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Basal Cell Carcinoma

What is basal cell carcinoma?

This is the most common form of skin cancer that arises in the basal cells, which line the deepest layer of the epidermis (top skin layer). Hence the name basal cell carcinoma. It is also called rodent ulcer.

Do not forget!

People who have one basal cell carcinoma are at risk of developing another in the future. This can occur at the site of the initial skin cancer or at another part of the body.

Basal cell carcinoma around the nose, eyes and scalp can be quite troublesome.

It is necessary to be seen at regular intervals by your plastic surgeon so that any recurrence can be detected early and treated promptly.

Basal cell carcinoma can spread to surrounding tissue causing destruction and disfigurement if not treated early. Fortunately when treated early, the cure rates are excellent.

Did you know!

Sun safety measures will help prevent the occurrence of basal cell carcinomas. These measures include efficient use of sunscreen, avoidance of tanning and UV booths, avoid sunburns and seek shades from the sun between 10am and 4pm.

It is useful to examine your skin from head to toe every month to look for new or unusual moles!

Who commonly gets it?
People with a lot of sun exposure and therefore commonly occurs on parts of the body excessively exposed to sunshine such as the face, ears, scalp.
Older people are often affected.

People with fair skin, blond or red hair are at a higher risk.

People with blue, green or grey eyes are also more prone.

What to look out for?
They can present as a non healing ulcer or sore that scabs, crusts and bleeds.

It can present as a reddish, itchy and crusty patch of skin.

It may arise a raised growth with rolled edges and very fine vessels on the surface and commonly a depressed centre.

It can look like a scar. Usually the borders are not well defined.

Can present as a pearly or translucent mole.

What kind of anaesthetic is used?
The operation is usually carried out under local anaesthetic. However if the area is very large and/or involves deep structures, a general anaesthetic will be used.
How is it performed?
An injection is given close to the skin cancer to make the skin numb. Then the area is removed and sent to the laboratory for analysis. The wound can be sutured directly or by re-arranging the nearby skin (local flap) or by transferring tissue form elsewhere to this area (skin graft or free flap).
How long will I stay in hospital?
It is usually a few hours (So patients go home the same day).
What kinds of treatment do I expect in hospital?
Painkillers to achieve adequate pain relief are given to take when the effect of the local injection wears off.

Sometimes prophylactic antibiotics are given.

How long will I be off work?
This depends on the size of the skin cancer removed. Usually a few days to one week off work is enough.
What are the problems that may occur after surgery for removal of basal cell carcinoma?
Most patients are very pleased with the results of their surgery.

Problems are not common.

However the problems that can arise with any surgery can occur including haematoma (collection of blood) which may require drainage, infection, small areas of superficial wound breakdown, partial or total loss of skin graft or flap.

What happens after the operation and the diagnosis is confirmed?
After removal, you will be followed up in the outpatient clinic at regular intervals and these will be discussed and agreed during the first post operative consultation. This will be discussed then because the result of the histology or laboratory analysis of the specimen is necessary not only to confirm the diagnosis but also the particular histological type and behaviour of the lesion.

All these and any concerns would be discussed during the consultation.

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