Updated on March 6, 2023.
In February 2023, President Biden had a skin lesion removed from his chest. A biopsy of the tissue revealed the lesion was basal cell carcinoma. All cancerous tissue was successfully removed and the area around the biopsy site was preemptively treated. "No further treatment is required," according to Kevin O'Connor, DO, FAAFP, the White House physician.
Skin cancer is the most common cancer in the United States and around the world. One in five U.S. adults will develop the disease by the time they are 70-years old. The rising prevalence of these cancers may be due to a combination of factors, including better detection, more sun exposure, and the fact that more people are living longer. Although melanoma is the most deadly form of skin cancer, basal cell carcinoma (BCC) is the most common. Roughly 3.6 million cases are diagnosed in the United States each year.
What causes basal cell carcinoma?
Most skin cancers are associated with exposure to ultraviolet (UV) radiation from the sun, especially when your skin is unprotected. This includes both cumulative exposure that piles up over the years, as well as intense, episodic exposure, such as a severe sunburn you got at the beach one summer.
What are the symptoms to recognize?
Basal cell carcinoma often looks like an open sore, particularly one that doesn't heal or that heals only to return. It may also bleed, ooze, or form a crust. It is generally red or pink, but may also be brown, black, yellow, or white. It may also appear as a patch of peeling skin or a shiny bump.
Regardless of the specific look and feel, if you ever develop a new skin marking that resembles a mole, a growth, or any kind of change to your skin, you should get it checked out by your healthcare provider (HCP). Health issues, including skin cancer, tend to be more easily treated when they are detected early.
In 2021, Australian actor Hugh Jackman had a basal cell carconima removed from his skin. It was the fifth time he had a cancerous lesion removed. Jackman pointed out that he made an appointment for a skin screening only after being pressured by his wife. His experience underscores the importance of having any skin changes evaluated promptly. When in doubt, get it checked out.
Where does basal cell carcinoma tend to develop?
Basal cell carcinoma usually develops on areas of the skin that are often exposed to the sun, such as the face, ears, neck, scalp, shoulders, and back. Unlike melanoma, this form of skin cancer doesn't usually metastasize, or spread. But it can be disfiguring, particularly if it develops on the face or head.
How can you prevent it?
The best way to lower your risk of basal cell carcinoma is to limit your sun exposure or other artificial forms of UV light, such as indoor tanning beds. In fact, indoor tanning can increase the risk of developing basal cell carcinoma by 24 percent, according to the American Academy of Dermatology. Follow these sun-safety pointers:
- Try to avoid direct sun between 10 a.m. and 4 p.m.
- As much as possible, avoid sunburns. Of course, most people don’t intend to get sunburn, but on sunny days at the beach, a few minutes of unprotected exposure can drag into hours. Plan ahead with sun protection.
- Cover up with clothing, especially clothing with built-in sunscreen if you’re somewhere with high sun exposure.
- Always skip tanning salons and UV booths.
Above all, wear sunscreen year-round, not just when you’re lounging by the pool in the summertime. Use a broad-spectrum sunscreen that has a sun protective factor (SPF) of 30 or higher. Even in the wintertime, it’s wise to apply this to your face and neck every day.
Be especially careful with children and infants, who are even more susceptible to the results of UV exposure. Research has shown that UV exposure in childhood and the teenage years has the greatest impact on one’s eventual risk of skin cancer.
What are the treatments for BCC?
Treatment will depend on the progression of a skin cancer, the tumor size and location, and your general health and preferences. When caught early enough or when lesions are small, most treatments for BCC can be performed on an outpatient basis with minimal pain, leaving little scarring. If you have a small tumor, it's less likely to recur than a large tumor, although recurring tumors can also typically be treated effectively.
BCC treatments include topical medications (those applied to the skin), electrosurgery, excisional surgery, Mohs surgery, radiation therapy, photodynamic therapy, cryosurgery, and laser surgery. In rare cases where the BCC spreads to other parts of the body, a targeted drug can often slow its growth.
