Skin basal cell carcinoma is a type of cancer . The neoplasm affects the upper layers of the epidermis and is localized mainly on the face of a person. If the basal cell is recognized in time, it will not pose any danger. Over time, the disease can progress, growing and affecting more and more healthy tissues. In order to prevent this, it is important to undergo a comprehensive diagnosis and choose the best treatment option.
A brief description of the pathology
Basal cell carcinoma (this is the official name for the diagnosis) is a malignant neoplasm arising from the upper layer of the dermis. The composition of the tumor includes follicular and atypical cells. The size of basal cell carcinoma depends on its stage, can reach 10-12 cm.
This type of skin cancer formation is considered a borderline tumor, since for a long time it remains benign and does not progress. After malignancy, basalioma rarely gives distant metastases, therefore, oncologists almost unanimously state: this disease is very treatable, especially if it was detected at an early stage. Basically, fatal cases have been reported in patients who requested specialist help with a significant delay. But even at the advanced stage of the disease, the cause of death is most often not the tumor itself, but complications that develop against the background of damage to nerves and blood vessels.
According to the ICD, the basal cell skin has the code C44. The indicators after "44" carry information about the location of the tumor.
Basal cell carcinoma is not the only type of skin oncology. Two more types of malignant tumors are known - squamous and metatypical. In the first case, we are talking about basal cell skin, which is accompanied by rapid metastasis and an aggressive course. This form of basal cell cancer carries the greatest danger to the patient's life. A metatypic tumor offers more chances for remission and complete recovery.
Another feature of skin basal cell carcinoma is a high probability of relapse. None of the methods of treatment used today can completely eliminate the oncology recurrence. By the way, this does not mean that the disease will return with an accuracy of 100%. Further events depend on the individual characteristics of the organism, the age of the patients, and the course of the pathology. At risk are mostly elderly people. In babies, basal cell carcinoma is very rarely diagnosed.
Forms of the disease, the main differences
- Nodular. The most common type of pathology. Most often it is confused with a small pimple due to the similarity in shape and color, but in the center of such an formation, if you look closely, you can see small light depressions. After some time, the pits merge into one. The disease progresses rapidly, in case of damage to the basal cell, it bleeds.
- Pigmented. Outwardly, this variety is practically no different from the previous one, with the exception of dark pigment. Pigmented skin basal cell carcinoma is often mistaken for melanoma.
- Superficial. In comparison with a nodular formation resembling a pimple, this tumor has no relief. She looks like a small flat spot of pale pink color. The edges of the superficial basal cell skin are slightly elevated. Visually, this form of basal cell cancer is confused with psoriasis. Despite the minimal danger of this type of tumor and a good chance of recovery, its relapses are very common.
- Flat. Outwardly, it resembles the previous one, but unlike the surface, the flat one has delimited edges and a dark color. The disease usually progresses rapidly, as evidenced by an ulcer that periodically heals and opens again.
- Cystic Inside the tumor, fluid is concentrated. In this case, cystic basal cell carcinoma is often diagnosed as nodular. Education has a gray or pink tint.
- Solid. It is often combined with a cystic type of skin cancer. Outwardly, it resembles a dome-shaped elevation, since the tumor does not grow inside, but outside the tissues.
- Flowing with sclerosis. This is the rarest form. It differs from the rest of the basal cell in that it penetrates deeply. Moreover, the exact boundaries of the tumor is almost impossible to determine.
- Ulcerative. It is more correct to talk about this type of cancer formation as a stage, since each of the above forms can turn into a peptic ulcer. She is characterized by the formation of scarring erosion. False ulcer healing often euthanizes vigilance and gives patients the false hope that the disease will go away on its own.
Naturally, cancerous tumors do not resolve by themselves. After some time, the formation returns, but with a larger ulcer, which will subsequently heal again. So the basal cell skin can disappear and appear repeatedly, gradually increasing.
To determine what form of a tumor a patient has, a series of clinical studies and differential diagnostics are performed.
Causes of the disease
The diagnosis of skin basal cell carcinoma is most often made to pale-skinned patients who spend a lot of time in the sun - it is ultraviolet rays that can trigger irreversible cancer processes in the tissues of the epidermis. In most cases, basal cell carcinoma affects exposed areas of the body and face (shoulders, arms, legs, forehead, nose, upper lip, corners of the eyes).
Today, there are many reasons why basal cell cancer develops. Provoking factors include:
- long stay in direct sunlight;
- addiction to tanning beds;
- smoking;
- ingestion or external contact with arsenic, its chemical derivatives;
- professional field of activity, involving work with carcinogens;
- the presence in the air of the combustion products of shale;
- the presence of skin diseases (pigment xeroderma, Gorlin-Holtz syndrome);
- injuries and burns of the epidermis;
- weakened immunity.
In addition, skin basal cell carcinoma (the tumor types described above are not indicated in the ICD) can develop after undergoing radiation therapy. People with fair skin, a large number of freckles or age spots have a predisposition to this disease.
Symptoms and stages of basal cell carcinoma
When the ailment is just beginning to develop, it is impossible to identify it with a visual examination. At the site of cancerous lesions, only after some time a small nodule is formed, which more often does not cause feelings for the patient, especially if he is prone to various types of rashes on his face. Progressing, the tumor spreads to other areas of the skin, penetrating into the tissues and accompanied by intense pain.
There are several stages of basal cell carcinoma:
- Zero (initial) stage. This is the launch of the malignant process, the beginning of tissue damage. Without special diagnostic procedures, it is impossible to recognize the tumor.
- First stage. This stage is characterized by a small formation, the size of which does not exceed 2 cm in diameter. Basalioma so far covers only the upper layer of the dermis.
- Second stage. The tumor grows to 5 cm across the entire thickness of the epidermis, while the subcutaneous tissue remains unaffected.
- Third stage. Its occurrence is marked by an increase in size - now the basal cell is more than 5 cm in diameter and is already spreading to the fatty tissue layer. In the third stage, ulcers are most often formed. In addition, the risk of damage to muscles, cartilage and bone tissue is increased.
- The fourth (terminal) stage. The chances of curing basal cell cancer are melting every day, since malignant cells destroy cartilage and bones, the patient suffers from severe pain.
It is difficult to identify specific symptoms of skin basal cell carcinoma that could indicate the need for an urgent visit to a doctor. At first glance, the signs of cancer are almost invisible - this is the only reason why pathology can be recognized at the initial stage only in isolated cases. Typically, a basal cell skin looks like a small pimple. As the disease progresses, the pimple becomes a painful, hard knot of yellowish, pale pink, grayish or almost white color.
Diagnostic Methods
Before undertaking the determination of the stage of basal cell carcinoma, you must first make sure that it is really cancer. Inspection and palpation of the neoplasm is not enough, therefore, these types of studies are used:
- cytological analysis - a smear is taken from the surface of the affected epidermis;
- histological analysis - the procedure of puncture of the material and further study of the sample in order to establish (exclude) its malignancy.
In addition, basal cell cancer must be differentiated in time from other dermatological and oncological pathologies. For example, to distinguish the pigmented form from melanoma, they resort to dermatoscopy, one of the latest methods involving instrumental non-invasive examination. Ultrasound is considered quite informative: during the screening, the boundaries of education, the depth of its distribution are determined.
Surgery
With skin cancer, as with any other cancer, removal of the tumor is the most preferred way to deal with the disease. The surgical procedure is performed under general or local anesthesia. The oncologist surgeon excises the affected area of the skin along with adjacent tissues. The area of healthy tissues that are affected by removal can range from a few millimeters to 2-3 cm, depending on the severity of the disease. This is the only way to minimize the risk of relapse. Inoperable cases with the disease “skin basal cell carcinoma” are a rarity. In the absence of contraindications, the intervention is carried out even at the terminal stage, when the patient already has significantly affected bones and cartilage - this can increase the life expectancy.
Surgical treatment of basal cancer is not recommended if:
- localization of the tumor on the nose, in the field of vision;
- old age of the patient;
- history of serious diseases;
- individual intolerance to anesthesia.
Facial skin basal cell removal is the only option if radiation therapy or chemotherapy is not medically appropriate. In addition, only after excision of pathological tissues is it possible to carefully study them, determine the boundaries of the cancerous focus and make sure that it is completely eliminated. If the operation is successful, specialists give a good prognosis for the next 5 years: in approximately 90% of cases, relapse will not threaten the patient.
Radiotherapy
Radiation exposure to cancerous tissue can be used as a separate technique or to consolidate the effect of surgical removal of the tumor. With basal cell carcinoma, radiation therapy is preferred. In addition, radiation can be prescribed even to elderly patients. Surface x-rays act on malignant cells, destroying them and preventing their reproduction. In the process of radiotherapy is the destruction of cells in the process of reproduction.
But, unfortunately, radiation therapy has many disadvantages. In addition to the tumor itself, healthy tissues are affected. Radiotherapy can cause mutations in healthy layers of the epidermis, which may not manifest itself for many years, and then new foci of oncology reappear. In this regard, radiation treatment is not recommended at a young and middle age.
After irradiation of basal cell carcinoma, the skin turns red, pain can also intensify, the patient needs a long rehabilitation period for tissue healing. The resulting sores and crusts need to be lubricated with Vaseline and Argosulfan, apply compresses with silver solution to them. After a course of radiotherapy, the radiation site should be regularly protected from the cold and exposure to direct ultraviolet rays. Do not rub vulnerable, not yet healed areas of the skin. On average, the regeneration process takes just over a month.
Chemotherapy
This method of treating basal cell carcinoma is hardly common, since its side effects can be much more serious than the course of the disease itself. In some cases, local chemotherapy is used - the treatment method involves treating the tumor with special ointments, which include the fluorouracil component. Preparations based on it are applied directly to the lesion sites: the substance, penetrating into the cancer cells, actively destroys them.
Immunity strengthening
In addition to measures to combat the tumor, patients with a diagnosis of skin basal cell carcinoma are prescribed therapeutic measures to strengthen their immunity. As a rule, a course of immunotherapy is carried out by the introduction of injectable drugs, vaccines that stimulate the immune system. In addition, creams and ointments can be used to treat basal cell carcinoma, which increase the production of natural interferon, which is also able to suppress the activity of cancer cells. Immunotherapy can be part of chemotherapy and used in the initial stages of the development of the disease.
Medications
In the early stages or in relapses of the disease, doctors can prescribe medication, which consists in the use of special ointments. From skin basal cell carcinoma use:
- cream "Metvix";
- "Omani ointment";
- cream "Kuderm";
- ointment "Solcoseryl".
These local action cytostatics are applied to the tumor itself, while neighboring healthy tissues are partially affected. When using drugs of this group, careful care of the epidermis is required, including treatment of the edges of the wound with hydrogen peroxide, removal of dead areas.
Diet for patients
The success of treatment largely depends on the diet and diet. With skin basal cell carcinoma, you need to use foods that contain trace elements that can inhibit malignant cells and prevent their reproduction. In addition, the regular use of healthy foods can be a good measure for the prevention of basal cell carcinoma. These include:
- Garlic is a natural protector against viral infections, skin cancer, the gastrointestinal tract, and the lungs.
- Greens - spinach, basil and dill are especially valuable due to the content of cretinoids (substances that remove harmful radicals from the body).
- Citrus fruits are natural stimulants of the immune system that remove carcinogens from the body.
- Cabbage, including cabbage, Brussels sprouts, cauliflower and broccoli, contains antioxidants and isothiocyanate. This substance is absolutely safe for healthy tissues, but toxic to malignant cells.
- Carrot. This root crop contains falkarinol, which triggers reverse processes in the tumor cells.
- Whole grain cereals. Regular consumption of cereals in food slows down the growth rate of the tumor.
- Beet. The anticancer effect of this vegetable is due to the content of betaine.
You need to pay attention to another list: it includes products that are undesirable to use with skin basal cell carcinoma:
- Refreshed fats reheated are a direct source of carcinogens.
- Nitrites and nitrates. Often there are too many of them in the "spring" vegetables and fruits, canned goods, sausages.
- Pickles. With skin cancer, it is better to abandon sauerkraut or lightly salted cucumbers, since they contain an increased content of salt and vinegar, which, in turn, create favorable conditions for fermentation in the body and the propagation of atypical cells.
- Any kind of alcohol.
- Coffee, chocolate and cocoa.
- Fatty dairy products.
Folk remedies
Treatment of basal cell carcinoma of the face or other part of the body with non-traditional methods, unfortunately, rarely gives any significant results. Herbal decoctions, lotions, compresses and tinctures will not even produce half the effect that can be obtained from surgical removal, radiation or chemical therapy.
But still, the use of alternative methods can weaken the course of the disease, reduce the severity of symptoms. Before using any remedies for basal cell carcinoma, you should always consult your doctor. Natural celandine based formulations help combat itching, burning and pain. Most often, there are positive patient reviews about the following two recipes:
- Ointment. Preparing a remedy from burdock and celandine, taken in equal proportions. Plant materials can be purchased at the pharmacy or prepared independently in the summer season. Both components are mixed in equal amounts and poured with melted lard (pork fat). Next, the mixture is put in a heated oven for a couple of hours. Over time, the medicine is filtered and set aside for several days in a dark place. Ready ointment should be applied to the tumor several times during the day.
- Infusion. Preparing this tool is even easier: one teaspoon of crushed leaves of celandine is poured with a glass of boiling water and covered with a lid. The mixture is insisted for 20-30 minutes. Use the drug inside by a third of a glass before each meal. In order to achieve a better therapeutic effect, it is impossible to increase the dose, since the plant has a toxic property. In addition, preparing a medicine in a large volume is not recommended, since the beneficial properties of the infusion will disappear the next day.
Predictions for Patients
In most cases, when patients promptly seek the help of doctors, the outcome of the disease is favorable. Survival in basal cell carcinoma ranges from 80-90%. If a relapse of basal cell skin develops, the prognosis for recovery is about 50-60%. That is why it is extremely important to regularly undergo a medical examination with the aim of early detection of a re-emerging tumor.