Basal cell carcinoma (BCC) is the most common type of skin cancer and the most frequent cancer in Australians, accounting for approximately 80% of all non-melanoma skin cancers.
- Origin
Develops in basal cells, located in the lowest layer of the epidermis.
- Risk Factors
- Fair skin.
- History of significant sun exposure or tanning bed use.
- More common after the age of 40.
- Common Locations
Found in sun-exposed areas such as the face, neck, and hands but can occur anywhere on the body.
- Growth and Spread
- Grows slowly and rarely metastasises.
- Can cause significant local tissue damage and disfigurement if left untreated.
Treatment Options for Basal Cell Carcinoma
The treatment plan for BCC is based on factors such as the size, location, subtype, and depth of the tumour, as well as the patient’s overall health.
Surgical Treatments
Surgical Excision
- The most common and effective method.
- Removes the tumour along with a margin of healthy tissue to ensure complete removal.
- Suitable for most BCC subtypes.
Mohs Micrographic Surgery
- Used for infiltrative subtypes or lesions in cosmetically sensitive areas (e.g., nose, near the eyes).
- Involves step-by-step removal and microscopic examination until all cancerous cells are removed.
- Minimises tissue loss and maximises cosmetic outcomes.
Laser Therapy and Curettage
- Laser Therapy (ALMA HYBRID or ACCLARO ULTRACLEAR) Ideal for certain types of BCC.
- Electrodesiccation and Curettage (ED&C) Scrapes away the tumour and cauterises the area.
Topical and Skin-Directed Therapies
Cryotherapy
Freezes the lesion with liquid nitrogen; effective for superficial BCCs.
Imiquimod Cream
- Stimulates the immune system to attack the tumour.
- Applied over several weeks for superficial BCCs.
Photodynamic Therapy(PDT)
- Involves applying a photosensitising agent and exposing the area to specific light wavelengths.
- Targets cancer cells selectively, offering a better cosmetic outcome than imiquimod cream.
Laser-Assisted PDT
- Enhances PDT by using lasers to increase the penetration of the photosensitising agent.
- Provides superior depth control, higher clearance rates, and excellent cosmetic results.
Advanced and Alternative Treatments
Radiation Therapy
- Used for advanced BCCs or cases where surgery is not feasible.
- Employs high-energy beams to destroy cancer cells.
Hedgehog Pathway Inhibitors
- Medications like vismodegib or sonidegib are used for locally advanced or metastatic BCC.
- Targets molecular pathways to shrink or slow tumour growth.
Collaboration for Complex Cases
- KDAA collaborates with the Head and Neck Multidisciplinary Team (MDT) at St George and Sutherland Hospitals.
- This partnership ensures access to advanced treatments, including radiotherapy and systemic medications like hedgehog pathway inhibitors.
Key Takeaways
- Early Detection is Crucial BCC is highly treatable when detected early.
- Customised Treatment Plans Tailored to achieve the best cosmetic and functional outcomes.
- Range of Effective Options From surgical excision and Mohs surgery to topical therapies and advanced systemic treatments.
- Regular Skin Checks Essential to detect BCCs early and reduce the risk of recurrence.
For personalised care and effective management of basal cell carcinoma, schedule a consultation with our dermatology experts at KDAA.
