- Telangiectasia: Dilation of the skin's finer blood vessels (in most cases).
- Scaly patches (in some cases).
Causes
The primary cause of basal cell carcinoma is excessive exposure to sunlight or artificial ultraviolet (UV) sources without adequate protection.
Risk Factors
Factors that increase the risk of developing basal cell carcinoma include:
- Spending prolonged periods in the sun, especially without protection.
- Using tanning beds.
- Having fair skin.
- A family history of skin cancer.
- Previous radiation therapy treatments.
- Certain genetic disorders, such as xeroderma pigmentosum.
Complications
Although uncommon, basal cell carcinomas can metastasize to other parts of the body (mainly the bones or lymph nodes) or contribute to the development of other types of skin cancer.
Prevention
The best ways to prevent basal cell carcinoma are:
- Avoiding sun exposure, especially during peak hours.
- Using high-protection sunscreen year-round and wearing hats and clothing that cover the skin during periods of intense sun.
- Not using tanning beds.
- Performing regular visual inspections of moles and warts to detect any changes in shape, texture, or color.
Which doctor treats basal cell carcinoma?
Basal cell carcinoma is diagnosed and treated by specialists in medical oncology, radiation oncology, and dermatology.
Diagnosis
The diagnostic process for basal cell carcinoma includes:
- Medical history and patient interview: The specialist focuses on identifying changes in existing skin lesions or the appearance of new ones.
- Physical examination: A thorough check of all moles, with special attention to the suspicious area.
- Biopsy: A tissue sample is taken and analyzed in the laboratory to determine malignancy.
Treatment
Treatment for basal cell carcinoma involves removing cancerous cells and some surrounding healthy tissue. Depending on the tumor's size and characteristics, different techniques are used. The most common ones include:
- Surgical excision: The most widely used option, as it allows for complete tumor removal using a scalpel. A subsequent examination determines whether the margins are cancer-free. If a large skin section is removed, grafts may be placed to cover the area.
- Curettage and electrocautery: The affected area is scraped with a curette, an instrument used for scraping, and remaining cancer cells are destroyed with heat generated by an electric current.
- Cryosurgery: For small tumors, liquid nitrogen is used to freeze the lesion.
- Imiquimod: A medication used for small lesions to stimulate the patient’s immune system.
- Radiotherapy: X-ray or gamma radiation is applied when other treatments have not been effective.
