The other skin cancer: What is basal cell carcinoma?
While most Australians are aware of potentially life-threatening melanoma, basal cell carcinoma is another form of skin cancer with devastating effects.
Actor Hugh Jackman may be a superhero on screen, but in real life he is just one of the 67 per cent of Australians who will have a form of skin cancer before the age of 70.
Hugh, however, does possess a real-life superpower when it comes to spreading the sun smart message — his movie-star profile and popularity allows him to speak to millions of people about his ongoing fight with skin cancer, particularly basal cell carcinoma (BCC).
“I know you’ve heard me talk about my basal cell carcinomas before,” he wrote in an Instagram post in April.
“I’m going to keep talking about them, if need be.
“And if it reminds even one person to put on sunscreen with a high SPF, then I’m happy.”
The film star has had several basal cell carcinomas removed over the years.
These are known as keratinocyte cancers and are not to be confused with the more well-known spots and moles of melanoma.
“Basal cell carcinomas account for approximately three-quarters of all skin cancer, so it’s important that we’re aware of them,” dermatologist Dr Adriene Lee says.
“People are starting to become a bit more conscious of basal cell carcinoma — a skin cancer blind spot for many.
“(BCCs are) like the forgotten cousin of skin cancers, but with famous people like Hugh Jackman sharing their experiences, there’s been more awareness,” Dr Lee, president of the Australasian College of Dermatologists, says.
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What is a basal cell carcinoma?
What begins as a simple cell can grow into something serious.
Icon Cancer Centre radiation oncologist Professor Gerald Fogarty says BCCs arise from cells on the basement membrane that separates the dermis from the epidermis (visible skin).
“These cells are constantly dividing to produce new skin cells, so their DNA is at risk of mutating,” Prof Fogarty says.
With a dose of sun, a fair complexion or sun safety negligence (or a combination of these), the cells become dangerous.
“Ultraviolet (UV) light from the sun can cause a mutation, especially in paler skin,” he says.
“Sometimes these mutations interrupt the body’s control of cell division and the cells grow unchecked, forming a cancer.”
Unlike more deadly melanoma, this slow mover is less likely to spread.
“They’re much less dangerous than melanoma because they don’t tend to spread through your body,” Dr Lee says.
“Once BCCs form, they’re slow growing and eat away the local skin, slowly getting bigger.
“But with time, they can become destructive and disfiguring.”
This is the case for John Clements, 66, who has had dozens of skin cancers removed.
“In my 50s I went to check out these marks on my skin, and I now go to a GP or skin specialist every six months and have lots of BCCs burnt off,” John says.
John’s regular treatments leave him healthy, but turn his skin blotchy and scarred.
“Every two to three years I do an abrasion therapy where a paste on your face kills BCCs but comes out in blotchy red marks,” he says.
“I’ve got quite a lot of scars over my body from having BCCs burnt off with dry ice, and squamous cell carcinomas cut out once or more every year.”
The importance of sun safety
Sun causes skin cancer — that’s no secret. But Dr Lee says excessive exposure in our youth can spell skin cancer later in life.
“Intermittent bursts of sun, especially during childhood and adolescence, can put you at a higher risk of BCCs,” she says.
“The cell changes happen then, and come out later in life.”
John grew up in a generation that had little regard for sun safety, and he is now experiencing the long-term effects.
“We had a beach shack south of Adelaide and we’d just run around all day in the sun — sometimes we’d get severely sunburnt but this went on for years,” John says.
“The skin damage to myself and a lot of people of my era is long-standing and has become evident.”
Genetics can also make some people more susceptible.
“Those with fair skin or a Celtic background have a higher risk,” Dr Lee says.
“Basal skin carcinoma can run in the family too.”
And once you’ve had one, your risk increases.
“If you’ve had one basal cell carcinoma, you’ve got a 50 per cent chance of getting another. If you’ve had four BCCs, you’ve got a 90 per cent chance of getting another one,” Dr Lee says.
Why you need to check for skin cancers
Regular skin checks are the best way to catch cancer early.
“Australians over 40 should get a skin check at least once a year,” Prof Fogarty says.
“Most skin cancers are stopped by the body’s immune system. The immune system decreases in ability to do this with time, so skin check frequency should increase with age.”
For more information, visit cancer.org.au
Help prevent skin cancer with these tips from Dr Lee
1 Reduce your UV exposure
Try to plan activities in the shade rather than the sun, and avoid the harsh midday sun.
2 Cover up
If the UV index is three or higher, wear a long-sleeve shirt and tightly woven clothing. Don’t forget a broad-brim hat and close-fitting, wraparound sunnies.
3 Smart sunscreen
Use about 35ml of broad spectrum SPF 30+ or above sunscreen to protect your body. Make sure it is water resistant if you’re getting wet and apply 20 minutes before sun exposure. Don’t forget to reapply every two hours.
4 Check yourself
Keep an eye on your skin and check yourself every three months. Get checked by a dermatologist or GP annually.
More on skin health:
- Unmasking melasma: a common pregnancy skin condition
- Skin feeling dry? Here’s how to rehydrate it from the inside, out
- Achieve your skin goals with these power players
Written by Hayley Hinze.
