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The word ‘cancer’ is frightening. Many of us have personal stories about cancer that cloud our view of it. As a dermatologist, I am used to telling patients that they have skin cancer, a condition which was once rare, but, unfortunately, which we now see all the time. Skin cancer is the commonest cancer is the world, but, not only that, it is the fastest rising. And the commonest skin cancer, by a long way, is basal cell carcinoma, which astoundingly is seen more frequently that ALL other solid cancers put together.
But, unlike breast cancer, testicular cancer or leukaemia, most people haven’t even heard of basal cell carcinoma. Why? Well unlike more serious internal cancers and skin cancers such as melanoma, it grows slowly (1mm every 4-20 weeks), almost always stays in the skin, hardly ever spreads to other organs and almost never shortens life. Basal cell carcinoma should not be frightening.
But basal cell carcinoma (also called BCC, or ‘rodent ulcer’) is an important problem, because if it is not treated early it can cause issues with local structures such as the nose, ears or eyelids, and if treatment is very delayed, surgery can be disfiguring. So early diagnosis and treatment is key. Treatment of basal cell carcinoma on the face often involves removal of the cancerous tissue by surgery, most accurately using a technique called Mohs Surgery, in which the cancerous cells are removed in stages leaving as a wound that is as small as possible and where specimens are examined immediately by the Mohs Surgeon under the microscope, giving a very high cure rate.
Fortunately, unlike internal cancers, skin cancers can be seen with the naked eye, and usually do not need complicated tests for diagnosis. Basal cell carcinomas are usually on the face, ears or neck, are often firm to the touch and may be red or slightly pearly white when the skin is stretched. They may have small visible blood vessels and may bleed easily when knocked.
If in any doubt, just ask your doctor or see a dermatologist.
The London Dermatologist
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