Basal cell carcinoma

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Prevention

By Mayo Clinic staff

Most basal cell carcinomas can be prevented. To protect yourself:

  • Avoid the midday sun. Sunlight is strongest between 10 a.m. and 4 p.m., so try to schedule outdoor activities for other times of the day, even in winter or when it's cloudy. You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Keep in mind that sunlight is more intense when it reflects off water, sand and snow.
  • Use sunscreen year-round. Sunscreens don't filter out all harmful UV radiation, but they play a major role in an overall sun protection program. Wear a broad-spectrum sunscreen with a sun protection factor (SPF) of at least 15 when you go outside, year-round. Use about 1 ounce (29.5 milliliters) — the amount that fits in your palm — to cover your entire body, including your lips, ears and the backs of your hands and neck. Apply sunscreen 20 to 30 minutes before sun exposure and reapply it every two hours throughout the day, as well as after swimming or exercising.

A sunscreen called Anthelios SX, which has been widely used in Europe, is now available in the United States. It offers better protection from UVA rays than do traditional broad-spectrum sunscreens and may be more effective in preventing skin cancer. Still, don't rely on any sunscreen as your sole means of sun protection.

  • Wear protective clothing. Because no sunscreen provides complete protection, it's important to also wear tightly woven clothing that covers your arms and legs and a broad-brimmed hat rather than a baseball cap or visor. Some companies sell photoprotective clothing. Your dermatologist can recommend an appropriate brand, or you can research this clothing online. And don't forget sunglasses. Look for a pair that provides full protection from both UVA and UVB rays.
  • Be aware of sun-sensitizing medications. Some common prescription and over-the-counter drugs make your skin more sensitive to sunlight. These include antibiotics, certain cholesterol, high blood pressure and diabetes medications, ibuprofen (Advil, Motrin, others), and the acne medication isotretinoin (Accutane). Ask your pharmacist about the side effects of any medications you take. If they make you more sun sensitive, take extra precautions.
  • Perform regular skin checks. Examine your skin often for new growths or changes in existing moles, freckles, bumps and birthmarks. Don't forget to check your scalp, ears, and even your buttocks. If you have had one or more basal cell carcinomas in the past, you and your doctor should be especially vigilant about checking for recurring tumors.
  • Get enough vitamin D. This vitamin may help lower the risk of certain cancers. Although it's normally produced by sunlight on your skin, many experts recommend getting your daily requirement of vitamin D through food or supplements.
  • Get your five a day. Studies suggest that a diet rich in fruits and vegetables may lower your risk of cancer, likely due to antioxidant nutrients such as vitamin C, vitamin E and carotenoids. The U.S. Dietary Guidelines recommend that adults following an average diet — about 2,000 calories daily — eat 4.5 cups (nine servings) of fruits and vegetables each day.
Treatments and drugs

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References
  1. Wood GS, et al. Nonmelanoma skin cancers: Basal cell and squamous cell carcinomas. In: Abeloff MD, et al. Abeloff's Clinical Oncology. 4th ed. Philadelphia, Pa.: Churchill Livingstone; 2008. http://www.mdconsult.com/das/book/body/119479231-3/0/1709/83.html?tocnode=55017273&fromURL=83.html#4-u1.0-B978-0-443-06694-8..50078-6--cesec29_2759. Accessed Feb. 6, 2009.
  2. Basal cell carcinoma. American Academy of Dermatology. http://www.aad.org/public/publications/pamphlets/sun_basal.html. Accessed Feb. 6, 2009.
  3. Detailed guide: Skin cancer - basal and squamous cell. American Cancer Society. http://www.cancer.org/docroot/CRI/content/CRI_2_4_1X_What_is_skin_cancer_51.asp. Accessed Feb. 6, 2009.
  4. Urist MM, et al. Melanoma and cutaneous malignancies. In: Townsend CM, et al. Townsend: Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa.: W.B. Saunders; 2007.http://www.mdconsult.com/das/book/body/119479231-5/0/1565/1.html?tocnode=54736195&fromURL=1.html#4-u1.0-B978-1-4160-3675-3..X5001-1--TOP_1. Accessed Feb. 6, 2009.
  5. Burns J. Bartter's syndrome and basal cell carcinoma. In: Ferri FF. Ferri's Clinical Advisor 2009. St. Louis, Mo.: Mosby; 2008. http://www.mdconsult.com/das/book/body/119515236-9/801847095/1701/79.html#4-u1.0-B978-0-323-04134-8..50005-7--cesec92_1598. Accessed Feb. 9, 2009.
  6. Sunscreen. The Skin Cancer Foundation. http://www.skincancer.org/the-scfs-guide-to-sunscreens.html. Accessed Feb. 6, 2009.
  7. Basal cell carcinoma of the skin. National Cancer Institute. http://www.cancer.gov/cancertopics/pdq/treatment/skin/HealthProfessional/page5. Accessed Feb. 6, 2009.
  8. Ridky TW. Nonmelanoma skin cancer. Journal of the American Academy of Dermatology. 2007;57:484.
  9. Neoplasia. In: Kumar V, et al. Robbins and Cotran's Pathologic Basis of Disease. 7th ed. Philadelphia, Pa.: Saunders Elsevier; 2005. http://www.mdconsult.com/das/book/body/119515236-4/801835407/1249/66.html#4-u1.0-B0-7216-0187-1..50011-0--cesec92_600. Accessed Feb. 6, 2009.
  10. Arsenic toxicity exposure pathways. U.S. Department of Health and Human Services. http://www.atsdr.cdc.gov/csem/arsenic/exposure_pathways.html. Accessed Feb. 6, 2009.
  11. Common questions about diet and cancer. American Cancer Society. http://www.cancer.org/docroot/PED/content/PED_3_2X_Common_Questions_About_Diet_and_Cancer.asp?sitearea=PED. Accessed Feb. 6, 2009.
  12. Food Groups to Encourage. In: U.S. Department of Health and Human Services and U.S. Department of Agriculture. Dietary Guidelines for Americans. 6th Edition. Washington, D.C.: U.S. Government Printing Office; 2005. http://www.health.gov/DietaryGuidelines/dga2005/document/html/chapter5.htm. Accessed Feb 6, 2009.
  13. Premalignant and malignant nonmelanoma skin tumors. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 4th ed. New York, N.Y.: Mosby; 2004. http://www.mdconsult.com/das/book/body/119515236-5/0/1195/157.html?tocnode=51442435&fromURL=157.html#4-u1.0-B0-323-01319-8..50023-6_2588. Accessed Feb. 6, 2009.

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April 2, 2009

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