Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is the most common form of skin cancer. The cancer arises in the basal cells, which line the deepest layer of the epidermis. Almost all basal cell carcinomas occur on parts of the body that are excessively exposed to sunlight, including the face, ears, neck, scalp, shoulders, and back. On very rare occasions, tumors can develop on unexposed skin areas.

For more information on BCC and to understand the common signs of skin cancer, click here.

Patients who choose SkinSpeaks for their medical dermatology needs have access to the following basal cell carcinoma treatment plans:


Treatments

  • Mohs Micrographic Surgery

    Using local anesthesia, we remove the tumor with a very thin layer of tissue around it. The layer is immediately checked under a microscope, and if the tumor is still present in the depths or peripheries of this surrounding tissue, the procedure is repeated until the last layer examined under the microscope is tumor-free.

     

    Mohs surgery saves the greatest amount of healthy tissue and has the highest cure rate—generally 98 percent or better. It is frequently used for tumors that have recurred, are poorly demarcated, or are in critical areas around the eyes, nose, lips, and ears. After Mohs surgery is performed, the wound may be allowed to heal naturally, be sutured, or be reconstructed using cosmetic surgery methods.

  • Excisional Surgery

    After numbing the area with local anesthesia, we remove the entire growth along with a surrounding border of normal skin. The skin around the surgical site is then closed with stitches, and the excised tissue is sent to the laboratory for microscopic examination to verify that all malignant cells have been removed.

    The effectiveness of the technique does not match that of a Mohs procedure but is still a highly effective form of skin cancer treatment.

  • Curettage And Electrodessication

    Using local anesthesia, our dermatology specialists scrape off the cancerous growth with a curette (a sharp, ring-shaped instrument). The heat produced by an electrocautery needle destroys residual tumor and controls bleeding. This technique may be repeated twice or more to ensure that all cancer cells are eliminated. It can produce cure rates approaching those of surgical excision, but it may not be as useful for aggressive basal cell carcinomas or those in high-risk or difficult sites.

  • Cryosurgery

    Tumor tissue may be destroyed by freezing it with liquid nitrogen, which eliminates the need for cutting or anesthesia. The medical dermatology procedure may be repeated at the same session to ensure total destruction of malignant cells.

    The growth becomes crusted and scabbed and usually falls off within weeks. Cryosurgery is effective for common skin cancer and is the treatment of choice for patients with bleeding disorders or an intolerance to anesthesia.

  • Photodynamic Therapy

    This treatment uses light-activated drugs and a laser to destroy cancer cells and treat symptomatic tissues. PDT utilizes photosensitizing agents (light-activated drugs), oxygen and light, to create a photochemical reaction that selectively destroys skin cancer.

    The photosensitizing agents concentrate in cancer cells and only become active when light of a certain wavelength is directed onto the area where the skin cancer lives. The photodynamic reaction between the photosensitizing agent, light, and oxygen kills the cancerous cells.

  • Topical Medications

    Imiquimod is FDA-approved only for superficial basal cell carcinomas, with cure rates generally between 80 and 90 percent. The 5 percent cream is rubbed gently into the tumor 5 times a week for up to 6 weeks or longer. It is the first in a new class of drugs that work by stimulating the immune system. 5-Fluorouracil (5-FU) is also FDA-approved for superficial basal cell carcinomas, with similar cure rates to imiquimod. The 5 percent liquid or ointment is gently rubbed into the tumor twice a day for 3-6 weeks.

    Trials with more invasive basal cell carcinomas are under way for both imiquimod and 5-FU. Side effects are variable, and some patients do not experience any discomfort; however, redness, irritation, and inflammation are predictable.