In recent years, oncological diseases quite often become the main cause of high mortality among the population. Cancer cells can infect absolutely any tissue in the human body, causing various pathological processes. Let us consider in detail what basal cell skin cancer is, what are its causes and whether it is possible to recover from this ailment.
What is this type of cancer?
This type of cancer is also called basal cell carcinoma. Most often, it develops on the face, neck or nose. Prefers to hit the male population over 40 years old. It is noted that representatives of the Mongoloid race and the Negroid are not susceptible to this type of cancer.
The name "basal cell carcinoma" comes from the fact that cancer cells begin their development with the basal layer of the skin, which is located deepest.
Causes of Skin Cancer
Currently, the question of histogenesis (a set of processes leading to the formation) of this disease has not yet been completely resolved. Many are of the opinion that basal cell skin cancer develops from pluripotent epithelial cells. Differentiation can occur in different directions. We list some reasons that, according to most experts, can provoke the development of this pathology:
- Genetic predisposition.
- Immune system disorders.
- External influences of adverse factors.
- Development against the background of senile keratosis, radiodermatitis, lupus tuberculosis, psoriasis.
Basal cell skin cancer (this photo shows) occurs most often in the epidermis and hair follicles. It grows slowly and very rarely gives metastases. Some doctors consider basal cell carcinoma not as a cancer or a benign mass, but as a tumor with local destructive growth.
Quite often, under the influence of strong carcinogens, such as x-rays, basal cell carcinoma of the skin turns into a carcinoma.
Provocateurs of basal cell carcinoma
There are a lot of risk factors for this disease:
- The most serious provocateur is ultraviolet radiation.
- Male affiliation. It is noted that its representatives are much more likely to experience such a disease.
- The presence of fair skin. It was found that people with dark skin practically do not suffer from this pathology.
- The tendency of the skin to receive sunburn.
- Work in the open sun for a long time. As you approach the equator, the frequency of this disease increases. Most often, basal cell carcinoma of the skin of the face or neck develops.
- High concentration of arsenic in drinking water. Those who are forced to work with this substance are at risk.
- Polycyclic aromatic resins can also cause the development of this disease. They can be contained in coal tar, shale, soot.
- Long-term use of immunosuppressants.
- Some hereditary pathologies, such as albinism or xeroderma pigmentosa.
- Chronic ulcers.
- Thermal burns.
- Ionizing radiation.
It was also found that excessive insolation (exposure to sunlight) in childhood can subsequently lead to the development of cell cancer.
Classification of basal cell carcinoma
If we consider histology, then this pathology is classified as undifferentiated and differentiated cancer. The first category includes:
- solid basal cell carcinoma;
- pigmented;
- morphine-like;
- superficial.
Differentiated is divided into:
- keratotic basal cell carcinoma;
- cystic;
- adenoid.
According to the international classification, the following skin cancer options are distinguished:
- Solid basal cell carcinoma. This form is found most often and represents cords and cells, which are compact. In this case, basaloid cells do not have clear boundaries; in the center, they can be with dystrophic changes and cystic cavities.
- Pigmented basal cell skin cancer (photo you can see in the article) is characterized by diffuse pigmentation due to the content of melanin.
- The superficial type of cancer often forms multiple foci. Relapse can occur after therapy along the borders of the scar.
- Scleroderma-like is characterized by a strong development of connective tissue, into which strands of basal epithelial cells are embedded. They can penetrate deep inside, down to the subcutaneous tissue.
- A malignant tumor with glandular differentiation is also called adenoid. It is distinguished not only by the presence of large sections, but also by narrow epithelial cords, which consist of several rows of cells forming an alveolar or tubular structure.
- Basal cell carcinoma of the skin of the right cheek with cyloid differentiation. It is distinguished by the presence of foci with keratinized areas that are surrounded by cells similar to prickly.
- Cancer with sebaceous differentiation is quite rare.
- The fibroepithelial type is a very rare variety of basal cell carcinoma. Usually distributed in the lumbar region and sacrum. Clinically, it may resemble fibropapilloma.
Types of basal cell carcinoma by type of manifestation
There is a classification of this pathology and the type of manifestation. The following types are distinguished:
- Nodular-ulcerative basal cell carcinoma. Consider this basal cell skin cancer. The initial stage (photo confirms this) is characterized by the appearance of a nodule on the eyelids, in the corners of the mouth. The skin around the pink or reddish color with a matte or shiny surface. After some time, the nodule is converted into an ulcer with greasy plaque. After some time, a vascular network appears on the surface, the ulcer is covered with a crust, and seals form on the edges. Gradually, the ulcer begins to bleed and grow into the deeper layers of the skin, but metastases do not form.
- If the ulcer heals in the center, and growth continues along the edges, then we are talking about cicatricial-atrophic basal cell carcinoma.
- Perforating basal cell carcinoma develops most often in places that are often injured. Very reminiscent of a nodular-ulcerative form, but develops at a much greater speed.
- The warty form of cancer resembles a head of cauliflower in appearance.
- Nodular view is a single nodule that develops upward and protrudes above the surface of the skin.
Only after the form and type of the disease has been determined, does the doctor determine how to treat basal cell carcinoma. Of course, there can be no talk of any self-medication.
Symptoms of the disease
Quite often, if there is basal cell carcinoma of the skin, the initial stage (photo confirmation of this) proceeds without any symptoms. In rare cases, slight bleeding is possible.
Patients may complain that a small ulcer appeared on the skin, which slowly increases in size, but at the same time it is completely painless, sometimes itching appears.
The clinical manifestations of basal cell carcinoma depend on the shape of the tumor and its localization. The most common is nodal basal cell carcinoma. It is a hemispherical node with a smooth pink surface, in the center of which there is a small depression. The node grows slowly and resembles a pearl.
With a superficial form of cancer, a plaque appears with clear boundaries, raised and having waxy-shiny edges. Its diameter can be from 1 to 30 mm. It grows very slowly.
If basal cell carcinoma of the skin is scarred, then it looks like a flat scar of a grayish-pink color, slightly pressed into the skin. The edges are raised and have a pearly shade. At the boundary of the formation, erosion occurs, covered with a pink-brown crust. During this form of cancer, periods are observed when scars predominate, and erosion is very slight or absent.
The ulcerative form of basal cell carcinoma is characterized by the destruction of soft tissues and bones that are located next to the tumor. Ulcers have an irregular shape, their bottom is covered with a crust of gray-black color, it is usually tuberous, and the edges are raised.
By the way, there is also basal cell carcinoma of the skin of a cat (primary multiple). In this case, you can see a lot of basal cell carcinomas on the body of the animal, in addition, mental disorders that are manifested by inappropriate behavior are observed, in addition, the skeleton pathology develops. This type of malignant tumor is characterized by slow growth, the depth of the lesion and the risk of relapse will depend on its size, location, cellular characteristics, immunity.
In humans, basal cell carcinoma of the skin is the most dangerous. The treatment in this case is rather complicated. Pathology is usually localized on the face, skin around the eyes and nose.
The scleral-like form of basal cell carcinoma is also a great danger to humans. But pigmented basal cell skin cancer has a favorable prognosis. This form of treatment lends itself well.
How can a disease be diagnosed?
In order to make an accurate diagnosis, sometimes it is enough for an experienced specialist to look at the patient. The clinical manifestations of this type of cancer are quite characteristic, and there are no diagnostic difficulties. On the surface, most often, the doctor discovers single or multiple foci of microerosion, which are covered with easily separated crusts on top.
When problems are found, patients often turn to a dermatologist, but the oncologist should deal with the therapy in this case. If you analyze a smear-scarification from erosive areas, then this is almost 100% of cases allows you to confirm the diagnosis.
If cytological and histological studies cause some doubts, then the patient is given a lymph node biopsy.
It is important when making a diagnosis to distinguish basal cell carcinoma from lupus, melanoma, keratosis, or psoriasis. After all the examinations, if the diagnosis is confirmed, the doctor selects a method of therapy strictly individually. This disease does not have the same approach to the treatment of all patients.
Pathology therapy
Once the diagnosis of basal cell skin cancer has been confirmed, treatment should be started immediately. Most often, the following methods are used to combat this pathology:
- electrocoagulation and curettage;
- cryodestruction;
- radiation therapy;
- Mos method, which consists in excising a tumor with intraoperative microscopy of frozen horizontal sections so that the volume of the upcoming operation can be determined.
The choice of treatment method depends entirely on the location of the tumor, its size, flow patterns and the condition of the patient. Dermatologists usually prefer to use electrocoagulation at the very beginning of therapy. But you must remember that this method of treatment is effective if there are small tumors and they are located in non-hazardous places.
If histological examination is required, then resort to the method of excision. It is most often used in the presence of tumors with a malignant course and located in dangerous places, for example on the face or head. With its help, it is possible to get a good cosmetic result.
Radiation therapy in the presence of basal cell carcinoma is rarely used, but if surgery is not possible, then it is simply irreplaceable. Doctors recognize that and is quite effective. Irradiation cannot be avoided even with a high degree of tumor malignancy. In this case, it is worthwhile to be careful about radiation therapy in young patients, since there is a high risk of developing radiation dermatitis and induced malignant tumors.
If we consider the method of Mos, then it allows you to maximize maintain healthy tissue. This method is effective for recurrent tumors, large sizes and dangerous localization. If there is an excision on the eyelid, then they also resort to that method of therapy.
If a cancerous tumor on the skin has formed recently, it is preferable to use close-focus x-ray therapy. And in advanced cases, it is combined with surgical intervention.
The technique of cryodestruction of the tumor is widespread, that is, its removal using liquid nitrogen. This procedure takes little time and is absolutely painless for the patient. There is, however, one drawback: a positive result can be obtained only if the neoplasm is superficial and does not affect the deeper layers of the skin.
With the location of basal cell carcinoma on the face, they often resort to its removal with a laser. It is safe and painless, after the intervention, as a rule, a short rehabilitation period and an excellent cosmetic effect.
If there is a basal cell carcinoma of the superficial type, then local treatment with Fluorouracil cream is prescribed. Recently, studies have been conducted on the effectiveness of injections of this drug into the lesions. If cancer on the skin appears for the first time and has a small localization, then injections of interferons are used.
Surgical treatment of basal cell carcinoma
Surgical removal of basal cell carcinoma is effective in the first stage of treatment. And also if relapse occurs, or a tumor develops at the site of the scar. During the operation, the tumor is removed, but this method of therapy is undesirable if there are lesions on the face.
The operation is performed under local anesthesia, the tumor is removed to the border with healthy cells, for reliability even slightly affecting them.
The effects of basal cell skin cancer
There are several types of skin cancer, and depending on this, the course and prognosis of pathologies can also be different. If we talk about the consequences of basal cell carcinoma, it must be borne in mind that this tumor most often has a compact arrangement, rarely penetrates inside and affects the lymph nodes.
But if the advanced form of cancer is located on the head and neck, then the process of destruction of the tissues of these parts of the body begins. It can even reach the bones, muscles and tendons.
Of all types of skin cancer, this is the most cosmetically unpleasant and slowly developing. But it, including the thermal stages, can respond to surgical treatment. Therefore, if your doctor recommends surgery, do not be afraid, you have to agree. Despite all its ugliness, the described type of skin cancer gives patients a chance to recover even in the most advanced cases.
Preventive actions
Those who have already once faced with basal cell skin cancer should be especially careful in the prevention of relapse. After treatment of basal cell carcinoma, all doctor's recommendations should be followed:
- During the period of solar activity, that is, in summer, it is necessary to limit your stay on the street from 11 o’clock to 17. At this time, ultraviolet radiation is most aggressive, so you should avoid exposure. If there is a need to go outside, then it is worth applying a special protective cream to the skin and use headgear and glasses.
- Without proper nutrition, it is impossible to maintain your immune system at the proper level. It is necessary to limit the number of animal proteins; they can be completely replaced with vegetable ones, for example, nuts, and legumes.
- The diet should have more vegetables and fruits.
- If there are old scars on the skin, measures must be taken to prevent injury.
- All sores and wounds on the skin should be treated promptly. If they tend to heal poorly, then consult a doctor.
- If your work involves contact with petroleum products, you should be especially careful to always use protective equipment.
Cancer of any form and type is a dangerous disease. It is better not to allow its development, but it is not always in our power. If this has happened, then do not give up and prepare for the worst. At present, medicine has stepped far forward, and sometimes miracles can happen in the most advanced cases.
Be attentive to your health, and then everything will be fine.