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THE MOST COMMON CANCER
Basall cell carcinoma is the most commom form of skin cancer, affecting nearly 1 milliom American each year. In fact, it is the most commom cancer. One out of every three new cancers is a skin cancer, the vast majority of which are basall cell carcinoma.
Cronic overexposure to sunlight is the cause of 95% of all basal cell carcinomas, which occur most frequently on exposed part of the body --the face, ears, neck, scalp, shoulders and back. In rare cases, however, tumors develp on non-exposed areas.
In a few cases, contact with arsenic, exposure to radiation and complications of burns, scars, vaccinations or even tattoos are contributing factors.
While anyone with a history of sun exposure can develop basal cell carcinoma, people who are at highest risk have fair skin, light hair and bue, green or gray eyes. Workers in occupations that require long hours outdoors, and people who spend their leisure time in the sun are particularly susceptible. Geographic location is also a factor. The closer to the equator you are, the higher the number of cases among fair-skinned individuals.
The five most typical characteristics of basal cell carcinoma are quite different from each other. Frequently, two or more features are present in one tumor. In addition, basal cell carcinoma sometimes resembles non-cancerous skin conditions such as psoriasis or eczema.
The Skin Cancer Foundation advices people to have a total body skin exam by a qualified skin specialist. He or she will suggest the correct interval for follow-up visits, depending on your specific skin factors, such as skin type and history of sun exposure.
After the physician´s examination, the diagnosis of basal cell carcinoma is confirmed with a biopsy. Through this procedure, a small piece of tissue is removed and examined in the laboratory under a microscope.
Fortunately, there are several effective methods for eradicating basal cell carcinoma. The physician´s choise of treatment is based on the type, size, and location of the tumor and on the patient´s age and general heath.
Some treatments are:
When removed promptly, basal cell carcinomas are easily treated in their early stages. The larger the tumor has grown, however, the more extensive the treatment needed. Although this skin cancer hardly ever spreads, or metastasizes, to vital organs, it can destroy surrounding tissue, sometimes causing considerable destruction and even the loss of an eye, ear or nose.
The Possibility of Recurrence
If you have one basal carcinoma, you have a greater chance of developing others in the years ahead. The damage which your skin has already received from the sun cannot be reversed. When the first basal cell carcinoma is diagnosed, your physician may find another, or even several other tumors that you had not been aware of, on different areas of your skin.
Even though a basal cell carcinoma has been removed, another growth can develop in the same place or in a nearby area. These recurrences typically take place within the first two years following surgery. Basal cell carcinomas on the scalp, nose and corners of the nose are especially troublesome. Should the cancer recur, the physician may recommend a different type of treatment the second time, as some methods --microsopically controlled surgery, for example-- are more effective than others in such cases.
The physician removes the entire grownth and additional border of normal skin as a "safety margin". The surgical site is then closed with stitches, and the tissue sent to the laboratory to determine if all the malignant cells have been removed.
This method is the most widely used by dermatologists. Cancerous tissue is scraped from the skin with a curette (a sharp, ring-shared instrument). An electric needle the burns a safety margin of normal skin around the tumor and at the base of the area that has been scraped. This technique is repeated several times to ensure complete removal.
Without cutting the growth, tumor tissue is destroyed by freezing with liquid nitrogen. This procedure may be repeated several times to insure total destruction of malignant cells. Easy to administer, cryosurgery is the treatment of choice for patients who have bleeding disorders or an intolerance to anesthesia.
X-ray beams are directed at the malignant cells. Total tumor destruction generally requires a series of treatments, usually several times a week. Radiation therapy may be used with elderly patients or with individuals whose overall heath is poor.
The physician removes very thin layers of the malignant growth, checking each layer thoroughly under a microscope. The excision is repeated as needed, until the siteis tumor-free. This method saves the greatest amount of healthy tissue and has the highest cure rate. It is frequently used for tumors that recur and for tumors in difficult location (the nose, ears, and around the eyes).
The laser beam is used either to excise the tumor, much as a scalpel does, or to destroy it by vaporization, in a procedure analogous to electrodesiccation. The major advantage of this relatively new surgical technique is that seals blood vessels as it cuts, making it useful for patients with bleeding disorders.
This genetically engineered product of the human immune system is being investigated and may be of value in the treatment of some basal cell carcinomas.
