by Chris Prakash, MD**
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Chris Prakash, MD
Q: ??? I had a skin cancer removed from my nose. The dermatologist told me that it is basal cell skin cancer. Should I be worried about it spreading to other organs? Do I need any other treatment besides removing it?
A: ???? Basal cell skin cancer is the most common form of skin cancer in the US. The other types are squamous cell and melanoma. Basal cell cancer is related to exposure to sunlight or ultraviolet radiation. Unlike melanoma, basal cell skin cancer almost never spreads. But, if left untreated, it may grow into surrounding areas and nearby tissues, and can be disfiguring. This is most worrisome around the nose, eyes, and ears.
You did the right thing. You noticed an abnormal skin lesion which was probably growing, and sought medical attention. Surgical removal of the basal cell skin cancer is often all that is required. Of course regular skin check ups would be of paramount importance as well.
What are the risk factors for getting basal cell skin cancer?
- Freckled skin
- Blue or green eyes
- Blond or red hair
- Close relatives with history of skin cancer
- Sunburns early in life
- Long-term daily sun exposure
What does basal cell cancer look like?
Basal cell skin cancer may not look that different from the normal skin. It usually presents as a growth that is painless. You may have:
- A sore or a red patch or pink growth
- A skin sore that bleeds easily
- A sore that does not heal
- Irregular blood vessels in or around the spot
- A lesion with a sunken area in the middle
Your doctor will do a biopsy of this lesion, which may then confirm that you have the cancer.
What are the Treatment Options?
- Excision: Cutting out the skin cancer.
- Cryosurgery: Freezing the cancer cells, which kills them.
- Skin creams: Creams containing imiquimod or 5-fluorouracil for superficial (not very deep) basal cell cancer.
- Mohs surgery: Removing a layer of skin and looking at it immediately under a microscope, then removing many layers of skin until you get negative margins (there are no signs of the cancer). This is usually used for skin cancers on the nose, ears, and other areas of the face.
- Photodynamic therapy: Treatment using light.
- Radiation may be used if a basal cell cancer cannot be treated with surgery.
- The FDA recently approved vismodegib (EVERIDGE), an inhibitor of the Hedgehog Pathway for treatment of basal cell carcinoma, in patients who are not candidates for other treatments.
Is the Prognosis good?
Yes, basal cell skin cancers almost never spread. Most of these cancers are cured when treated early. However, some may return. Therefore it is very important to have regular skin check ups so that any abnormal skin lesions are removed.
How can I prevent skin cancer?
The best way to prevent skin cancer is to reduce your exposure to sunlight. Protect the skin by wearing hats, long-sleeved shirts, long skirts, or pants. Always use sunscreen (SPF at least 15). Look for sunscreens that block both UVA and UVB light.
This information is strictly an opinion of Dr Prakash, and is not intended to replace the advice of your doctor. Dr Chris Prakash is a contributing columnist, and author of eParisExtra?s ?The Doctor is In? column. He is a medical oncologist at Texas Oncology Paris. He is board certified in Internal Medicine, Oncology and Hematology. He lives in Paris, TX with his wife and two children, and can be reached at 9037850031, or Sucharu.prakash@usoncology.com
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