Basal Cell Carcinoma Skin Cancer – BCC Treatment NZ by Dr Gittos

Are you worried about a non-melanoma skin cancer? Skin cancers can have an impact on your quality of life and overall well-being. There are Two primary non-melanoma categories – squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). BCC makes up roughly 70% of non-melanoma cases. If BCC treatment is delayed, this skin cancer can disfigure and destroy local tissues. (1)

Dr. Mark Gittos offers surgery, treatment and evaluation. Dr. Mark is a plastic and reconstructive surgeon based in Auckland with clinics around New Zealandand is well known in the field of skin cancer surgery.

What Is Basal Cell Carcinoma (BCC)?

BCC is typically a benign cancer that emerges on areas of the skin that have been exposed to long-term UV sunlight radiation. This is a complex ailment that can be the result of an intricate connection between genes, environmental and phenotypic factors like your behavioural and physical traits. (2)

Different Types of BCC

Over 26 basal cell carcinoma subtypes exist. But, most patients develop:

  • Nodular – This is the most typically recorded facial BCC. You can recognize it by the pearly or shiny nodule with a smooth surface.
  • Micronodular – This is an aggressive BCC variant. It is vulnerable to recurrence and hard to get rid of. Micronodular BCC often has a poorly defined lesion with a flat surface. And, in most patients, it affects the neck and head area. (3)
  • Superficial – This BCC subtype typically affects the shoulders or upper trunk. Superficial BCC looks like a well-defined patch and can have a whitish scale. It has a minimal risk of being invasive and takes time to grow. (4)
  • Morpheaform – This is a very uncommon ailment and makes up 10% of lesions. It can be flat or slightly firm, depressed, or fibrotic. (5) (6)

This ailment mainly affects areas of the skin that are exposed to the most sunlight. In around 80% of patients, BCC develops on the head. And in 50% of those affected, it impacts the skin of the nose and cheeks. In roughly 4% of patients, a lesion can emerge on the genitals and perianal area (the spot around the anus). (7)

Options for BCC Basal Cell Carcinoma Treatment

BCC removal surgery is usually the recommended treatment. The cornerstone of BCC treatment is to take out cancer completely. The surgical option your doctor recommends will vary based on how big the BCC is, its location, and type.

  • Surgical excision – Done under a local anaesthetic, this standard surgical procedure is meant to take out the entire tumour. Together with a fraction of unaffected tissue. Doctors then examine the removed sample to see if the tumour has been extracted. This is a proper treatment for primary pigmented and well-defined BCC.
  • Electrodessication and curettage (EDC) – When a patient is not a candidate for invasive surgical procedures, doctors can recommend EDC. During treatment, doctors scrape the cancerous skin surface with a spoon-shaped instrument known as a curette. After the removal, the wound is cauterized. This is a practical choice for those with a pre-cancerous skin ailment referred to as actinic keratosis.
  • Mohs Micrographic Surgery (MMS) – Mohs surgery is a good option for primary BCC that affects the face. The reason doctors suggest MMS is because this procedure offers the lowest recurrence rates. But, Mohs surgery can leave a scar.
  • Cryosurgery – This treatment is better meant for superficial and smaller BCC. Experts recommend it when a patient has a bleeding disorder or can’t tolerate anaesthesia. It offers an over 95% cure rate. Because of the good tolerance, cryosurgery can be a practical choice for elderly patients. (8)

Treatments for basal cell carcinoma are affordable, safe, and can be done with relatively high cure rates. Also, patients experience good cosmetic results post-surgery. The surgical modalities can vary, such as:

What Is the Survival Rate for Basal Cell Carcinoma?

This tumour progresses slowly and spreading to other areas of the body is rare. In fact, metastases are recorded in just 0.5% of cases. The possibility of having basal cell carcinoma varies. Recent studies show that BCC incidence is roughly 2,000 cases per 100,000 population.

Luckily, the 5-year BCC survival rate is relatively high, with the potential to reach 100%. The 5-year cure rate is also beneficial, especially for localized BCC with a general cure rate of more than 95%. Simply put, all BCC patients have very high odds of living at least five years after their diagnosis as the rest of the population. (9)

Is Basal Cell Carcinoma Fatal?

If you don’t receive proper treatment for a very long time, then the BCC could become fatal. But, overall, this carcinoma needs time to grow and won’t always spread to nearby areas. The goal is to not let these lesions grow and disfigure the affected area, or they could be dangerous.

Should I Worry About Basal Cell Carcinoma?

It’s completely normal to feel overwhelmed and anxious. Being diagnosed with basal cell carcinoma can take a heavy toll on your mental and physical health. Do bear in mind, however, that BCC is the least risky compared with other types of skin carcinoma. When caught early, the cure rates can be significantly higher.

So, instead of worrying too much, consult with a skin cancer specialist. Let them observe the lesion and they will let you know what kind of ailment you are dealing with.

What Will Happen if Basal Cell Carcinoma Is Left Untreated?

BCC requires treatment. Proper surgical procedures can make a significant difference in the way cancer affects the body. If you avoid treatment, then the cancerous cells could grow larger and lead to disfigurement. Sometimes, although rarely, the untreated BCC can spread, which could put your life in danger.

BCC FAQsQuestions about Basal Cell Carcinoma

How long does it take to recover from basal cell carcinoma surgery?

  • Basal cell carcinoma surgery recovery time is different for each patient. Mostly, people need 3-6 weeks for their spot to completely rejuvenate. Others need more than that, particularly if the size of the treatment area is bigger. For ideal recovery and results, the wound must be kept clean and dry. (10)

Can basal cell carcinoma be easily removed?

  • Experts and doctors can successfully and easily remove a BCC. Particularly if the tumour is caught early and is smaller. The sooner you get the BCC taken out, the better. Don’t let it grow or affect the surrounding tissues. Otherwise, it can prove a more difficult challenge to overcome. (11)

How long does BCC surgery take?

  • With a standard BCC excision, you can expect the BCC surgery to last around 30 min. Patients will most likely leave the doctor’s office soon after. It’s not uncommon for individuals to develop a scar post BCC surgery. But, it is expected to dissipate with time. Cryosurgery is much faster. It can take roughly 10 min. While EDC treatment can take as little as 1 hour. Mohs surgery duration, however, is difficult to predict. It will vary according to the size of the tumour and how much it affects the surrounding skin.

Is basal cell carcinoma surgery painful?

  • The anaesthesia itself can be uncomfortable and slightly painful. That’s because you are being injected with a solution that’s meant to numb the area. This slight discomfort lasts a couple of seconds. After that, during surgery, you can feel pressure as the doctor works with the area. The surgery is not supposed to be painful. But, after treatment, the area can feel sore. Follow your doctor’s advice on maintaining adequate basal cell carcinoma post-surgery care.

Does basal cell carcinoma grow deep?

  • BCC is slow to spread and very unlikely to metastasise. But, when it does, the basal cell carcinoma can grow deep below the skin. With time, it can start to destroy the nearby tissues. Without adequate treatment, the BCC can be fatal. For instance, an untreated BCC on the face can grow into the bones. As time goes on, it can reach the central nervous system. (12)

What is considered a LARGE basal cell carcinoma?

  • Are you wondering what the average size of a basal cell carcinoma is? In one study, the average size of BCC was 5.7 mm, which can range anywhere from 5 to 6 mm. A tumour that’s bigger than 2 cm may be considered large. This is a stage 2 tumour and can be any size and have 2 or more high-risk features. It’s best to consult with a specialist to know the size of the tumour and how big of an impact it can have on the body. (13) (14)

Are basal cells itchy?

  • Not for everyone. But, for some patients, an elevated reddish patch can be itchy. Overall, tenderness and pain are some of the most common problems linked to skin cancer, instead of itchy skin. However, carcinoma might have the potential to irritate the skin’s fine nerve endings and make the affected area feel itchy.

Can basal cell carcinoma treatment make you feel tired?

  • Targeted therapy for basal cell carcinoma does come with potential side effects. It can lead to a drop in weight, hair loss, muscle cramps, and a loss of taste. For some individuals, it can cause tiredness. If you feel significant fatigue post-treatment, talk to a doctor. They can give you practical advice on how to stop feeling tired. (15)

What’s worse basal cell or squamous cell (BCC or SCC)?

  • Squamous cells are considered a more serious problem. Mainly because they have a higher risk of affecting nearby tissues. A basal cell is less likely to cause such a problem. The best tactic to manage the issue is to get on-time treatment, with either of these conditions.

How do they cut out basal cell carcinoma?

  • With surgery. The cutting method will vary based on the surgical treatment. With excision, a surgical knife or scalpel is used to cut out the tumour. The doctor will then proceed to some nearby areas that might have also been affected.

How long can you live with squamous cell carcinoma?

  • BCC has quite a high survival rate. The surgeries are highly effective at removing cancer and restoring a sense of normalcy. How long a person lives will depend on cancer’s impact, growth, and size. If you catch it early, you have better odds of removing it.

Does a basal cell carcinoma have roots?

  • Let’s say the basal cell carcinoma has been successfully removed with the first treatment. In some patients, BCC can still recur. That’s because some cells could remain undetected post-surgery. While others have formed roots that go deeper or further beyond the visible site. So yes, it is possible for the BCC to have roots. Not for everyone, but it can happen.

What is the difference between BCC excision and Mohs surgery?

  • Experts suggest Mohs surgery when the BCC is on areas where saving the skin is very important (like the face). The goal of this surgery is to maintain the aesthetic appearance of the affected area if possible. An excision, on the other hand, works on deeper layers and can cause a small scar that will fade over time. Only a doctor can suggest the best form of treatment.

What is advanced BCC?

  • People want to know how you can tell if BCC is advanced. Advanced BCC is a more complicated type of cancer that can be caused by a lot of different things. Such as plenty of sun exposure, some medications, lifestyle factors, even your genetic predisposition can play a role. Patients with advanced BCC usually develop nerve complications, like muscle weakness, change in appearance, problems with hearing, vision, etc.

Medical References for BCC

  1. https://www.cancer.org.au/cancer-information/types-of-cancer/non-melanoma-skin-cancer
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432343/
  3. https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-021-03124-6
  4. https://www.medscape.com/answers/276624-100146/how-is-superficial-basal-cell-carcinoma-characterized
  5. https://www.medscape.com/answers/276624-100145/how-is-morpheaform-sclerosing-basal-cell-carcinoma-characterized
  6. https://www.ncbi.nlm.nih.gov/books/NBK482439/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573444/
  8. https://ijdvl.com/basal-cell-carcinoma-treatment-with-cryosurgery/
  9. https://www.ncbi.nlm.nih.gov/books/NBK482439/
  10. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=abp7908
  11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4516103/
  12. https://www.yalemedicine.org/conditions/basal-cell-carcinoma
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7430350/
  14. https://stanfordhealthcare.org/medical-conditions/cancer/basal-cell-carcinoma/stages.html
  15. https://www.cancersupportcommunity.org/sites/default/files/fsac/metatastic_basal_cell_carcinoma.pdf

About Dr Mark Gittos FRACS (Plast) – New Zealand Plastic Surgeon 

Practice locations in Herne Bay Auckland, Northland and Bay of Plenty – Kerikeri, Whangarei, New Plymouth & Tauranga

Dr Mark Gittos is a leading Specialist Plastic Surgeon and operates a practice in Herne Bay, Auckland and in the UK. The practice focuses on both surgical and non-surgical procedures, each designed to help restore, improve or change a physical characteristic or problem. The first step in every case is to talk through your personal requirements and explore all the options, before deciding on the most effective solution.

Dr Mark Gittos offers high quality, natural-looking cosmetic surgery results and is highly experienced in BreastBody and Face Surgery having performed over 4000 Surgeries in the last 26 years.  With worldwide expertise Dr Gittos is an expert in breast, face and body surgery for men & women.

Naturally, before any treatment is begun, we will explain clearly the advantages and risk factors; so that you have the information you need to make an informed decision that is best for you. Visit the practice to find out more.

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