This is the most common type of skin cancer and it is estimated that over 50,000 people in England and Wales are diagnosed with this every year. The appearance of a BCC varies from just a small nodule to a much larger ulcerated area if left untreated for a long period of time. BCCs grow very slowly and hardly ever spread to other parts of the body. However, if left untreated, they can damage the surrounding parts of the body and are generally easiest to treat when they are smaller. When near the eye, these lesions themselves or the treatment required, can damage delicate tissues around the eye, as well as the eye itself.
Pictures 1, 2 and 3 show basal cell carcinoma on the eyelid
The commonest cause is too much exposure to ultraviolet (UV) light from the sun or from sun beds. Basal cell carcinomas can occur anywhere on your body, but are most common on areas that are exposed to the sun, such as your face, head, neck and ears. It is also possible for a basal cell carcinoma to develop where burns, scars or ulcers have damaged the skin. Basal cell carcinomas are not infectious. Basal cell carcinomas mainly affect fair skinned adults and are more common in men than women.
Those with the highest risk of developing a basal cell carcinoma are:
Most basal cell carcinomas are painless. People often first become aware of them as a scab that bleeds occasionally and does not heal completely. Some basal cell carcinomas are very superficial and look like a scaly red flat mark: others have a pearl-like rim surrounding a central crater. If left for years, the latter type can eventually erode the skin causing an ulcer – hence the name “rodent ulcer”. Other basal cell carcinomas are quite lumpy, with one or more shiny nodules crossed by small but easily seen blood vessels. Seldom, if ever, do they spread to other parts of the body.
Generally the preferred method of treatment when the BCC is around the eye is surgical removal of the tumour, and reconstruction of the defect. The reconstruction operation is normally done by an oculoplastic surgeon (an eye plastic surgeon). The tumour removal is often done by a Mohs surgeon (see Mohs information) to ensure clear margins and to spare as much tissue as possible in this sensitive area. Sometimes other treatments may be needed and your doctor will discuss this with you if necessary.
Once you have had treatment for your BCC, it is unlikely you will get any further problems from this particular lesion. However, once you have had a BCC, you are at more risk of developing another and you will need to check your skin regularly as it is easiest to deal with these lesions when they are small. Another lesion could develop many years later. It is therefore very important that you monitor your skin and especially the area where the operation took place, and notify any suspicious lumps that do not disappear to your GP.
Sunscreens should not be used as an alternative to clothing and shade, rather they offer additional protection. No sunscreen will provide 100% protection.
Where can I get more information?
Macmillan Cancer Support
89 Albert Embankment
If you have any questions about cancer, need support or just someone to talk to, call free, Monday to Friday 9am-8pm – 0808 808 0000. www.macmillan.org.uk