Skin Cancer Facts
Basal cell carcinoma is the most common type of skin cancer. Fortunately, in 95 percent of cases it can be cured — if it’s treated early.
By Rear Adm. Joyce Johnson, D.O

Each year there are about a half million new cases of basal cell carcinoma, most in people 40 years and older. Basal cell carcinoma is often difficult to recognize. It’s usually painless and not very noticeable, and it can manifest itself in many ways. It may be a small bump on the skin that is shiny and somewhat translucent or a bump that is ulcerated, oozing, and crusted. Sometimes the lesion looks like a flat, reddened area, resembling a small scar. It also can be a slightly raised, irritated-looking area resembling psoriasis. In most cases — 90 percent — it occurs on parts of the body that are exposed to the sun, including the scalp.

Basal cell carcinoma lesions can change slowly over time, generally over months or years. After several years of growth, a lesion could be less than an inch in diameter. It might begin as a shiny bump and gradually grow and develop visible, purple-reddish blood vessels. A lesion might be an oozing sore, then appear to heal, then ooze and crust again.

These “healing” lesions can be the most dangerous, because even though they appear to be gone, they are still growing. Meanwhile, patients (and even physicians) who suspected a problem can forget about it when it appears to heal.

When a lesion is suspicious, a biopsy is essential — it’s the only way to make an accurate diagnosis. A biopsy is usually quite simple and can be done quickly and easily in the doctor’s office. After an injection of a local anesthetic, a small piece of the affected skin is removed, and a pathologist looks at it under a microscope.

Once basal cell carcinoma has been diagnosed, treatment is essential. The specific treatment depends upon the location and severity of a lesion; the goal is to remove the entire lesion. A small, clearly delineated lesion may be treated by scraping and electrodessication (burning). Cryosurgery (freezing) is another accepted treatment. Surgical removal is optimal when additional pathology examinations are desired to ensure the entire tumor has been removed. If the tumor is large or near important or fragile tissues, such as on the face, microsurgery (sometimes called Moh’s surgery) may be performed.

If basal cell carcinoma is found and treated early, nearly all patients are cured. However, a patient can have another lesion months or years later in another area of the skin. Tell your doctor about any suspicious lesions, and once a year ask your doctor to examine your skin to check for this cancer.

Sun exposure increases your risk of basal cell carcinoma. People with fair skin, blond or red hair, and blue or green eyes are more susceptible because they don’t have as much skin pigment to filter the sun’s damaging UV rays.

— Rear Adm. Joyce Johnson, USPHS-Ret., D.O., M.A., is vice president, Health Sciences, Battelle Memorial Institute, Arlington, Va. Find more health and wellness resources online at www.moaa.org/wellness.