Basal cell carcinoma, or BCC, is the most common type of skin cancer. Many people worry about whether it is life threatening. The short answer is that death from BCC is uncommon. However, BCC can still cause significant local damage if it is not treated.
Most primary BCCs grow slowly, and the chance of the cancer spreading to other parts of the body is very low. Studies have estimated metastatic BCC rates at well under one percent. Even with this low risk, BCC should not be ignored, since untreated lesions can continue to grow and affect surrounding tissues.
BCC is still a cancer, and it can be locally invasive. When left untreated, it may affect the skin, cartilage, or underlying structures. Advanced lesions may ulcerate, which can create challenges with wound care. For these reasons, timely assessment and appropriate treatment are recommended.
People who have had one BCC are more likely to develop additional BCCs in the future. Research has shown that individuals with a history of BCC may develop new lesions over time, especially if they have had multiple previous BCCs. A prior BCC can also be associated with a higher risk of other skin cancers, including squamous cell carcinoma and melanoma.
BCCs may recur after treatment, sometimes months or years later. Recurrence can vary based on several factors, including lesion type, treatment method, and where the cancer originally developed.
Factors that may increase the chance of recurrence include:
- previous radiation in the area
- cancers located on high risk areas of the face
- lesions on the hands or feet
- previously treated lesions that return
- large lesions
- lesions with more aggressive microscopic features
- weakened immune system
- cancers involving growth near nerves
Some research has reported a higher overall risk of additional malignancies, such as lung, colon, or breast cancer, in people who have had BCC or squamous cell carcinoma. These findings are still being studied, and routine screening for internal cancers is not typically recommended based solely on a BCC diagnosis.
Although metastatic BCC is rare, it can occur in deeply invasive or very large cancers. Reported sites of spread include lymph nodes, lungs, bones, liver, and skin. These cases are uncommon and represent a very small percentage of all BCC diagnoses.
In general, BCC is considered the least aggressive of the major skin cancers. While it is unlikely to be fatal, it is still important to address it promptly to avoid local tissue destruction and long term effects.
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