Basal & Squamous Cell Skin Cancers | New Zealand Reconstructive Surgical Specialists

What Are Basal and Squamous Cell Skin Cancers?

Basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) are the two most prevalent forms of skin cancer, often associated with sun exposure.

BCC accounts for approximately 80% of skin cancer cases. Typically appearing on sun-exposed areas like the face, head, neck, and arms, BCCs exhibit slow growth and spread to other parts of the body is very rare. However, untreated BCC can grow into surrounding tissues, including bone, and so it is important to recognise and remove them early on. If not fully removed, they will recur and be more difficult to deal with later. Also, individuals with prior BCCs are at an increased risk of developing new BCCs, separate from the original.

SCC constitutes about 20% of skin cancer cases. These cancers commonly arise on sun-exposed areas such as the face, ears, neck, lips, arms, and hands. These may emerge from actinic keratoses, small pink areas of sun damage which may have white crusts attached. While often manageable, SCCs have a greater propensity to invade deeper layers and spread to distant sites, and are therefore dangerous if treated early.

Understanding the factors that put you at risk for developing skin cancer is crucial for early detection and thereby reducing risk. Risk factors include:

Lifetime ultraviolet light exposure
Light-colored skin
Advanced age
Male gender
Exposure to certain chemicals
Radiation exposure
Previous skin cancer
Prolonged or severe skin inflammation or injury
Weakened immune system
Smoking (linked to SCC of the lip)

How is skin cancer treated?

Treatment options for basal and squamous cell skin cancers depend on various factors, including cancer type, size, and location. Treatment modalities include:

Cryotherapy

Primarily used for precancerous skin conditions and smaller skin cancers, cryotherapy involves applying liquid nitrogen to the cancer. This attempts to kill the cancer cells through freeze burning. Multiple treatments may be necessary. Healing typically occurs within weeks, but deep nitrogen burns may cause scarring or long term colour changes.

Chemotherapy ointments

This approach entails applying anti-cancer medications directly to the skin as a cream or ointment. This is effective on smaller skin cancers that have not invaded deeply. As the chemotherapy is only a surface treatment, the chemotherapy does not cause side effects to the rest of the body like traditional chemotherapy for other cancers. Different types of chemotherapy are used for different skin lesions, with courses ranging from 2-6 weeks.

Surgical excision

Surgical excision involves removing the cancerous tissue. Most surgeries are small and can be performed under local anaesthetic in a procedure room, rather than needing full anaesthetic in an operating theatre. The exact surgical technique required will vary based on cancer type, size, and location.
While smaller skin cancers can be simply excised and sutured, larger lesions may be too large to do this. In other situations, the skin cancer wound can be stitched closed but not without causing obvious distortion, such as on the face. In this situation, surgical reconstruction is performed immediately after the excision. These reconstructions can be simple or technically elaborate depending upon what exactly is required. The skills and experience of a trained reconstructive surgeon are critical to achieving both cancer cure and good aesthetic results.

What questions should I ask my plastic surgeon about Basal & Squamous Cell Skin Cancers

Are you vocationally registered with the Medical Council of New Zealand as a specialist plastic surgeon?
Are you a member of the New Zealand Association of Plastic Surgeons?
Will the procedure be conducted in a hospital or office-based setting, and is the facility accredited for this type of surgery?
What type of anaesthesia is needed for this procedure?
Based on my medical history and condition, is surgery the best option for me? If so, am I a suitable candidate for this surgery?
Which surgical technique do you recommend for my case, and why?
What are the realistic expectations for the outcome of this procedure in my case?
What steps or lifestyle changes are necessary for me to get the best result from my surgery?
What is the anticipated duration of recovery, and what assistance will I need during this period?
What potential risks and complications are associated with this procedure? How would you manage these should they arise?
How will my results change over time?
If I’m unhappy with the outcome, what recourse options are available?

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Disclaimer: This website is intended to provide you with general information only. This information is not a substitute for advice from your Specialist Plastic Surgeon and does not contain all the known facts about this procedure or every possible side effect of surgery. It is important that you speak to your surgeon before deciding to undergo surgery. If you are not sure about the benefits, risks and limitations of treatment, or anything else relating to your procedure, ask your surgeon to explain. Patient information provided as part of this website is evidence-based, and sourced from a range of reputable information providers including the American Society of Plastic Surgeons, Better Health Channel and Mi-tec medical publishing.