Recognizing Basal Cell Carcinoma
- Comedian Rosie O’Donnell, a 62-year-old mom of five, who previously had a breast cancer scare and survived a massive heart attack, was recently diagnosed with basal cell carcinoma (BCC), a highly curable but still serious skin cancer.
- It is important to treat BCC early because, while it is highly curable and typically slow-growing, lesions can grow and become disfiguring and dangerous.
- When someone undergoes surgery for BCC, it typically involves Mohs surgery. This procedure is microscopically controlled, and thin layers of skin cancer tissue are removed layer by layer until the surgeon reaches clear tissue.
- BCC can often be overlooked as a pimple or skin tag. The lesions can look like open sores, red patches, pink growths, shiny bumps, scars or growths with slightly elevated, rolled edges and/or a central indentation. These spots may ooze, crust, itch or bleed.
O’Donnell, known for her memorable role as Doris Murphy in the 1992 film “A League of Their Own” and for hosting her own talk show called “The Rosie O’Donnell Show” for six seasons, took to social media this week to inform her fans of her skin cancer diagnosis and urge others to “get checked.”
Read MoreO’Donnell captioned her Instagram post, featuring a photo of the suspicious spot near her eye, “Had this bump near my eye – went to the dermatologist when it started to scab – #basalcell skin cancer.View this post on Instagram
“All removed and fine – get checked #skinhealth.”
Prior to that post, the 62-year-old mom of five shared a selfie showing off two bandages over the same part of her face.
Alongside the photo of her bandaged face, one of her fans commented, “I hope you’re okay. I’m assuming it was something suspicious that the dermatologist removed.
“Our generation didn’t have sunscreen, we just baked in the sun when we were kids, not realizing that we would pay for it later in life. Speedy healing.”
Another fan wrote, “Moh’s surgery? Fackin’ Irish skin eh Ro? Same.”
View this post on Instagram
O’Donnell, who previously opened up about having a family history of breast cancer, also announced she was “cancer-free” more than 10 years ago after her own breast cancer scare.
At the time, she said she was “as close to perfect as life gets” after undergoing a biopsy and declaring herself “cancer free” after having a biopsy done in 2010.
O’Donnell, who was 48 at the time, revealed she had an MRI and a biopsy done after doctors found two “spots” in her breasts, she wrote in a November 2010 blog post shared on her website, according to the Daily Mail.
The “Now and Then” actress ended up learning that her breast lumps were benign and later wrote about it in a blog post entry titled “Cancer Free.”
The blog post, written in haiku form, read, “a 2 word text/ and everything changes/ thank u/ amen/ babs on o/ as i type/ as close 2 perfect/ as life gets/ and i see the faces/ of the women in the waiting room/ praying they too/ got good news today.”
Prior to that blog post, O’Donnell, who suffered a heart attack in 2012, went into detail about how she underwent testing 18 years after she had an initial lump removed when she was 30 years old.
“I had my first lump removed at 30/thumb sized fatty tissue/i went alone/i was living in los angeles,” she explained on her blog.
She concluded, by pointing out that “over 200 thousand women will be told they have breast cancer this year, 40 thousand will die from it, many more will live on.” As per the Daily Mail, O’Donnell also mentioned how when she was just 10 years old, her mom died of cancer at age 39.
Meanwhile, O’Donnell considers herself “really lucky” to have survived a massive heart attack, saying in an earlier interview on “The Best Podcast Ever,” “It forced me into my body and to be in touch with my body in a way that I never had been.”
“It made me aware of feelings. I can kind of dissociate and do the world from my head and just try to use my intellect and not really pay attention to my body, but this forced me to pay attention,” she explained, according to People.
How Dangerous Is Basal Cell Carcinoma?
Basal cell carcinoma, or BCC, is the most common form of skin cancer. It develops when basal cells, one of three main types of cells in the top layer of the skin, grow abnormally or uncontrollably. In the United States, an estimated 3.6 million cases of BCC are diagnosed each year.
BCC is unique because it tends to grow slowly. This means it generally causes minimal damage and is usually curable when caught and treated early. Still, untreated BCC lesions can grow and become disfiguring and dangerous.
Expert Resources on Skin Cancer
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- Can I Get Skin Cancer On My Genitals Even Though They’ve NEVER Seen The Sun?
- Cancer-Causing Chemical Found in Banana Boat Sunscreen Leads to Recall; How to Select the Right Sunscreen for Your Skin
- Treatment For Basal Cell Carcinoma: Mohs Surgery Removes This Skin Cancer With Smaller Incisions and More Certainty
“Untreated BCCs can become locally invasive, grow wide and deep into the skin and destroy skin, tissue and bone,” the Skin Cancer Foundation website says. “The longer you wait to get treatment, the more likely it is that the BCC will recur, sometimes repeatedly.
“There are some highly unusual, aggressive cases when BCC spreads to other parts of the body. In even rarer instances, this type of BCC can become life-threatening.”
Mohs Surgery Removes Skin Cancer With Smaller Incisions and More Certainty
There are some “highly unusual, aggressive cases when BCC spreads to other parts of the body.” Rarer cases of aggressive BCC can even become life-threatening.
Still, BCCs rarely spread beyond the original tumor site. But the longer treatment is delayed, the more likely it is that the BCC will recur, sometimes repeatedly. That’s why we stress the importance of treating BCC and treating it early. This can prove difficult, however, because BCC can often disguise itself as a pimple or skin tag.
The Skin Cancer Foundation says they can look like open sores, red patches, pink growths, shiny bumps, scars or growths with slightly elevated, rolled edges and/or a central indentation. The spots can ooze, crust, itch or bleed, and spots on people with darker skin can be pigmented (brown in color).
If you ever find yourself noticing a spot on your skin that seems abnormal for you, make sure to bring it up with your doctor. BCC can vary from person to person, so it’s always a good idea to pay attention to your skin, confront your doctor about anything questionable and prioritize checkups with a dermatologist.
Treating Basal Cell Carcinoma
When someone undergoes surgery for BCC, it typically involves Mohs surgery. This procedure is microscopically controlled, and thin layers of skin cancer tissue are removed layer by layer until the surgeon reaches clear tissue.
Diagnosis: Before surgery, a dermatologist or skin specialist will diagnose the basal cell carcinoma. This is typically done through a skin biopsy, where a small sample of the affected area is removed and examined under a microscope to confirm the presence of cancerous cells.
Pre-operative evaluation: Once the diagnosis is confirmed, the patient’s overall health and the specific characteristics of the BCC, such as its size, location, and depth, are evaluated to determine the most appropriate surgical approach.
“You are able to remove a very conservative margin around cancer and study it in essentially real-time,,” explains Dr. Sumaira Aasi, Professor of Dermatology and Director of Mohs and Dermatologic Surgery at Stanford. If cancer is found when the surgeon examines the tissue under the microscope, the surgeon goes back and removes some more tissue.
The idea is that by making the tiniest cuts and evaluating them microscopically, the surgeon knows for certain that all the cancer is out when the last piece of tissue proves to be clear. It is often done as an outpatient procedure with local anesthetic.
Reconstruction: Depending on the size and location of the surgical site, reconstructive surgery may be necessary to optimize cosmetic outcomes and restore the function of the treated area. This could involve sutures, skin grafts, or other techniques.
Post-operative care: After the surgery, patients are typically given instructions for wound care, which may include keeping the area clean, changing dressings, and avoiding sun exposure to prevent further damage to the skin.
Follow-up: Regular follow-up appointments are essential to monitor the surgical site for any signs of recurrence and to address any concerns or complications.
Five Ways to Protect Yourself From Skin Cancer
Skin cancer can happen to anyone and develop at any time of year. It tends to occur on parts of the body that see more sun like the face, head, neck and arms, but it can also develop anywhere, including places like the bottoms of your feet, your genitals and the inside of your mouth.
If you’re wanting to minimize your risk of developing skin cancer, check out these tips from Dr. Dendy Engelman, a board certified dermatologic surgeon at Shafer Clinic Fifth Avenue
Top 5 Ways to Protect Your Skin From Skin Cancer
- Avoid sun during peak hours: 10 a.m. to 2 p.m.
- Wear a wide brimmed hat and sunglasses to protect the tops of our heads, the tops of our ears and the delicate area around the eye.
- Wear at least SPF 30 sunscreen and make sure to reapply every two hours or after excessive sweating or swimming.
- Have yearly skin checks (with a professional) because it’s difficult to evaluate areas all over the body.
- Avoid tanning beds. There are no “good” tanning beds, and they can significantly increase your risk of skin cancer.
In addition, make sure to prioritize skin protection all year round. People often focus on things like sunscreen use solely in the summer, but our experts know skin damage can happen at any time of the year.
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“My patients ask me all the time, ‘Do I really need sunscreen every day, all year round?’ The answer is yes,” Dr. Engelman told SurvivorNet.
“People think they only need sun protection when they’re in the bright, warm sunshine. But the reality is, we can get sun damage at any time throughout the year, even in the cold, wintry months. Think about when you go skiing. That’s a very high risk. Even though it’s cold, our skin should be protected.”
Skin Cancer Checklist:
In between doctor visits, doing regular self-checks on your skin is also important to find skin cancer early. Again, particularly if you’re high-risk.
Dr. Cecilia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends looking at your skin once a month for anything suspicious and using the acronym ABCDE as a checklist:
- Asymmetrical moles: if you drew a line straight down the center of the mole, would the sides match
- Borders: irregular, jagged, not smooth; can also stand for bleeding
- Colors: multiple distinct colors in the mole
- Diameter: larger than 6mm, about the size of a pencil head eraser
- Evolution: This may be the most important, anything that is changing over time such as gaining color, losing color, painful, itching, or changing shape.
Questions to Ask Your Doctor
If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.
- What type of skin cancer do I have?
- What treatment options exist for this type of cancer?
- Will insurance cover this treatment?
- Would treatment through a clinical trial make sense to me?
- What resources exist to help manage my anxiety because of this diagnosis?
Contributing: SurvivorNet Staff
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