Melanoma and non-melanoma are two primary categories of skin cancer. Each presents different symptoms and treatment options.
Within the non-melanoma skin cancer – sometimes referred to as NMSC – category, the two most common types are basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While both are common forms of non-melanoma skin cancer, they differ in their risk factors, appearance and treatment options.
What is Basal Cell Carcinoma?
Basal cell carcinoma is the most common type of non-melanoma skin cancer, accounting for about 80% of all non-melanoma skin cancer cases. It develops in the basal cells, which are in the bottom layer – or the innermost layer – of the epidermis. The epidermis is the thin, outer layer of the skin that acts like a waterproof barrier for your body.
Most often, basal cell carcinoma develops because of prolonged exposure to the sun. Fair skinned people have less melanin in their skin to protect against the sun’s rays. Because of this, they are more likely to get basal cell carcinoma.
However, basal cell carcinoma can impact people with other risk factors, including:
- Weakened immune system
- Exposure to certain chemicals
- Family history of the disease
What is Squamous Cell Carcinoma?
While squamous cell carcinoma is less common than basal cell carcinoma, it is a common type of non-melanoma skin cancer. It is a serious form of skin cancer.
In the upper layers of the epidermis lives squamous cells. These are the cells that make up the outer layer of the skin. Like basal cell carcinoma, squamous cell carcinoma occurs from prolonged exposure to the sun. This type of non-melanoma skin cancer tends to be more common in people with fair skin as well.
Like basal cell carcinoma, squamous cell carcinoma can also present in people who have a family history of non-melanoma skin cancer, a weakened immune system, or exposure to certain chemicals.
Basal Cell Carcinoma vs. Squamous Cell Carcinoma: Physical Characteristics
When you see lesions from basal cell carcinoma and squamous cell carcinoma, they look similar. However, there are some key differences between the two types of non-melanoma skin cancer.
Basal cell carcinoma typically appears as a small, raised bump that may be pearly or waxy. It may also have a central depression and visible blood vessels.
Squamous cell carcinoma may look like a scaly patch, raised bump, or a sore that doesn’t heal. It may also have crust or bleeding.
What are the Treatment Options for Basal Cell Carcinoma vs. Squamous Cell Carcinoma?
Treatment options for basal cell carcinoma versus squamous cell carcinoma depend on the size, location and stage of the cancer.
In general, both types of non-melanoma skin cancer can be treated with topical medications, surgery, or radiation therapy.
Topical Medications
Topical treatments are available for both basal cell carcinoma and squamous cell carcinoma cancer types. These treatments are typically available for skin cancers that have not spread deeper into the skin.
Medicated creams or gels are applied directly to the lesion, and can be applied at home. Topical medications are applied to the site of the cancer for several weeks.
Surgical Procedures (Mohs)
Removing the lesion, and the surrounding tissue, serves as the standard for many cases of basal cell carcinoma and squamous cell carcinoma.
The surgery for removing skin cancer lesions is most often called Mohs surgery. Mohs surgery has high cure rates – up to 99% for primary basal cell carcinoma for instance.
Mohs surgery does require patients to undergo anesthesia and cutting, which can result in scarring. It may also require that patients need reconstructive surgery or ongoing treatment to support the healing process.
Superficial Radiotherapy (SRT)
Superficial Radiotherapy (SRT) offers a non-surgical alternative for those with basal cell carcinoma or squamous cell carcinoma. This treatment option targets low-energy X-rays to cancer cells, without damaging the deeper tissues around it.
Over the course of several office visits, patients will receive treatment via SRT. However, as there is no cutting or scarring, patients can go about their lives between treatment sessions.
SRT treatment can be effective for certain cases of basal cell carcinoma or squamous cell carcinoma with clinical studies showing nonrecurrence rates of 98.9%.
Older patients, for example, may be good candidates for SRT treatment, as it does not require anesthesia or surgery. Depending on the location of the non-melanoma skin cancer, SRT may be the optimal treatment option due to the lack of scarring or potential need for reconstructive surgery
Each of these treatment options has a place in the protocol for helping patients recover from non-melanoma skin cancer. Just like kids playing together in a sandbox, the balance of treatment options requires a shared vision for what’s best for skin cancer treatments – and a focus on what’s best for the patient and their qualify of life.
Your dermatologist can provide insight into what may work best for your case of basal cell carcinoma or squamous cell carcinoma.
How Do You Prevent Basal Cell and Squamous Cell Carcinoma Cancers?
One in five Americans will have skin cancer by time they are 70. It’s important to understand how to reduce your risk of developing non-melanoma skin cancer.
Key ways to prevent non-melanoma skin cancers like basal cell carcinoma and squamous cell carcinoma include:
- Avoid prolonged exposure to the sun, especially during peak hours (between 10 a.m. – 4 p.m.)
- Wear protective clothing, such as long-sleeved shirts, hats, and sunglasses (extra bonus if the clothing has UPV protection!)
- Apply sunscreen with SPF of at least 30, and make sure to reapply every two hours or after swimming or sweating
- Avoid tanning beds and other artificial source of UV radiation
- Perform regular skin self-exams and schedule annual screenings to detect skin cancer types early
By taking these steps, you can help protect your skin and reduce your risk of developing non-melanoma skin cancer.
If you have any concerns about your skin or notice any changes, be sure to talk to your health care provider right away. With early detection and treatment, most cases of non-melanoma skin cancer can be successfully treated.
Interested in learning more about the treatment options available for non-melanoma skin cancer? Read more on the Sensus blog.
