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How serious is a basal cell carcinoma?

A basal cell carcinoma is a very common problem, with over 100,000 new cases in the UK every year. Usually a basal cell carcinoma can be treated with little problems, but there are a number of potentially serious issues that must be considered when treating them.

Mr Tehrani lectures to GPs and other specialists, and his talks include the serious issues that basal cell carcinomas can cause. We list and describe some of these issues below.

 

Tissue destruction – basal cell carcinomas grow slowly, but they do continuously enlarge, both sideways (along the skin) and deeply. As they grow, they destroy the skin and tissue around them, which will need to be removed. When they are on areas such as the nose, ears, lips or eyelids, this can be more serious and result in loss of vital skin and tissue which can be very challenging to replace and reconstruct. Unfortunately, for larger basal cell carcinomas, it may be impossible to replace the lost tissue; for eyelid tumours it can be so serious as to even result in loss of the eye and vision. If the basal cell carcinoma has reached bone, then major surgery or radiotherapy may be needed to try and treat it.

Death – dying from a basal cell carcinoma is fortunately extremely rare, and they do not tend to spread to other organs such as liver, lungs or lymph glands. Those that do spread are usually extremely large and neglected BCCs, or of the rarer ‘basosquamous’ type.

Bleeding – basal cell carcinomas can start to bleed as they grow, which at first is a nuisance. If left long enough though, bleeding can occur almost continuously, which can rarely lead to a significant amount of blood loss.

Pain – basal cell carcinomas are usually painless, but can itch and sometimes feel sore. If they grow onto nerves or into areas such as the eye though, then they can become painful. Treating them at this stage may help stop the pain, but sometimes the pain can be a long-lasting issue.

Infection – basal cell carcinomas can become inflamed, but usually do not become infected. If they do get infected, then antibiotics may be needed to treat them, although some serious infections can be very difficult to treat

Scarring – removing a basal cell carcinoma will leave scarring, which can be significant especially when on the face. Reconstruction can be difficult in some areas, leaving noticeable changes in appearance. For this reason, it is important to ensure that the person performing the surgery is suitable qualified to do so.

Incomplete excision – when a basal cell carcinoma has been removed by traditional surgery, it is sent to the laboratory to be checked over the next few days. Sometimes, the report says that it has not been completely removed, and more treatment is needed. This can lead to more scarring and unnecessary loss of vital areas such as parts of the nose or eyelid. For this reason, some basal cell carcinomas may be best treated with Mohs surgery, as the slides are checked on the same day as the surgery.

Recurrence – removing a basal cell carcinoma often cures it, but occasionally they can return in their same location. The risks of this are 5-10% with traditional surgery, but only around 1% with Mohs surgery.

 

Read more about Mohs surgery here

Read more about Basal Cell Carcinomas here

 

The information given is for general information only, and does not replace that given by a specialist. If you have any concerns about a skin growth, please seek medical attention as soon as possible.

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