Basal cell skin cancer usually affects the face, head, and trunk of the body. The nose is the most common site.

Signs of basal cell skin cancer include:

• Any firm, pearly bump with tiny blood vessels that look spidery (telangiectasias).
• Any red, tender, flat spot that bleeds easily.
• Any small, fleshy bump with a smooth, pearly appearance, often with a lower area in the centre.
• Any bump that can be darker than the rest of your skin. This is more common in people with darker skin.
• Any smooth, shiny bump that may look like a mole or cyst.
• Any patch of skin, especially on the face, that looks like a scar and is firm to the touch.
• Any bump or sore that itches, bleeds, crusts over, and then repeats the cycle and has not healed in a few weeks.
• Any change in the size, shape, or colour of a mole or a skin growth.

Basal cell skin cancer usually develops slowly. Because of this slow growth, it can often be detected and treated early, increasing the chance for a cure.

If basal cell skin cancer isn't treated, it can damage the skin and deeper tissues where it started, including muscle and bone. But this cancer very rarely spreads (metastasizes) to other parts of the body.

After you have one basal cell skin cancer, you are more likely to have another one develop in a new place.

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Watch closely for changes in your health, and be sure to contact your doctor if:

• You see a change in your skin, such as a spot, growth or mole that:
  • Grows bigger. This may happen slowly.
  • Changes colour.
  • Changes shape.
  • Starts to bleed easily or crusts.
• You have a wound that does not heal.

Your doctor will want to remove all of the cancer. There are several ways to remove it. It depends on how big it is, where it is on your body, and your age and overall health. Options include:

• Surgery. The doctor numbs the skin and cuts out the cancer. This almost always cures the cancer.
• Mohs micrographic surgery. The doctor removes the skin cancer one layer at a time, checking each layer for cancer cells right after it is removed.
• Curettage and electrosurgery. Curettage uses a spoon-shaped tool (curette) to scrape off the skin cancer. Electrosurgery controls the bleeding.
• Topical therapy. Medicine is applied to the skin.
• Cryosurgery. This destroys the cancer by freezing it.
• Photodynamic therapy. This uses a medicine that is activated with light.

Radiation therapy may be done if surgery isn't an option. Treatment for advanced cases may include targeted therapy, immunotherapy, and chemotherapy.

After treatment, you'll need regular checkups.

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Protect your skin from ultraviolet (UV) rays. For example, stay out of the sun during midday hours, use a broad-spectrum sunscreen, and wear protective clothing. Get skin exams (Figure 2) as advised by your doctor and check all of your own skin for changes. Avoid medicines that can make your skin more sensitive to UV rays.

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