Recognizing Basal Cell Carcinoma

It's the most common of all skin cancers. It strikes 3 out of every 10 women and 4 out of every 10 men in the United States. It is diagnosed 900,000 times a year in the USA alone. This most common of all cancers is basal cell carcinoma.

A basal cell is, as its name suggests, a skin cell from which the very top layers of the skin are based. Basal cells are pluripotent, that is, they can form skin cells, hair cells, or sweat glands. These cells are not exposed to the damaging UV-A rays of the sun as much as top levels of skin, but when they are, the damage is more serious. UV-A rays rearrange the sequence of the A-G-C-T bases in DNA and disable the gene that "turns off" cells when they become cancerous.

Even though basal cells are below the surface of the skin, cancerous basal cells typically work their way to the top and are just sloughed off. Only when they are trapped in a hair shaft or a pore do they typically survive long enough to cause problems.

Unlike another common skin condition, actinic keratosis, basal cell carcinomas do not occur exclusively on sun-damaged skin. It's possible to get them anywhere on the body, although their appearance on normally covered skin surfaces suggests a severe immune deficiency. Also unlike an actinic keratosis, cancerous basal cells tend to bleed, a lot. They can be a pink bump surrounded by tiny blood vessels radiating out, or a just a pink bump that bleeds easily.

These tiny skin cancers may present as a tiny open sore that just does not heal after 3 weeks, or, most dangerously, as white, yellow, or waxy spot with a scar or a crust. All basal cell cancers tend to bleed easily. (There may be more symptoms of the condition that these; always consult a physician about persistent skin abnormalities.)

What happens if you never treat this form of skin cancer? Unless you have HIV or receive chemotherapy, it will not spread through your body. It can, however, scar. If near the eyes, it can interfere with vision. And, especially in the elderly, it can cause unsightly black blotches on ears and nose. Fortunately, this skin condition is relatively easy to treat.