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Basal Cell Carcinoma

Basal Cell Carcinoma (BCC) is a skin cancer that begins from the basal cells.  Basal cells produce new skin cells as the old ones die off.  It is a very common type of skin cancer.  They tend to grow slowly and consistently over time and almost never spread to lymph nodes or other organs.

BCCs are thought to be caused by excessive sun exposure.  So, avoiding excessive UV exposure can help reduce the risk of developing them. 

What do BCCs look like?

There are several different subtypes of BCCs.  As a result, they have varying appearances.  Common appearances of a BCC are:

  • A small shiny skin-coloured nodule with fine blood vessels- The bump can be pearly white or pink on white skin.  On darker skin, it may look brown or black.  It can be translucent i.e. you can see through the surface a little bit.  It will often have fine blood vessels on the nodule called telangiectasia.

  • A bleeding area which refuses to heal:  this area will scab over and then ulcerate again.

  • A red scaly patch with a raised rolled edge:  This subtype can grow quite large overtime.

  • A lesion that looks like a scar:  These can have an indistinct border and tend to be white and waxy.

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Am I at risk of developing a BCC?

Factors that increase your risk of BCC are:

  • Excessive UV exposure:  Spending lots of time in the sun or tanning beds will increase your risk of BCC.   Blistering sunburns as a child or teenager will also increase your risk.

  • Fair skin:  blue eyes, blond or red hair, tendency to freckle or sunburn easily all increase the risk of developing BCCs

  • Increasing age: BCCs are more common as a person ages

  • A personal history of precancerous skin lesions or any type of skin cancer increases the risk of developing BCC

  • A weak immune system:  People on immunosuppressive drugs for organ transplants or inflammatory medical conditions (e.g. Crohn’s disease) are at increased risk of developing BCCs. 

  • Arsenic exposure:  This is a toxic metal which increases your risk of BCC and other cancers.

  • Rare genetic disorders:  Inherited conditions which can increase your risk of BCC e.g. Gorlin syndrome

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How can I prevent BCC?

  • Avoid strong sun:  Avoid the sun in the middle of the day (10am -4pm).  Use a UV app to know what level of UV radiation that is currently present.

  • Wear sunscreen year-round.  Use a broad spectrum sunscreen (UVA, B and C) that is at least SPF 50+.  Re-apply regularly (15 mins before going out in sun and repeat every 2 hours/ reapply after swimming or heavy physical exertion).

  • Wear protective clothing.  Wear a broad-brimmed hat and clothing which covers your arms and legs.  A collared shirt is excellent for the back of your neck.  A good choice of hat for children is:  https://sundayafternoons.co.nz/product-category/kids-hats/   Sunglasses are important to protect your eyes from the sun.

  • Avoid tanning beds

  • Check your skin regularly and see your GP if you develop any concerning lesions.

What to expect at the clinic?

Usually a BCC can be diagnosed by examination by Dr Mooney.  Sometimes a biopsy needs to be performed.

The most common way of treating an BCC is with surgery.  This can usually be done under local anaesthetic in the rooms.  This is sometimes done on the day of your first visit.   If more time is needed, a further appointment will be made to have the surgery.

Occasionally, Dr Mooney will recommend you have a general anaesthetic and be treated in the main hospital.

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Possible complications of surgery include:

  • Bleeding

  • Infection

  • Delayed wound healing

  • Scarring

  • Incomplete margins : leaving some of the cancer cells behind

  • Recurrence

  • Further surgery or other treatment recommended e.g. radiotherapy

Other treatment options

Occasionally Dr Mooney will recommend other treatments such as radiotherapy.

Superficial BCCs (a very early BCC) can be treated with a topical ointment called Aldara (imiquimod)

What will happen if I do not treat a BCC?

In general, a BCC will slowly grow until it invades into bones, nerves and deep tissues.  A BCC is usually very treatable.  However, if it is neglected and ignored it can become a significant problem that requires major surgery or other treatment modalities. 

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