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Understanding Basiloma (Basal Cell Carcinoma)

In this article:

Incidence and Mortality Statistics
Common Symptoms
Risk Factors
Diagnostic Methods
Treatment Methods
Personal Care

Overview of Hong Kong

Basal Cell Carcinoma Incidence and Survival Rate: The Most Common Skin Cancer

Many people are unfamiliar with basal cell carcinoma and may not have heard of it, yet it is one of the most common types of skin cancer. According to data from the Hong Kong Cancer Foundation, basal cell carcinoma accounts for approximately 70% to 85% of all skin cancer cases. It originates in the epidermal cells and typically has a limited impact, commonly appearing on the face, neck, nose, and ears. It grows slowly and usually does not spread to other tissues, making it largely non-lethal. However, if left untreated, cancer cells can infiltrate deeper layers of the skin, causing damage to surrounding tissues and complicating treatment, thereby increasing the likelihood of recurrence.

As mentioned earlier, basal cell carcinoma is a prevalent form of skin cancer. Data from the American Cancer Society suggests that an estimated 4.3 million people in the United States are diagnosed with this condition each year. The increasing prevalence of basal cell carcinoma is likely linked to prolonged exposure to sunlight, such as frequent outdoor activities or work under direct sunlight, which raises the risk of developing this cancer. Since basal cell carcinoma typically takes a long time to develop, most cases occur in individuals over the age of 50. Additionally, due to its lower risk profile, the 5-year survival rate for basal cell carcinoma is as high as 99% to 100%.

The primary cause of basal cell carcinoma is skin exposure to intense ultraviolet (UV) light. While UV rays are necessary for producing vitamin D, which promotes bone growth, prolonged sun exposure can damage the DNA within skin cells, leading to cancer. It is crucial not to underestimate the threat of skin cancer, as several factors can increase the risk:

  • Skin Colour: Individuals with lighter skin have a reduced genetic ability to produce melanin to block UV light, making them more susceptible to basal cell carcinoma than those with darker skin. Additionally, people with blue or green eyes and red or blonde hair are at a higher risk.
  • Age: Basal cell carcinoma usually requires several decades to develop; thus, most cases occur in older adults.
  • Exposure to Arsenic: Arsenic is a toxic metal commonly found in the environment that increases the risk of basal cell carcinoma and other cancers. Individuals who consume contaminated well water or work in industries that produce or use arsenic, such as coal-tar products or petroleum, may also face increased cancer risk.
  • Radiation Therapy: Receiving radiation therapy for conditions like acne or other skin diseases can increase the likelihood of developing basal cell carcinoma in the treated area.
  • Immunosuppressive Drugs: Medications that suppress the immune system, such as those used after transplant surgeries, significantly increase cancer risk.
  • Genetic Disorders: Certain rare genetic disorders, such as xeroderma pigmentosum and basal cell nevus syndrome, can elevate the risk of basal cell carcinoma.

Symptoms of Basal Cell Carcinoma

Common Signs, Symptoms, and Indicators

As previously mentioned, basal cell carcinoma often appears on the face, particularly on the eyelids, cheeks, and nose, allowing for noticeable skin changes. In the early stages, basal cell carcinoma typically presents as small, shiny nodules that are almost transparent or pink and may appear raised but firm, often accompanied by visible blood vessels. These nodules usually do not cause pain or tenderness, and the skin may lose its normal lustre. Over time, which could range from months to years, these nodules may crust, flake, or ulcerate, resembling insect bites.

Common Diagnostic Methods

Basal Cell Carcinoma Diagnosis Methods: Dermatoscopy and Biopsy Process

When a doctor suspects a patient may have basal cell carcinoma, they will first conduct preliminary and straightforward examinations, such as checking for skin nodules, inquiring about sun exposure habits, and assessing the family history of cancer. If necessary, further tests will be performed for a more accurate diagnosis, primarily involving:

  • Biopsy
    • Skin Biopsy: The doctor extracts a sample from the affected skin to examine under a microscope to confirm the presence of cancer. The type of biopsy required depends on the type and size of the lesion, including shave, punch, and excisional biopsies.
    • Lymph Node Biopsy: While it is rare for basal cell carcinoma to spread beyond the skin, if signs of spread are detected, a lymph node biopsy may be conducted to determine whether cancer cells have invaded nearby lymph nodes.
  • Imaging Tests: If signs of cancer spread to distant organs, imaging tests will be performed for further evaluation.
    • Computed Tomography (CT) Scan: This special X-ray examination uses computer analysis to assess tumour size, infiltration, and other characteristics.
    • MRI: This imaging technique accurately identifies the extent of tumour invasion and assesses whether it has eroded surrounding fat, muscle, other organs, blood vessels, or nerves.

Following these diagnostic methods, doctors can determine whether the patient has basal cell carcinoma and accurately assess the stage of the disease. Factors for determining the stage include tumour size, whether it has spread, and if it has metastasised to more distant tissues, categorised as follows:

Stage Description
0 Carcinoma in situ
I The tumour diameter does not exceed 2 cm and has not spread to nearby lymph nodes.
II Tumour diameter exceeds 2 cm but does not exceed 5 cm, and has not spread to nearby lymph nodes.
Or
The tumour diameter exceeds 5 cm without lymph node involvement.
III Tumours invade deeper structures beyond the dermis, such as cartilage, muscle, or bone, but do not spread to nearby lymph nodes.
Or
Any size tumour that has spread to nearby lymph nodes
IV Any size tumour that has spread to nearby lymph nodes and distant organs.

Main Treatment Methods

Basal Cell Carcinoma Treatment Methods: Surgical Excision and Photodynamic Therapy

Upon diagnosis, doctors will determine the most appropriate treatment for confirmed basal cell carcinoma patients. The treatment methods depend on the type of cancer, extent of spread, patient age, and overall health, primarily including the following:

  • Surgical Treatment
    • Surgery: During the biopsy process, the doctor can remove the tumour, and if the cancer is larger or has infiltrated deeper, more tissue may need to be excised. Surgery is the most common treatment method, with specific approaches depending on tumour size and location.
    • Mohs Surgery: Mohs surgery may be performed if there is a higher risk of recurrence and the tumour is larger or extends deep into the skin. This minimally invasive procedure involves local anaesthesia, where the doctor removes tissue incrementally and inspects it microscopically to ensure all cancer cells are excised.
    • Laser Surgery: Using laser beams instead of scalpels minimises bleeding and can be used to excise surface lesions.
    • Lymph Node Dissection: Since cancer cells can invade nearby lymph nodes, removing lymph nodes near the tumour can prevent cancer cells from spreading through the lymphatic system.
  • Other techniques include:
    • Curettage and Electrodesiccation: The doctor will locally anesthetise the area and use a curette to scrape out the tumour, followed by electrosurgery to control bleeding and destroy the remaining cancer cells. Healing usually occurs within weeks, and scarring varies by individual. This method primarily treats back, chest, hand, and foot tumours.
    • Cryotherapy: This treatment is suitable for small surface tumours, where liquid nitrogen or carbon dioxide is sprayed onto the tumour to freeze and destroy cancer cells. Some patients may require multiple sessions to eradicate cancer cells.
    • Photodynamic Therapy combines photosensitising drugs with light therapy to treat superficial skin cancers. During treatment, the doctor uses a drug that becomes active only when exposed to light, then uses a laser to target the area, causing the drug to attack the cancer cells.
    • Topical Immunotherapy: For smaller surface tumours, a cream called Imiquimod can stimulate the immune system to fight cancer cells. This is particularly useful for tumours in locations that are difficult to remove surgically or for patients with multiple tumours.
    • Radiation Therapy: This utilises radiation to kill cancer cells by targeting them with radiation beams to shrink the tumour. However, most cancer cells resist radiation, requiring high doses for effectiveness.
    • Chemotherapy: Medications such as cisplatin and 5-fluorouracil are administered intravenously to target cancer cells that have spread to lymph nodes and other organs.

Healthy Living

Post-Basal Cell Carcinoma Surgery Care: Is Wound Care and Sun Protection Important?

After tumour removal, patients must have regular follow-up appointments and self-examine their skin. Since sun damage to the skin is irreversible, individuals recovering from basal cell carcinoma face a higher risk of developing new tumours in situ or elsewhere. Any changes in skin condition should prompt immediate consultation with a doctor. Additionally, patients should pay attention to skincare post-surgery, particularly avoiding sun exposure and skin injuries.

Prevention Methods

Basal Cell Carcinoma Prevention: Sun Protection and Regular Skin Examinations

As previously mentioned, the primary cause of basal cell carcinoma is prolonged exposure to UV rays. Therefore, taking adequate sun protection measures and avoiding long periods in direct sunlight is essential.

Frequently Asked Questions

Basal Cell Carcinoma FAQS

How can basal cell carcinoma tumours be distinguished from regular moles?

Basal cell carcinoma tumours can resemble moles, making them easy to confuse. However, the “ABCDE” method can help differentiate them. It stands for asymmetry; it warrants attention if a new black or brown spot is asymmetrical or an existing mole changes shape to become asymmetrical. B represents Border; irregular edges in a place may indicate skin cancer. C stands for Colour; typical moles are usually one colour, but spots with colour changes or uneven pigmentation should be scrutinised. D is for Diameter; if a spot enlarges or exceeds 0.6 cm in diameter, it should be monitored closely. E is for Enlargement; noticeable rapid growth in a place could indicate skin cancer.

Can basal cell carcinoma be detected early?

Basal cell carcinoma rarely causes pain during its development, and while minor injuries may bleed and scab, the slow growth can lead to misinterpretation as a minor wound. Additionally, basal cell tumours can resemble other skin spots, making them easily overlooked. If you notice any unusual, newly appeared, or changing skin lesions, consult a doctor promptly.

Will treatment leave scars?

Procedures such as cryotherapy, curettage, and electrosurgery can leave scars. Moreover, Mohs surgery typically involves larger incisions, which may require skin grafts from other body areas to repair the appearance.

Is basal cell carcinoma hereditary?

While basal cell carcinoma is primarily linked to prolonged UV exposure, rare genetic conditions such as xeroderma pigmentosum and basal cell nevus syndrome increase the risk of developing this cancer.

Is there a risk of recurrence for basal cell carcinoma?

Due to irreversible sun damage, individuals recovering from basal cell carcinoma are at a higher risk of developing new tumours. Any changes in skin condition should prompt immediate medical consultation.



▣ The information on this website has been reviewed by the HEAL Medical Team and is regularly updated according to the most recent clinical evidence. All content is provided for general informational purposes only and should not replace professional medical advice. Please consult your doctor or another qualified healthcare professional for personalized medical guidance.

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