SKIN CANCER, BASAL-CELL

General Information

DEFINITION--Skin cancer affecting skin's basal layer. Basal-cell skin cancer invades areas under skin, but rarely does it spread to distant areas.

BODY PARTS INVOLVED--Skin of face, ears, backs of hands, shoulders and arms.

SEX OR AGE MOST AFFECTED

• Both sexes.
• Adults 40 and older.

SIGNS & SYMPTOMS--

A small skin lesion that does not heal in 3 weeks with the following characteristics:

• The lesion appears flat and "pearly." Its edges are translucent and rounded or rolled. The edges may have small, curvy, new blood vessels. The ulcer in the center is dimpled. Lesion size varies from 4mm to 6mm, but it may grow larger if untreated.
• The lesion occurs on skin that is exposed to the sun and shows evidence of sun damage.
• The lesion grows slowly. It does not hurt or itch. It may alternately crust and heal.

CAUSES--Skin damage from sun that occurs many years prior to the cancer's appearance.

RISK INCREASES WITH

• Adults over 60.
• Exposure to excess sunlight.
• Fair skin complexion.

HOW TO PREVENT

• Limit exposure to sun. Protect skin from sun exposure with a hat, clothing and sunscreen with protective factor of 15 or more.
• Perform a skin self-exam once a month (see Skin Self-exam in Appendix).

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Pathological exam of tissue after removal to confirm diagnosis.

APPROPRIATE HEALTH CARE

Treatment selection varies with appearance, extent and location of the lesion. > Removal of cancer by one of the following methods. The treatment method is chosen in a doctor-patient conference:

1. Curettage and electrodesiccation-local anesthetic applied, then cutting out or shaving of lesion, followed by high-frequency electrical current to destroy tissue with heat. 2. Surgical excision-local anesthetic is applied, then skin is marked for surgery, and a scalpel is used for the excision. 3. Moh's surgery-a specialized type of excisional surgery used to treat high-risk cancers. 4. Cryosurgery-use of liquid nitrogen to freeze and kill the cells. A local anesthetic is sometimes used. 5. Laser treatment-is being used in some medical centers. 6. Radiation treatment-used if tumor location requires it, such as locations near lips and eyelids.

POSSIBLE COMPLICATIONS--Without treatment, cancers may enlarge, ulcerate and disfigure. Less than 1% spread to other sites, but they should be removed to prevent local damage.

PROBABLE OUTCOME--Curable with proper treatment. Over a third of the patients will develop a new lesion within 5 years.

How To Treat

GENERAL MEASURES----After surgery:

• Apply rubbing alcohol to the scab twice a day.
• Apply an adhesive bandage to the scab during the day. Leave it uncovered at night.
• Wash the wound as usual. Dry gently and completely after bathing or swimming.

MEDICATION--

• For minor pain, you may use non-prescription drugs, such as acetaminophen or aspirin.
• Your doctor may prescribe an antibiotic ointment to prevent wound infection.

ACTIVITY--No restrictions.

DIET--No special diet.

Call Your Doctor If

• You have symptoms of basal-cell skin cancer.
• The wound bleeds after surgery and the bleeding cannot be stopped by applying pressure for 10 minutes.
• The wound shows signs of infection, such as pain, redness, swelling or increased tenderness.