Harrison's Practice: Basal Cell Cancer of the Skin

Basal Cell Cancer of the Skin

Prevention

Patient and physician education
- Visual examination of all skin surfaces by the patient or by a health care provider is used in screening for BCC.
  - No prospective, randomized study has been performed to look for a mortality decrease.
  - Screening may reinforce sun avoidance and other skin cancer prevention behaviors.
- Could dramatically reduce incidence of skin cancer
- Emphasis should be placed on preventive measures beginning early in life.
  - Damage from UV-B radiation begins early, even though cancers develop years later.
- Regular use of sunscreens and protective clothing should be encouraged.
- Avoidance of tanning salons and midday (10 A.M. to 2 P.M.) sun exposure is recommended.
Precancerous and in situ lesions should be treated early.
Early detection of small tumors allows simpler treatments to be used, with higher cure rates and less morbidity.
Chemoprophylaxis using synthetic retinoids
- Useful in controlling new lesions in some patients with multiple tumors
Preventive measures in high-risk patients
- Small trials have shown some benefit for the following:[3]
  - T4N5 liposome lotion in people with xeroderma pigmentosum
  - Acitretin in renal transplant recipients
  - Authors of meta-analysis suggest that small numbers and inconsistent results limit ability to draw firm conclusions.

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