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Ohm Society
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Basal Cell Carcinoma Print E-mail
by Ron Kennedy, M.D., Santa Rosa, CA

Dr. Kennedy Basal cell carcinoma (BCC) is the most common form of skin cancer making up more than 90 percent of all skin cancer in the U.S. These cancers almost never spread to other parts of the body unless they are close to cartilage (like the ear) where they can slide down the surface of the cartilage and escape into the rest of hte body. They can, however, cause damage by growing and invading surrounding tissue. Light-colored skin and sun exposure are important factors in the development of BCC. About 20 percent of these skin cancers, however, occur in areas that are not sun-exposed, such as the scalp, chest, back, arms, and legs. The face is the most common location for BCC. Weakening of the immune system, whether by disease or medication, can also promote the risk of developing BCC as can the use of certain kinds of hair dyes. UV radiation from the sun is believed to be the main cause of skin cancer. Artificial sources of UV radiation, such as sunlamps and tanning booths also put one at risk. People who live in areas receiving high levels of UV radiation from the sun are more likely to develop skin cancer. In the U.S. skin cancer is more common in the South where the sunlight is generally more intense. The highest rates of skin cancer are found in Australia and South Africa, areas that receive high amounts of UV radiation. Also, skin cancer is related to lifetime exposure to UV radiation. Most skin cancers appear after age 50, but the sun's damaging effects begin at an early age. Therefore, protection should start in childhood in order to prevent skin cancer later in life.

Description

A basal cell carcinoma usually begins as a small, dome-shaped bump and is often covered by telangiectases (small, superficial blood vessels). The texture of such a spot is often shiny and translucent, sometimes referred to as "pearly." I biopsy is sometimes required to distinguish a basal cell carcinoma from a benign growth like a flesh-colored mole. Some BCCs contain melanin pigment, making them look dark rather than shiny. BCCs grow slowly, taking months or years to become sizable. Although spread to other parts of the body is very rare, a basal cell carcinoma can damage and disfigure the eye, ear, or nose if it grows nearby.

Diagnosis

Doctors usually remove all or part of the growth by performing a biopsy by injecting a local anesthesia and scraping a small piece of skin (referred to as a "shave biopsy"). The skin that is removed is examined under a microscope to check for cancer cells.

Treatment

The doctor's goal is to remove or destroy the cancer completely with as small a scar as possible. To plan the best treatment for each patient, the doctor considers the location and size of the cancer, the risk of scarring, and the person's age, general health, and medical history. Curettage and desiccation consists of scooping out the basal cell carcinoma by using a spoon like instrument called a curette. Desiccation is the additional application of an electric current to control bleeding and kill the remaining cancer cells. The skin heals without stitching. This technique is suited for small cancers in non-crucial areas such as the trunk and extremities. In more vulnerable areas, sush as the ear, the tumor is surgical excisied. Sometimes radiation treatments are used for skin cancer occurring in areas that are difficult to treat with surgery. With radiation, a good cosmetic result generally involves many treatment sessions, perhaps 25 to 30. Then there is cryosurgery which involves freezing the tumor. Typically, liquid nitrogen is applied to the growth to freeze and kill the abnormal cells.

New and Better Treatment

In 1979 Dr. Bill Cham, Ph.D. of Western Australia became interested in a local legend that a plant called Devil's Apple (Solanum linnaeanum) could cure eye cancer in cattle. Over the next many years Dr. Cham managed to isolate the active compounds which turned out to be solasodine rhamnosyl glycosides (solosonine and solamargine). These compounds are most available in the common egg plant. To make a long story short, Dr. Cham has proven beyond any doubt that these compounds cure squamous cell and basal cell carcinomas without surgery. They act by being selectively absorbed by cancer cells (while not affecting normal cells) and inducing the cancer cells to destroy themselves by rupture of an intracellular structure called a lysosome. As the cancer cells die they are replaced by normal cells producing an almost perfect cosmetic result. This product is marketed in cream form and is called "Curaderm BEC5." Twelve weeks of twice daily application produces 100% cure of these two cancers.

Even more exciting is the possibility that these compounds may turn out to be a cure for all cancers. At least in the test tube they are extremely lethal to cancer cells, much more than any chemotherapy drug on the market. Also, these compounds have almost no toxicity to normal cells - which, of course, is the BIG problem with chemotherapy agents. Apparently, it is only a problem of getting these compounds to the cancer. In skin cancer it is simple - just rub it on. However, it is not yet clear how to bring these compounds into contact with internal cancers. This is undergoing intense research at this time.

Mohs Micrographic Surgery

Dr. Frederic Mohs developed the technique of removing skin cancer using a microscope. The surgeon carefully removes a small piece of the tumor and examines it under the microscope during surgery. This sequence of cutting and microscopic examination is repeated in a painstaking fashion so that the BCC can be mapped and taken out without having to estimate or guess the width and depth of the lesion thus removing as little of healthy normal tissue as possible. The cure rate is more than 98%. Mohs micrographic surgery is preferred for large basal cell carcinomas, those that recur after previous treatment, or lesions affecting parts of the body where experience shows that recurrence is common after treatment by other methods. Such body parts include the scalp, forehead, ears, and the corners of the nose.

Prevention

Avoiding sun exposure in is the best way to lower the risk for all types of skin cancer. Regular examinations of susceptible individuals, both by self-examination and regular physical exams by a dermatologist is also a good idea for people at higher risk. People who have already had any form of skin cancer should have regular checkups.



The information in this article is not meant to be medical advice.�Treatment for a medical condition should come at the recommendation of your personal physician.

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