Health A-Z

What is basal cell carcinoma?

Basal cell carcinoma (BCC) is a type of skin cancer that forms in the basal cells of your skin. Basal cells exist in the lower part of your epidermis, which is the outside layer of your skin. Basal cell carcinoma looks like a small, sometimes shiny bump or scaly flat patch on your skin that slowly grows over time.

Signs of basal cell carcinoma include:

• Lumps, bumps, pimples, scabs or scaly lesions on your skin.
• The lump may be slightly see-through (translucent) and close to your normal skin color or white to pink, brown to black or black to blue.
• The lump may appear shinier than the skin around it with tiny visible blood vessels.
• The lump may grow slowly over time.
• The lump may be itchy or painful.
• The lump may form an ulcer, which can ooze clear fluid or bleed with contact.

Where will I find symptoms of basal cell carcinoma?

Basal cell carcinomas most commonly appear on areas of your body exposed to the sun. The most common places to have BCC include:

• Face.
• Scalp.
• Nose.
• Eyelids.
• Legs.
• Ears.
• Arms.

How is basal cell carcinoma treated?

Your provider will treat basal cell carcinoma by removing cancer from your body. To remove cancer, your treatment options could include:

• Electrodessication and curettage: Scraping off the cancerous lump with a curette and then burning with a special electric needle.
• Surgery: Removing the cancerous lump or lesion with a scalpel (excision or Mohs surgery).
• Cryotherapy or cryosurgery: Freezing the cancerous lump to remove it.
• Chemotherapy: Using powerful medicines to kill cancerous cells in your body.
• Photodynamic therapy (PDT): Applying blue light and a light-sensitive agent to your skin.
• Laser therapy: Using lasers (high-energy beams) to remove cancer instead of using a scalpel.

Your provider will choose the best treatment option for you and your diagnosis by factoring in your overall health, your age, the location of the cancer and the size of the BCC.

What happens if basal cell carcinoma is left untreated?

If you don’t receive treatment for basal cell carcinoma, the skin cancer can slowly grow in size and invade deeper tissues like muscle and bone and cartilage. The BCC may become painful and ulcerated, which can cause bleeding and infection.

In extremely rare cases, basal cell carcinoma can spread to other parts of your body and cause life-threatening side effects.

What medications treat basal cell carcinoma?

Although rare, if your basal cell carcinoma becomes locally advanced or spreads (metastasizes) to another location in your body, the U.S. Food and Drug Administration (FDA) has approved two medicines:

• Vismodegib: For treatment of locally advanced or metastatic BCC.
• Sonidegib: For locally advanced BCC.

These drugs can be used in people who aren’t good candidates for surgery or radiation therapy. Vismodegib and sonidegib can cause several side effects, most commonly muscle cramps, change in taste and hair thinning. You must not get pregnant while on therapy and for several months after the completion of therapy.

Are there side effects of surgical treatment?

Any type of surgical removal will leave a scar. There’s a low risk of bleeding or infection.

How is basal cell carcinoma diagnosed?

Depending on the appearance of the skin lesion, your healthcare provider might immediately suspect a basal cell carcinoma diagnosis. To confirm the diagnosis, your provider will complete a physical exam and ask you questions about your symptoms, including:

• When did the lump or lesion appear on your skin?
• Did the lesion change in size?
• Does the lesion look different today from when you first noticed it?
• Is the lesion painful or itchy?
• Have you had a skin cancer previously?

What tests diagnose basal cell carcinoma?

After a physical exam, your provider might offer tests to confirm a diagnosis, which could include:

• Skin biopsy: Your provider will remove a piece of the affected skin area (lesion) to examine it under a microscope.
• Imaging tests: It’s extremely rare for basal cell carcinoma to spread throughout your body. If your healthcare provider suspects your cancer has spread elsewhere in your body, they might perform an MRI or a CT scan to detect cancer in lymph nodes or internal organs.

Your provider will determine the stage of your diagnosis after providing a physical exam and reviewing the results of your tests. Qualifiers to determine the stage includes:

• Identifying the size of the lesion (tumor) and determining if it grew deeper into your tissues.
• Looking for signs of cancer in your lymph nodes.
• Checking other parts of your body to see if cancer spread (metastasized).
• Measuring the size, shape and location of the lesion and recording the speed of its growth.