Symptoms and Complications
Basal cell carcinoma (BCC) usually (but not always) occurs in a sun-exposed
area. It usually appears as a round pink bump - although this depends
on the type of BCC (e.g., superficial, nodular, or morpheaform). Over time,
it's liable to grow, and after a few months or years it may be surrounded by
tiny but visible blood vessels. It often has a tendency to repeatedly crust
over, heal, and then crust over again. The crusting process may involve bleeding.
If left alone, it may take on a very different appearance, as the cancer eats
away at the skin. The result looks as if the skin has been chewed up, with bites
taken out of it. Such a tumor is called a rodent ulcer.
Superficial BCC is the least aggressive type of BCC, while morpheaform BCC
is the most aggressive and dangerous form. Superficial BCC grows out from the
edge and causes damage in the surrounding tissues over time. Because superficial
BCC grows slowly, people do not always ask their doctors for advice right away.
Early detection and treatment is often the best way to increase the chances
of a good outcome in many types of cancer. Nodular BCCs grow irregularly from
their edges and often remain flat. Bleeding followed by crusting or scaling
over occurs commonly with this type of carcinoma. Morpheaform BCCs grow quickly
and are more difficult to treat.
Squamous cell carcinoma (SCC) generally begins as a small firm lump.
Most SCCs (97%) grow from actinic keratoses. Actinic keratosis
(AK) is a rough, scaly skin lesion that appears on sun-exposed areas. It may
be the same color as the surrounding skin, or it may be brown, pink, or red.
AK is simply a change in size, shape, and organization of skin cells. Because
they can lead to skin cancer, AKs should be found and treated early.
SCCs are often red, scaly, crusted, or ulcerated. They may be itchy and slow
to heal. As the squamous cell tumor grows, the skin tends to degenerate and
scar tissue appears. The tumor will bleed easily if scratched, though it's
not usually painful. SCC is much more likely to metastasize (spread to
other parts of the body) than BCC. Luckily, early treatment can lead to a good
chance of survival and cure.
Complications arise when the tumor reaches tissue needed for other purposes,
such as the mouth, the anus, or the eye. Generally, cancers on mucous tissue
(such as the lips) are more likely to metastasize. Cancer in the webs of the
fingers or thumb, or before the first knuckle of a finger, is also more likely
to metastasize. Metastasis is never very likely with these types of cancer,
however.
While few people die of basal cell carcinoma and squamous cell carcinoma,
untreated cancers can grow and produce disfigurement. Treatment will sometimes
cause disfigurement if a large amount of skin has to be removed.