What is a BCC?

BCC starting image

What is Basal Cell Carcinoma?

 

Basal cell carcinoma (BCC) is the most prevalent form of cancer in the world, with millions of people diagnosed with a BCC every year. It is by far the most common type of skin cancer seen in Australia.  But there are measures you can take to minimise your chances of being part of the stats. The key to doing this is to first understand what basal carcinoma is and how it comes about.

 

How does basal cell carcinoma come about?

Our skin cells slough off everyday. Whether it’s because of mechanical friction or chemical exfoliation, every human leaves behind a wake of dead skin cells. But if our skin sheds continuously, why do we never see the deeper, raw layers?

 

For that, we can thank our basal cells. These form the deepest part of the most superficial layer of the skin called the epidermis. Basal cells divide steadily in order to replace the skin cells we slough off everyday so we are always protected.

 

The problem is when basal cells divide abnormally fast due to cancerous changes. They spread upwards to the surface of the skin causing noticeable lesions. If left to their own devices, these cells can also spread in the opposite direction, going deeper into the skin and damaging structures such as blood vessels, nerves, and bone.  The good news is that BCC’s rarely spread and cause nasty problems.  

 

 

BCC cross section of skin

Risk factors of BCC

So what causes basal cells to go berserk and start dividing uncontrollably? Well, the answer is mutations.  Whilst these mutations can be inherited from one’s parents, the bulk of mutations occur from exposure to DNA-damaging factors. And you guessed it, the culprit is most often ultraviolet rays from the sun. Chronic, unprotected exposure to the sun causes problems with DNA repair systems and induces mutations. 

 

People who have mutations in the genes responsible for the hedgehog signalling pathway (yes, that is an actual medical term) are predisposed to cancers including BCC. This system is essential in regulating cell growth. When the genes here run amok, cells grow unchecked and tumours result.

 

Symptoms of BCC

Because BCC’s present on the surface of the skin, it makes it easy to detect with the naked eye. With knowledge of abnormal skin lesions and daily observation of one’s skin, it’s possible to catch the early stages of BCC’s.  Catching BCC’s in its early stages may mean avoiding surgery, or if surgery is required, having a smaller scar.  This is particularly important for BCC’s on the face which can encroach on important structures like your eyes and nose.

 

Keep an eye out for patches of skin that look different from the surrounding area and appear to grow bigger over time (keeping in mind that BCC’s in general are slow growing). Look for changes in color, texture, or elevation. Some BCCs present as skin wounds that don’t seem to heal and bleed, some as red rough patches and others as smooth skin-coloured or pink humps, bumps or sometimes divots in the skin.

 

Note that other skin lesions may be confused with BCC, especially to untrained eyes. But remember that it’s better to be safe than sorry. If you find something on your skin that looks suspicious, visit a doctor for an expert opinion. 

 

How to minimise the risk of BCC

The association between chronic exposure to UV radiation and basal cell carcinoma has long been established. Consistent and proper use of sunscreen, wearing sun-protective clothing and accessories, seeking shade and limiting time spent under the sun are simple measures that can effectively minimise your chances of getting this disease.

 

For the young, start being vigilant with sun protection early.  For those of us who have received plenty of UV rays in our lifetime, be vigilant about looking out for new and different spots and seek medical attention early.

 

Resources:

 

https://dermnetnz.org/topics/basal-cell-carcinoma/

https://www.aad.org/public/diseases/skin-cancer/types/common/bcc

https://dermnetnz.org/topics/genetics-of-basal-cell-carcinoma

 

 

The information presented on this website is for general information and example purposes only, does not contain health advice specific for users and must not be relied on for that purpose.  Please see your GP, dermatologist or other health care professional for specific advice.

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