What is a basal cell carcinoma? Basal cell carcinoma (or basocellular carcinoma or basal cell carcinoma) is the most common type of skin cancer. About 1 in 6 Dutch people will get a basal cell carcinoma in his or her lifetime. It starts in the upper layer of the skin and almost never spreads to other parts of the body.

How do you get basal cell carcinoma? The main cause is the sun. It often involves a lot of sun exposure in life, or acute sun exposure with burning. This causes damage to the skin. Especially much sun exposure in childhood is a risk for getting basal cell carcinoma later in life. People with light-colored skin have a greater risk of developing basal cell carcinoma than those with dark-colored skin.

A special and rare form of basal cell carcinoma is Gorlin syndrome. This is a mistake in DNA that causes a person to develop many basal cell carcinomas at a young age. This form is not discussed further here. For more information about Gorlin syndrome, see the leaflet Gorlin syndrome.

What symptoms does a basal cell carcinoma cause and what does a basal cell carcinoma look like? Usually, a basal cell carcinoma does not cause any symptoms and is seen by chance. Often it looks like a small wound that just won't heal. Sometimes it is a shiny lump or spot that bleeds easily.

Basal cell carcinoma can look a variety of ways. The three most common forms are:

1. Superficial (superficial) basal cell carcinoma:
   • Occurs mainly on the skin of chest and back.
   • Looks like an eczema spot, but usually does not itch.
   • Spot has a typical sheen that is easy to see in bright light.
2. Nodular, (compact or solid) basal cell carcinoma:
   • Slowly growing red, slightly shiny lump with occasional blood vessels.
   • A non-healing wound may develop in the lump.
3. Sparkling basal cell carcinoma:
   • Has "spiky" shoots in the skin.
   • Boundary between tumor and normal skin is often indistinguishable.
   • Appearance may resemble nodular basal cell carcinoma, but the growing tumor often lies flatter on the skin and is more difficult to recognize.

A basal cell carcinoma usually develops in areas that are heavily exposed to sunlight, such as on the face or ears. Basal cell carcinomas continue to grow, which is why it is important to always treat them.

How does your doctor know if you have basal cell carcinoma? The dermatologist usually recognizes basal cell carcinoma quickly. Only when in doubt will a small piece of skin be taken (a biopsy) for further examination to confirm the diagnosis.

What are the treatments for basal cell carcinoma? Treatment depends on the growth of the basal cell carcinoma. The choice of the best therapy is made in consultation with your own doctor.

Below are the different treatments for basal cell carcinoma:

1. Cutting / excision:
   • Dermatologist cuts away basal cell carcinoma.
   • Skin is numbed with punctures.
   • Removed piece of skin is examined in the laboratory.
   • Suitable for all forms of basal cell carcinoma.
2. Fluorouracil cream (= Efudix®):
   • Inhibits the growth of basal cell carcinoma cells.
   • First redness and crusting followed by healthy skin growth.
   • Suitable for superficial basal cell carcinoma.
3. Imiquimod cream (= Aldara®):
   • Locally in the skin, turns on the immune system.
   • Basal cell carcinoma is cleared.
   • Redness and crusting followed by healthy skin growth.
   • Suitable for superficial basal cell carcinoma.
4. Photo dynamic therapy (= Photodynamic therapy (PDT):
   • Cream makes malignant cells more sensitive to light.
   • After 3 hours of exposure with special lamp, cancer cells die.
   • Get more information from your doctor.
5. Cryosurgery:
   • Basal cell carcinoma is frozen externally with liquid nitrogen.
   • Quick treatment, but often leaves scars.
   • Only for superficial cases.
6. Curettage and coagulation:
   • Basal cell carcinoma is scraped away under local anesthesia.
   • Skin is superficially cauterized.
   • Quick treatment, but depth control is lacking.
7. Radiation therapy (radiotherapy):
   • Good results, often in locations where cutting is not possible.
8. Mohs' micrographic surgery:
   • Minimal removal of healthy skin.
   • Suitable for specific features, such as difficult to close wound on the face.

Is a basal cell carcinoma curable or will it always bother you? Yes, a basal cell carcinoma is completely curable. However, you are at risk of developing a new basal cell carcinoma in a different location.

What else can you do yourself?

• Keep a close eye on your skin.
• Benign spots should go away on their own after 6 to 8 weeks.
• In case of continued growth or non-healing wound, make an appointment with your doctor or dermatologist.
• Protect your skin well from the sun to prevent new basal cell carcinomas.