The term ‘non-melanoma’ means cancers that develop slowly in the upper layers of the skin. These cancers are the more common types (Basal and Squamous Cell Carcinomas), whereas melanomas are rarer and can be more serious. Non-melanoma skin cancers (BCCs and SCCs) are still serious and require specialist medical attention and treatment, and this is why suspected pre-cancerous lesions should always be checked by a medical expert.
Non-melanoma skin cancers typically present in the outermost layers of the skin (also called the epidermis) and are frequently named after the type of skin cell from which they develop.
The term ‘basal’ does not always refer to skin cancer. Basal cells are present throughout the body, and are located at the bottom of the epidermis. They are constantly being shed and regenerating as part of the body’s natural processes.
In the case of Basal Cell Carcinoma, the cancer forms in the basal cells that line the bottom of the epidermis – the thin, flat cells that make up the outermost layer of the skin.
Basal Cell Carcinoma is also known as a ‘rodent ulcer,’ because the cancer tends to ‘gnaw away’ at the skin, as though a rodent would. BCCs are the most common types of skin cancer – accounting for 75% of all skin cancers.
Basal Cell Carcinoma
According to NHS data, around 150,000 new cases of non-melanoma skin cancer are diagnosed in the UK each year.
Non-melanoma skin cancer is more likely to affect men than women, and it tends to affect older people with the rates being highest in those over the age of 75.
Symptoms of Basal Cell Carcinomas (BCC)
The first sign of a non-melanoma skin cancer is typically a lump, bump or discolouration in a small- to medium-sized patch that appears on the skin, and doesn’t resolve itself after 4 weeks of monitoring. This is known as a suspicious growth, which needs to be investigated by a doctor. Suspicious growths may also develop over time, changing shape, size or colour.
Basal Cell Carcinomas typically present as a small shiny pink, or pearly white lump, which may have a ‘waxy’ or translucent appearance. In roughly half of patients with darker skin tones, basal cell carcinoma will be pigmented (brown).
BCCs may also appear as scaly and red, meaning people who have other skin conditions – like eczema or psoriasis – might incorrectly self-diagnose the condition.
If non-melanoma skin cancers are not treated, it is possible that they will cause significantly worse damage. Basal Cell Carcinoma does not typically spread to other parts of the body, but it can have a more ‘aggressive’ form.
It is important that you visit your GP if you are worried about a lesion, and they will refer you to a dermatologist for treatment if they feel this is appropriate. It is important to self-monitor for any changes, and follow up with your GP if you have been asked to keep an eye on a lesion and have any concerns.
Causes of Basal Cell Carcinoma
The exposure to ultraviolet radiation can cause the DNA of skin cells (keratinocytes) in the outer layer of the skin to change, which allows the skin cells to grow out of control, developing into BCCs.
Factors that may mean someone has an increased susceptibility to Basal Cell Carcinomas include;
- Previous skin cancer
- Fair, or pale skin
- A history of sun exposure, or historic use of indoor tanning beds
- Chronic infections, or inflammation from burns, scars, or other skin conditions
- Working outdoors
- Previous radiotherapy
- Medications that suppress your immune system
Gender is also likely to play a role, as men are more susceptible to developing basal cell carcinomas than women.
Basal Cell Carcinomas can recur, and patients who have already been treated for BCCs are at increased risk of developing them again. This is because some cancer cells can be undetectable, even by skin cancer experts, and others can form ‘roots,’ extending beyond visibility. BCCs on the nose, ears and lips are most likely to recur, usually within two years.
Patients can manage their basal cell carcinoma by self-monitoring their skin for any changes, undergoing annual follow-up appointments, and being vigilant against lifestyle factors that increase risk.
While adhering to sun awareness advice – for example, staying out of the sun (especially during midday hours) and applying a broad-spectrum sunscreen – is best practice for everyone, patients who have previously had BCCs should take all precautions to avoid harmful UV rays. Staying in the shade, wearing a wide-brimmed hat and UV-blocking sunglasses outdoors are all recommended.
Treatment for Basal Cell Carcinoma at Derma
Your appointment with the dermatologist will begin with analysis of the affected area, and together you will discuss your medical history, before a course of treatment for Basal Cell Carcinoma is recommended.
Many non-melanoma skin cancers can be treated by excision, which is a relatively painless procedure that can be performed efficiently and effectively. Depending on insurance, treatment can be carried out the same day as the consultation.
If Basal Cell Carcinoma is recurrent, the dermatologist may recommend an alternate approach to excision, like MOHS surgery, which is a highly effective way of treating BCCs.
Please note that further tests – such as a biopsy – may be necessary. Follow-up appointments will be required to ensure that the BCC is properly treated, and your skin monitored for any changes, as having skin cancer is likely to increase susceptibility.
We see and treat more skin cancer patients than any other doctors in Reading, so you can be assured that Derma will provide the very best care, the latest research and the most effective treatments.
Related Specialists at Derma
Dr Charles Archer
Consultant Dermatologist
Dr Charles Archer is a registered specialist with the GMC and his NHS Consultant post is split between The Royal Berkshire Hospitals and Oxford University Hospitals.
Dr Sanju Arianayagam
Consultant Dermatologist
Dr Sanju Arianayagam is a Consultant Dermatologist and gained her dermatology experience at Cambridge University Hospitals, Oxford University Hospitals and the Royal Berkshire Hospital.
Dr Rima Clayton
Consultant Dermatologist
Dr Rima Clayton is a UK trained Consultant Dermatologist who practises in Reading and Oxford. She is fully trained in both paediatric and adult dermatology.
Dr Sabrina Khan
Consultant Dermatologist
Dr Khan consults on all general dermatology conditions such as eczema, psoriasis and acne.
Dr Rachel Fisher
Consultant Dermatologist
Dr Fisher consults on all general dermatology conditions such as eczema, psoriasis and acne.
Dr Inge Kreuser-Genis
Consultant Dermatologist
Dr Kreuser-Genis is a UK trained Consultant Dermatologist who practices in Reading and Oxford. She is fully trained in both paediatric and adult dermatology.
Mr Andy Pay
Consultant Plastic Surgeon and Skin Cancer Surgeon
Andy is very experienced in the management of skin cancer, particularly melanoma, but also in the management of squamous cell and basal cell carcinomas and other skin and soft tissue tumours.
Dr John Reed
Consultant Dermatologist
Dr John Reed has been a UK trained consultant dermatologist and senior lecturer in Oxford since 2007