Skin deep – Basal Cell Carcinoma
It began with an insect bite on my right cheek. At least I thought it was a bite though I didn’t remember being bitten.
I dabbed it with tea tree oil and waited for it to heal up. It sort of did, but then grew a little and flaked a little. It was tiny, maybe 2-3mm across but something about it bothered me. I told myself that if it hadn’t gone in a month, I’d see the GP. It didn’t change much over that time, but neither did it go away so, listening to my gut feelings, I went to see my GP feeling a little foolish (I wasn’t sick after all) and fully expected to be dismissed as one of the worried well, but after inspecting it the GP looked thoughtful. “I think it might be a BCC. A basal cell carcinoma.” I was shocked. Carcinoma was cancer, right? I was only 50. Was I going to die?
A basal cell carcinoma is indeed a type of skin cancer. There are two main types of skin cancer: melanoma and non-melanoma. BCC is a non-melanoma type, and accounts for more than 80% of skin cancers in the UK.
As with most skin cancers, exposure to ultraviolet (UV) light from the sun or from sunbeds is the cause, which is why they often appear most often on the face or head of fair skinned people like me. I am not a sunbather, nor have I ever used sunbeds. I do like to be outdoors, cycling and kayaking but I always wear sun protection and a hat. I’m a natural redhead though, with freckles so I am in a higher risk group.
BCCs vary in appearance, from small red flaky areas; scabs that bleed but don’t heal, or pearly little lumps, often with a central depression. They are generally painless, although sometimes they can be itchy or bleed a little if you catch them with your nail.
I had to undergo a skin biopsy under local anaesthetic to confirm the diagnosis. The dermatologist was at pains to reassure me that BCCs rarely spread to other areas of the body and can be cured in almost every case, although treatment can be more complicated if the BCC has been present for a long time, or if it occurs in an awkward place, such as close to the eye or on the nose or ear.
The commonest treatment for BCC is surgery under local anaesthesia. The BCC is cut away, along with some surrounding skin. There are generally just a few stitches but sometimes a skin graft is needed. Sometimes radiotherapy, curettage (scraping), cautery (heat treatment), cryotherapy (freezing treatment), photodynamic therapy (PTD), or creams may be used instead.
My BCC was removed surgically. I was worried I would have a large scar as the wound seemed very large in comparison to the size of the lesion but six months later it’s faded so much that you can barely see it.
Treatment is easier if a BCC is detected early. So, if you notice a new lesion on your face (or anywhere on your body) which is growing, or which bleeds and never really heals, or if your skin appearance has changed in any way don’t wait, consult your GP. It’s worth it.
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