Basal cell carcinoma, also known as basal cell carcinoma, is the most common form of skin cancer worldwide. The tumor develops from the cells of the basal layer of the skin or the root sheaths of the hair follicles. The skin tumor is rarely pigmented and is therefore also known colloquially as white skin cancer.
You can find more information and selected basal cell carcinoma specialists here.
In contrast to malignant melanoma of the skin, basal cell carcinoma only metastasizes very rarely and is only life-threatening in exceptional cases. It is therefore also classified as a semi-malignant, i.e. "semi-malignant" type of cancer. In Germany, around 180,000 people are diagnosed with basal cell carcinoma every year. This corresponds to a disease rate of 20 to 30 cases per 100,000 inhabitants. Men and women are equally affected by the disease, the average age is 60 years, although younger people are also increasingly developing the disease.
As with other skin cancers, the greatest risk factor for the development of basal cell carcinoma is long-term exposure to UV radiation from sunlight. This is why basal cell carcinomas tend to develop on areas of the body that are frequently exposed to the sun. In addition to the cheeks, nose and lips, this also includes the neck or the head with little hair.
Long-wave UVA light in particular plays a role in tumor formation. It penetrates into the deeper layers of the skin and leads to genetic changes in the skin cells. People with fair skin who get sunburnt easily and are sensitive to UV radiation are particularly at risk. A genetic predisposition can also favor the development of the disease. For example, hereditary skin diseases such as oculocutaneous albinism or Gorlin-Goltz syndrome lead to an increased incidence of basal cell carcinoma. There is also a higher risk in people who receive medication to suppress the immune system.
A special case is the so-called trunk skin basal cell carcinoma, which does not occur on an area of skin exposed to sunlight, but on the trunk of the body. People with this form of basal cell carcinoma have usually been exposed to arsenic for many years. In the past, the substance was mainly used as a pesticide, but today arsenic is still produced when ore is mined.
The clinical picture of basal cell carcinoma is very varied, which is why the skin tumor is also referred to as "skin cancer with a thousand faces". Particularly at the beginning of the disease, the tumor is rather inconspicuous. Initially, the skin cancer appears as a small pimple, nodule or scaly patch of skin. A yellowish-reddish nodule often develops, which is surrounded by a bead-like seam. Small blood vessels may be visible on the surface of the skin.
Scarring changes can also be an indication of a basal cell carcinoma. The special form of pigmented basal cell carcinoma, on the other hand, can easily be confused with malignant black skin cancer. For a long time, the tumor only spreads horizontally. In later stages, however, the cancer grows infiltrating and can thus destroy bone and cartilage. As a general rule, every pimple, every skin change and every wound that does not heal within three weeks should be examined by a dermatologist, as it may be a basal cell carcinoma.
A dermatologist can often recognize a basal cell carcinoma with the naked eye due to their experience. They can also use a dermatoscope to differentiate it from other types of cancer. However, in order to make a reliable diagnosis, a tissue sample must be taken and then subjected to a histological examination in the laboratory. If the basal cell carcinoma is already growing into other tissue structures, a computer tomography or magnetic resonance imaging can be carried out to assess the spread.
Superficially destructive therapy methods such as photodynamic therapy are also used. This involves the targeted destruction of degenerated skin cells, while the healthy cells are largely spared. Radiotherapy and curettage, in which the tumor cells are scraped out, are also among these superficially destructive treatment methods. The tumor can also be frozen as part of cryotherapy or treated with a laser. Compared to complete surgery, these non-surgical procedures have an increased risk of recurrence.
A relatively new treatment method for superficial basal cell carcinoma has been approved since the early 2000s. A cream containing the active ingredient imiquimod, which belongs to the group of antivirals, is applied to the affected skin area by the patient over a period of several weeks. The substance is intended to activate the body's own immune system and thus contribute to the destruction of the tumor. If basal cell carcinoma cannot be treated with the aforementioned methods, medication containing the active ingredient vismodegib can be helpful. However, as these drugs from the group of so-called hedgehog inhibitors, which influence cell growth and proliferation, have numerous side effects, they should only be used after careful consideration of the risks and benefits.
The Leading Medicine Guide's quality assurance is ensured by the following acceptance prerequisites.
