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Is Basal Cell Carcinoma Serious? – Let’s ask Dr Ben Wiese

By , On , In Dr. Ben Wiese

The short answer is: No, if you are concerned that it might kill you. The chance that this type of skin cancer will kill you is extremely low, but causing disfigurement could be a different story.

The prognosis for most patients with primary BCC is excellent. These lesions are typically slow growing and metastatic disease is a very rare event.

Estimates of the rate of metastasis for BCC was estimated to be 0.1% or even lower.

The mortality rate for BCC is approximately 0.05%

However, it is not something that you want to ignore and leave on your skin indefinitely.

Basal Cell Carcinoma (BCC) is still a cancer and is locally invasive, aggressive and can cause considerable disfigurement by locally destroying skin, cartilage and even bone.

Untreated advanced lesions typically ulcerate, creating wound care problems.

Therefore, treatment of BCC is definitely indicated.

Having a Basal Cell Carcinoma also puts you at risk of developing more Basal Cell Carcinomas.

Approximately 15% of patients with one BCC subsequently develop another primary BCC within one year, and 35% develop a new BCC within 5 years. This risk increases to approximately 34% within one year and 75% within 5 years for patients with more than one previous BCC.

Patients who develop a BCC are also at increased risk of developing both Squamous Cell Carcinoma and Melanoma. Their risk of developing Melanoma is more than 3 times higher than the general population.

There is also a risk of recurrence of Basal Cell Carcinoma. Recurrence may appear months to years after initial treatment, leading to local tissue destruction, morbidity, increased risk for metastasis, and the need for retreatment.

Factors that increase the risk for recurrence include:

  • lesions in sites of prior radiation
  • lesions in high-risk areas of the face
  • lesions on the hands and feet
  • recurrent lesions
  • large lesions – more than 10mm in diameter
  • lesions with aggressive pathologic features
  • lesions in immunocompromised patients
  • lesions where there was tumour growth in or around nerves

There has also been a studyreporting an overall twofold increased risk of second malignancies (including lung, colon, and breast cancer) in people with either confirmed cutaneous Squamous Cell Carcinoma or Basal Cell Carcinoma.

Althoughthis study suggests an increased risk of other cancers, routine evaluation for systemic malignancy is not indicated in healthy individuals who are diagnosed with Basal Cell Carcinoma.

As mentioned previously, metastatic BCC is luckily very rare and usually occurs in association with deeply invasive or very large lesions.Common sites for metastasis include the regional lymph nodes, lungs, bones, skin and liver.

Metastatic disease unfortunately has a very poor prognosis, with a median survival of 10 months after diagnosis of metastatic disease.

In summary: Basal Cell carcinoma is the least serious of all the types of skin cancer. It is extremely unlikely to be deadly and complete cure is almost always possible.

However, it is not harmless and is still a cancer, so it should not be ignored or taken lightly.

Also, see our blog on Vitamin B3 on options available to prevent skin cancer.