What is ordinary skin cancer (basal cell carcinoma)
The most common form of skin cancer in Denmark
Basal cell cancer is the most common form of skin cancer. The occurrence of this form of skin cancer continues to climb in number. Just within the last 10 years, the number of new cases have doubled. According to the fight against cancer, there were 1200 new cases in 2014, evenly divided between men and women.
Skin cancer is a slowly growing and can always be cured. Most often, skin cancer develops in the face, on the ears, in the neck and on the upper part of the breast, but it can be seen anywhere on the body. The disease is most often seen in the older part of the population, but the last years it has been seen in increasing amounts among younger people. The lifetime risk of developing skin cancer is 30%, and 20% of all new cases occur among people under 50 years of age.
The risk of developing this form of cancer rises with the age and the amount of sun exposure, both out in the sun and in a solarium. That is why skin cancer predominantly develops in areas with a sun exposure. Other risk factors are people with light skin that burns easily in the sun. Previous radiation treatment or intake of the metal arsenic (a treatment against psoriasis) and long term exposure to carcinogenic material such as soot and tar are also a risk. Finally it indicates that people with a reduced immune system or people in treatment with immuno-suppressive medicines develop skin cancer 10-15 year earlier than normal.
If you have once found skin cancer, there is a 40% risk that you will develop skin cancer in another place on the body. Therefore, patients with skin cancer are recommended to have annual check ups with a skin doctor.
Skin cancer is an invasive tumor, that destroys tissue locally, but only very rarely spreads (metastasizes). On the other hand, there is a not insignificant risk for recidivism (recurrence) of a tumor after the end of treatment. Half of this recurrence is seen within the first 3 years. The risk of recidivism depends on the size of the tumor, the tumor type, tumor location, the selection of treatment and the competence of the person treating.
The diagnosis is set against a background of a tissue sample (biopsy, curettage).
There are several types of treatments for skin cancer. Among these are curettage/scraping and creams (both are used especially with low risk tumors) and surgical intervention (like Mohs surgery) and X-rays. Mohs surgery provides the greatest possible assurance that the tumor is removed in healthy tissue, and thereby gives the lowest recidivism rates. After five years, the recurrence rate for first time cases of skin cancer are 1 – 3% with treatment with Mohs surgery. For recurring cases, it is 5-10%. Mohs surgery is considered to be the “gold standard” for treatment of high risk BCC in the head/neck region, since this method provides the most certain and cosmetically optimal results.
Read more about Mohs surgery here.
Sources
The Cancer Register 2014. www.sundhedsdatastyrelsen.dk (10 Apr 2016).
Miller DL, Weinstock MA. Nonmelanoma skin cancer in the United States: incidence. J Am Acad Dermatol 1994;30:774-8.
Leman J, McHenry P. Basal cell carcinoma. Arch Dermatol 2001;137: 1239-40.
Diffey BL, Langtry JAA. Skin cancer incidence and the aging population. Br J Dermatol 2005;153:679-80. 5. Birch-Johansen F, Jensen A, Mortensen L et al. Trends in the incidence of nonmelanoma skin cancer in Denmark 1978-2007: rapid incidence increase among young Danish women. Int J Cancer 2010;127:2190-8
Birch-Johansen F, Jensen A, Mortensen L et al. Trends in the incidence of nonmelanoma skin cancer in Denmark 1978-2007: rapid incidence increase among young Danish women. Int J Cancer 2010;127:2190-8 [6] Baxter JM, Patel AN, Varma S. Facial basal cell carcinoma. BMJ 2012;345:e5342-e5342.
Baxter JM, Patel AN, Varma S. Facial basal cell carcinoma. BMJ 2012;345:e5342-e5342.
Rowe D, Carroll R, Day C. Long-term recurrence rates in previously untreated (primary) basal cell carcinoma: implications for patient followup. J Dermatol Surg Oncol 1989;15:315-28.
Smeets NWJ, Kuijpers DIM, Nelemans P et al. Mohs’ micrographic surgery for treatment of basal cell carcinoma of the face – results of a retrospective study and review of the literature. Br J Dermatol 2004;151:141-7.