Description of basal cell carcinoma
It is the most common malignant (cancerous) tumor of the skin that affects mainly older people, between 70 and 80 years, but recently has unfortunately tend to occur in increasingly younger individuals.
It occurs mostly on otherwise healthy skin to areas most exposed to sunlight. In 80% of cases, it is the upper half of the face.
For consolation it is to say that is one of the most treatable cancers, which also does not tend to metastasize (foundation deposits elsewhere in the body). It must, however, be treated in time, because it has a tendency to locally aggressive behavior and can grow to its surroundings and destroy adjacent tissue.
The problem lies in the fact that it tends to relapse, thus the recurrence after cure.
Causes of basal cell carcinoma
The main cause is the damage to the basal cells of the skin, most commonly caused by UV radiation.
The skin consists of three layers. The surface layer is called the cuticle (epidermis), consisting of several layers of cells which mature towards the surface. Below the epidermis is a layer of connective tissue called corium (dermis). Below the dermis is the subcutaneous tissue layer called the hypodermis.
Formation basal cell takes place in the outer part of the skin, therefore the skin. In its deepest layer (stratum basale) the cells which are divided and together with the cells of the stratum spinosum, which is a layer above and also includes dividing cells give rise to more superficial layers of the skin.
Under normal circumstances, there is a proliferation of cells in the basal layer when the need to replace worn or damaged cell surface layers. This process is controlled at the DNA level so that an exact number for the formation of functionally and dimensionally perfect cells.
If damage occurs to the DNA of these cells, for example UV radiation, which normally occurs, there is nothing major happens. The cells are in fact regulatory mechanisms that guard the quality of the DNA, and in case of damage are able to fix it. If repair is not possible, they cause the cell programmed cell death (apoptosis).
But if there is a malfunction and these regulatory mechanisms, there is a problem that may end in the formation of cancer cells. This may occur after years of repeated exposure to the sun. It has been found that, for the UV radiation acts in addition to acute (single) also damage cumulatively, ie.that the influence is also repeated damage of these cells which are summed. To changes in regulatory mechanisms then occurs after The sum of individual episodes.
Emerging cells are then functionally and morphologically inferior and stops them from multiplying subject to regulation, so it divides in an uncontrolled and tumor formation.
Risk factors for basal cell carcinoma
As with most cancers even in this case, they play in the development of basal cell role of geneticfactors and environmental factors.
Holds a very important role especially long-term (usually lasting for years), repeated exposure of the skin to sunlight, the UV component is able to damage the DNA of cells basal layer.
Related to this is also frequent visits to tanning, which in addition leads to wear devices emitting UV radiation and it can then be changed in increasingly harmful. Therefore they should frequent visits sunbeds have an interest in the frequency of inspections and the possible replacement of their equipment and to guarantee their safety.
Before the penetration of UV radiation into the deeper layers of the skin protects us from skin pigment melanin. According to its amount is then skin is more or less sensitive to sun damage.
A related, in this case genetically determined risk factor. People according to the amount of melanin in the skin is divided into six known. Phototypes. People with phototype 1 and 2 have at least the melanin, and therefore their higher risk DNA damage basal cells.
Among other factors, it is the excessive exposure of the body radiation exposure, when there is an increased risk of developing many, not only skin cancer.
Risk factor for basal cell carcinoma is also the effect of arsenic as a proven carcinogen. It may be present in the soil, air, water or food. Fortunately, nowadays its incidence is monitored and there should be a more frequent exposure to its effects.
Increased risk is also observed in humans immunosuppressed (highly immunosuppressed), either because of disease (HIV disease hematopoiesis, other cancers), or artificially induced, for example in the treatment of systemic autoimmune diseases, after the transplantation, oncological treatment.
Finally, there are several specific diseases in which the occurrence of basal cell very frequent, possibly acts directly on the part of the syndrome. Examples include genetic disease calledxeroderma pigmentosum. People with this disease have a deficiency of enzymes responsible for repairing DNA damaged by UV rays. They are highly sensitive to solar radiation and occurs with them at a very early development of various skin tumors including basal cell carcinoma.
Another disease which is observed when the regular occurrence of basal cell carcinoma syndrome névoidního basal cell carcinoma (Gorlin syndrome), which is an inherited disease characterized by multiple basal cell carcinoma, bone abnormalities, cataracts, and the formation of bone cysts.
prevention of basal cell carcinoma
As prevention is worth considering the possibility of avoiding all risk factors caused by the external environment.
Thus, tan wisely, avoid exposure to direct sunlight and when it does, just in time when the sun has the most power (that is in the late morning and early afternoon).
Of course, the use of sunscreen, which we should choose according to our skin type. The lower we go, the stronger the UV protection factor should include our cream.
Tanning walk rather sparingly and choose those that are able to demonstrate the quality and safety of services provided.
Signs and symptoms of basal cell carcinoma
As mentioned above, the basal most often occurs at places repeatedly exhibited sunlight. Mostly on the face.
There are several variants, differing in appearance and spread. The tumor can spread either to the surrounding area, flat, or primarily in depth (in this case the risk of disability and destruction of deeper structures, namely, muscle, bone and cartilage).
Usually begins as a growing, sometimes bumpy hardened nodule on the skin, which has a skin color in the area are seen widespread catheter. Gradually leads to the forfeiture of his middle, then a rough, raised edges. Its center zvředovatí often, but usually painless.
A variant is pigmented (brown to black) basal, which differs only in that there is in the place of the presence of melanin.
Rarely can manifest as so-called. Sklarodermiformní basal cell carcinoma, which has the appearance of yellowish, solid, smooth, uneven scarring, usually around again extended the catheter. This form usually nevředovatí.
Called. Superficial basal cell carcinoma is a variant with the best prognosis, occurring most commonly on the trunk, a reddish deposits, which sometimes can flake and so remind eczema.
treatment of basal cell carcinoma
Diagnosis is done on the basis of the appearance of the tumor and histological examination afterbiopsy.
Once started treatment, which in most cases is surgical. When it occurs to remove the entire tumor mass, while removing more of the healthy tissue around the tumor to rule out the possible retention of potential cancer cells in the surrounding tissue.
Another possibility is the so-called. Cryotherapy, when the tumor is removed by using liquid nitrogen.
In special cases, it may be used cytostatic treatment (5 – fluorouracil) or local therapyimiquimod, an immunomodulatory agent, affecting the local immune response.
After treatment, the patient still has long-term monitoring in order to ensure the timely discovery of a possible recurrence (reappearance of the tumor).
In most cases, treatment of uncomplicated, with a success rate of treatment exceeding 95%, for treating the recurrence of 90%. So the prognosis is very good.
complications basal cell carcinoma
In the early capture the majority of complications occur. A major complication is therefore an oversight of the tumor, which can then acquire large dimensions and behave aggressively to their surroundings. Then there may be penetration into the surrounding area and in depth when the tumor destroys its surroundings (muscles, bones, joints and other tissues, just everything that comes its way) and there is a risk of serious harm.
The only common complication is the recurrence rate. However, if you’ve had one basal cell carcinoma, a doctor in future years monitored and any recurrence will be caught in time to remove as soon as possible and does not make you hurt.
Finally, I would like to add that if you do not like something on your skin, you notice a suspicious formation, overcome laziness and shame, or fear of diagnosis and visit with your doctor as soon as possible. It may of course be a banality, but leave it to the expert assessment. In the best case, at least to make better and get rid of the stress of the classic questions of “what if it was also that …”. In the event that the skin is really a judgment you have, and generally for treatment of tumors is true that time is against you, so the sooner you begin to solve the problem, the greater the chance for a successful achievement.
Finally, I would like to say that as described in the text, basal cell carcinoma, although cancer is in most cases very well treatable and leaves no consequences.
Therefore, may not always be all bad, as it first may seem.
Other names: basocelulární cancer, skin cancer, malignant skin cancer, skin cancer, basal cell carcinoma syndrome névoidního, Gorlin’s syndrome
