- Most common and least dangerous skin cancer
- Grow slowly over months or years
- Usually appear as persistent flat red area or a red/pearly lump
- May present as an ulcer or sore that doesn’t heal
- Does not usually metastasize
- Needs treatment as it is a locally destructive cancer
BCCs can be treated with a variety of methods, depending on the tumour type, depth, location etc.
Your dermatologist will discuss your options with you.
Skin biopsies are often required to establish a diagnosis.
A biopsy is a simple procedure done at the time of the consultation.
Under local anaesthetic a small sample of the skin cancer is taken.
The sample is the sent to pathology for analysis.
Treatment options for BCC’s
At Drummoyne Dermatology surgical excision of your skin cancer will be under local anaesthetic. This will make the skin go numb so no pain should be felt during the procedure
The lesion is excised and sent to pathology for analysis.
The skin edges will then be sewn together to make a thin suture line.
There may be two layers of sutures (stitches) a layer underneath that is absorbable and a layer of sutures on the surface which will need to be removed in 7-14 days.
The excision is usually designed so that the resulting scar runs parallel with existing skin creases.
It is impossible to cut the skin without scarring in some way, so you will always have some sort of scar. Your dermatologist will try to excise the lesion in a way that will keep the scar to a minimum.
Some people have an abnormal response to skin healing and these people may get larger scars than usual (keloid or hypertrophic scarring).
Curette and Cautery
This treatment works well for superficial BCCs.
Under local anaesthetic the lesion is biopsied with a surgical blade, then scraped off with a curette (which is like a small spoon with very sharp edges) and then cauterized.
The treated area usually looks like a graze and takes 2-3 weeks to heal.
The wound can heal well with a flat scar which is often paler than the surrounding skin.
Aldara cream ( Imiquimod)
Aldara is a treatment option for some superficial BCCs.
The skin cancer must be biopsied before Aldara is used. This is to confirm the type of skin cancer and the depth. If the cancer is deep then Aldara is not a suitable option.
Aldara is applied by the patient once or twice a day for 6 weeks, depending on a number of factors.
Aldara mobilizes your own immune system to attack the skin cancer cells.
The reaction to this cream is variable but most people experience some redness and crusting.
The cure rate with Aldara is approximately 80%.
The cost is subsidized by medicare for superficial BCCs, so it is the price of a normal prescription($6-$35).
The cosmetic result of a skin cancer treated with Aldara is usually better than a surgical scar.
If Aldara is not effective then the skin cancer can be treated by other methods such as excision, curette and cautery, PDT, radiotherapy etc.
Treatment of Superficial BCCs with Aldara
Photodynamic Therapy (PDT)
Photodynamic Therapy is a treatment option for some superficial BCCs.
PDT has a cure rate of approximately 80%.
Cream is applied to the lesion to be treated for approximately 3hours.
The cream is then activated by exposure to a specific wavelength of light for 10-20minutes.
Often the treatment is repeated 2-4 weeks later.
The advantage of PDT, compared to Aldara, is that the red crusted stage is of shorter duration, one to three weeks, rather than six weeks.
The disadvantage of PDT is the expense, approximately $600 (compared to $35 for Aldara) and the treatment itself may be painful.
Find out more on PDT under our facilities
Mohs’ Micrographic Surgery
This is a surgical technique for treating large, deep and recurrent skin cancers, as well as some skin cancers in difficult sites such as the eye and nose.
The skin cancer is surgically removed, colour coded and mapped to identify the location of any remaining cancer cells.
The skin cancer is examined under a microscope at the time of surgery.
Further sections will be taken if there is any skin cancer left.
The treatment is repeated until all the tumour is removed.
Find out more at DermNet NZ
Radiotherapy for skin cancers is usually for patients over 60yrs, with large or difficult to treat tumours.
The advantage of radiotherapy for these tumours is that a skin graft or flap is avoided.
The treatment is painless and the patient does not feel sick or unwell.
The main disadvantage of radiotherapy treatment is that it requires attendance at the hospital 5 days a week for about 3 weeks.
Cure rates are high with radiotherapy.
The initial cosmetic result is excellent.