Mole Clinic
Skin Cancer Clinic
Types of Skin Cancer

Basal Cell Carcinoma

The Commonest Cancer in Australia

BCC


Basal cell cancer (BCC) is the commonest form of skin cancer seen at our clinic. BCCs grow slowly over months or years, and vary in size from a few millimetres to several centimetres in diameter. There are several different types of BCC.

Although not generally a dangerous tumour it is important to detect and treat them early to simplify management and avoid unsightly scars.
BCC - Who is at risk?

BCC occurs mainly in fair skinned people who live in sunny climates. Sunburning and high level episodic sun exposure in childhood is a risk factor. Other risk factors include:
  • Sun exposure, particularly during childhood
  • Fair skin that burns easily
  • Blistering sunburn, especially when young
  • Previous BCC or SCC
Appearance of BCC


Nodular BCC - This usually presents as a pearly pink/grey nodule with a fragile surface which bleeds easily. Small blood vessels can be seen over the lesion and a central ulcer (hole) often develops.

Superficial BCC – A shiny pink flat patch which bleeds easily. It may resemble a patch of eczema, fungus (ringworm) or a poorly healing sore.

Infiltrating BCC - This resembles an old scar – a flat, firm grey indistinct skin tumour. This is the most difficult type of BCC to treat because it often has spread significantly beyond what is visible on the skin surface.

Nodular BCC - This usually presents as a pearly pink/grey nodule with a fragile surface which bleeds easily. Small blood vessels can be seen over the lesion and a central ulcer (hole) often develops.

Superficial BCC – A shiny pink flat patch which bleeds easily. It may resemble a patch of eczema, fungus (ringworm) or a poorly healing sore.

Infiltrating BCC - This resembles an old scar – a flat, firm grey indistinct skin tumour. This is the most difficult type of BCC to treat because it often has spread significantly beyond what is visible on the skin surface.

Basal cell cancer (BCC) is the commonest form of skin cancer seen at our clinic.

Every day several BCCs are diagnosed and treated at our clinic.
Treatment of BCC

Surgery

If a BCC can be removed easily by surgical excision this is generally the best way to deal with it. This is the most appropriate treatment for nodular, infiltrative and morphoeic BCCs. Most BCCs diagnosed at the clinic can be excised here at the clinic, avoiding the need for costly and inconvenient specialist referrals.

The tumour is removed as an ellipse (oval) of skin, together with a margin of normal skin to ensure complete removal. The skin edges are sutured together, resulting in a linear scar that usually 3-4 times longer than the width of the original lesion. Occasionally a specialized skin procedure called a Skin Flap or Skin Graft is used to close the skin. If this is needed the doctor will discuss this with you prior to the procedure.

A big advantage of skin surgery is that the laboratory pathologist can determine whether the cancer has been completely removed or nor. If excision is reported as complete, recurrence rates are very low — 1-2% at most.

PDT

PDT is a relatively new form of BCC treatment involving an anticancer cream activated by a special lamp. For more about PDT read here. A big advantage of PDT is the minimal scar left behind—the cosmetic results are generally excellent.

It is best for superficial BCCs in areas that are difficult to remove and where the scar appearance is of great importance – eg the face. It however has a higher recurrence rate than surgery (about 10- 20%). For more about PDT, please click here.

Aldara

Aldara is a prescription only cream that is applied for 6 weeks to superficial BCCs. Inflammation and ulceration are common side effects. Again recurrence is of the order of 20%, and it is not recommended for nodular and infiltrative BCCs where the recurrence rate is even higher. It is also not recommended for recurrent BCC tumours.

Curettage/Cautery

This treatment involves scraping and burning the lesion under local anaesthetic to destroy the surface skin cancer cells. A scar forms from the deeper skin tissues remaining. This treatment results in a wide pale scar. It also has a higher recurrence rate (about 20%) because some cancer cells may be left behind.

Curettage is best reserved for slow growing non aggressive BCCs in areas that are difficult to remove and where the scar appearance is not important.


After Treatment of BCC

Patients with BCC are at increased risk of developing further BCCs. They are also at increased risk of other skin cancers, especially SCC and Melanoma.

Arrange a complete skin examination from time to time. Ask your doctor to check any persisting or growing lumps or sores or otherwise odd-looking skin lesions. Early detection means easier treatment, and less scarring.

Avoid excessive exposure to the sun. Stay indoors or under the shade in the middle of the day. Wear covering clothing. Apply broad spectrum sunscreen to exposed skin if you are outdoors for prolonged periods, especially during the summer months.
We are now a Fully private billing Practice

We are now a Fully private billing Practice.