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We are currently using Zoom as our preferred teleconferencing software. Our friendly Patient Care Executive will kindly guide you through this process after you contact us.
If our doctors suspect that your mole or skin growth might be cancerous during the consultation, we can arrange for it to be removed as soon as possible.
What is Basal Cell Carcinoma?
Basal Cell Carcinoma (BCC) the most common type of skin cancer in the world. It commonly develops on regions of the skin that are highly exposed to UV radiation like the face and lateral (outer) side of the forearms. As the name suggests, it originates from the basal cells layer in the skin, which is the found in the epidermis. Specifically, BCC tends to develop from immature cells associated with the hair follicles that are not yet fully differentiated. When these cells are exposed to ionising radiation like UV rays from the sun, DNA damage can accumulate and cause irreversible mutations, eventually leading to a cancerous growth.
BCC, although common, are unlikely to be fatal as the cancer cells tend to be localised and metastases (spreading of cancer cells) are rare. Any mortality that does occur are mostly in immunocompromised individuals. Prognoses are usually related to potential recurrences and damage of functional skin tissue, including nerves, blood vessels and hair follicles.
Risk factors associated with Basal Cell Carcinoma
Some risk factors that are associated with BCC are as follows:
- Excessive exposure to UV radiation from the sun or tanning beds. This especially affects regions with harsh sunlight like low and high latitude regions (tropics and near the poles as opposed to temperate regions)
- Old Age. Older individuals tend to have reduced immunity and more cumulative exposure to UV radiation, hence a higher occurrence rate of skin cancer. The median rate of diagnosis is typically around 68 years in most medical studies
- Sex: Men in general are more likely to develop skin cancer as compared to women
- Fairer skin. Fair-skinned individuals have less natural protection from UV rays from the sun as they have less pigment, and are at higher risk of developing skin cancer.
- Chronic infections and skin inflammation from burns, scars and other conditions. In these cases, the damaged skin may be exposed to other physical or chemical carcinogenic factors other than UV light, and can lead to malignant growths in the long run
- Smoking and tobacco consumption: Cigarettes are known to contain carcinogens like N-nitrosamines and benzene, and consumption of them is known to be associated with increased cancer risks, including skin cancer like BCC.
- Hereditary/congenital factors: Individuals with a family history of BCC, other skin cancers or are prone to sunburns tend to have higher risks of developing malignant growths.
- Previous history of BCC or other skin cancers: Patients who have suffered and recovered from BCC or other skin cancers in the past (Squamous Cell Carcinoma and Melanoma) have increased risks of the cancer recurring.
The risk of recurrence is different for each case, but generally have the following patterns depending on the location of BCC:
- Low Risk: Trunk and limbs;
- Intermediate risk: Forehead, cheeks, neck and scalp;
- High risk: Centre of the face, nose, ears, near the orifices and embryonic fusion planes.
Signs and Symptoms
As with most skin cancers, BCC can only be definitively diagnosed with a skin biopsy. However, there are some guidelines that can be used if you suspect that a mole or skin growth is potentially cancerous..
BCC typically presents as mole-like skin growths with the following features:
- A persistent, open sore that may crust, bleed or ooze. The sore may appear to heal at first before returning at the exact same location.
- A reddish, irritated patch which itches constantly for no obvious reason.
- A bump or nodule on the skin that may be shiny, pearly, clear or pinkish in colour. The bump may appear tanned or brown in people with darker skin tones and can be difficult to tell apart from a regular mole
- A scar like area with poorly-defined borders that fade into the surrounding skin. The skin in this area is usually white or yellowish in colour, and can appear smooth, shiny, taut and waxy in texture.
At first glance, these can be mistaken for regular moles or skin lesions. However, they have the following key differences:
- Regular moles usually have a roughly circular shape with clear, well-defined edges. They are also usually constant in size and will not grow quickly within a few weeks
- Common skin lesions usually heal in 1 to 2 weeks while cancerous ones will persist for several weeks or more.
Even though BCC is seldom lethal, it can have serious complications if left untreated. These complications can include skin tissue and nerve damage, disfigurement and rarely, metastasis. Therefore, it is important to detect and remove any moles suspected to be malignant early.
Currently, The Clifford Clinic is offering the following treatments for mole removal:
1. Excision/Mole removal
The most direct method to treat a potentially cancerous mole is to surgically remove it via excision. In this case, our doctors will use a scalpel or a surgical razor to carefully remove the mole and its roots completely. This is carried out under local anaesthesia. The removed tissue is sent to a histological lab for examination and our doctors will follow-up as required if the mole is cancerous, or to help you remove any scars left over from the mole removal with other treatments.
2. Laser Therapy
In the case where surgical excision is not possible, Laser treatment can be an alternative to remove the mole or other cancerous growths. The lasers work by selectively damaging cells at the skin surface, which can include pigment cells in moles or cancer cells. Depending on individual conditions, different lasers may be used. These can include:
- Ablative lasers like the Edge Fractional CO2 laser
- Neodymium – Yttrium Aluminium Garnet (Nd-YAG) lasers like the Q-switched laser
- Pulsed dye Lasers (PDL) like the Vbeam Prima Laser
However, it is important to note that Laser therapy has limited effectiveness in removing non-surface, nodular moles when compared to excision removal. Hence, they are the most effective in the earliest stages of BCC development.
What to do if you suspect that your mole is cancerous
If you are worried that your mole is cancerous, or is simply unsure, it is always safer to seek medical attention. You can schedule a teleconsultation with our doctors to have your mole inspected. If necessary, we will arrange for the mole to be removed as soon as possible.