There actually are cases in which basal cell carcinoma, sometimes called a non-spreading cancer, has metastasized to the lungs, bones and other crucial parts of the body.
You’ve probably read that basal cell carcinoma “can’t spread” or “doesn’t spread,” but does cause “local destruction” if not treated.
But basal cell carcinoma CAN spread — and kill.
“Unlike melanomas, basal cell carcinomas (BCCs) usually do not metastasize but instead spread locally,” says Dr. Tess Mauricio, MD, FAAD, a leading board certified dermatologist from Stanford University Medical School and CEO of MBeautyClinic.com.
“However, if BCCs are allowed to spread without treatment, there could be a chance for metastasis,” warns Dr. Mauricio.
What are the chances of basal cell carcinoma metastasis?
The chances, in terms of percent, have not been determined. However, check out the following:
Metastasis of basal cell carcinoma (BCC) rarely occurs. Few cases have been reported in the literature.
…the occurrence of BCC metastasis is exceedingly rare, with an average rate of approximately 0.03%, typically involving a large, long-standing, locally destructive, recalcitrant tumor of the head or neck.
Cutis, July 2007
To put this in more perspective, here are intriguing excerpts from DermatologyTimes (April 2010).
A search of the current literature shows that only about 350 cases of metastatic BCC (MBCC) have been reported.
However, with 1 million new cases of BCC every year in the United States alone, Dr. Giannelli says it is very hard to believe, and highly unlikely, that these metastases do not occur more frequently than they are actually reported.
From the Journal of the American Academy of Dermatology (August 2008):
Basal cell carcinoma (BCC), the most common human malignancy, metastasizes in 0.0028% to 0.5% of cases, usually to the lymph nodes, lungs, bones, and skin.
After metastatic spread of BCC, survival averages 1 to 2 years.
Logic says that if left untreated, it will metastasize if the patient lives long enough.
Nobody knows just how many people, who never sought medical attention for the BCC growing on their face, behind their neck or on their scalp, would have eventually been diagnosed with a metastatic basal cell carcinoma had their lives not been cut short by a car accident, homicide, pneumonia, hip fracture, primary breast cancer or primary prostate cancer.
Think of elderly people with no health insurance who notice an early stage BCC on their already age-ravaged face.
They ignore the lesion, perhaps suffering from dementia, unable to realize that the progressing lesion is eating away at their nose, ear or whatever structure is nearby.
It’s not uncommon for very elderly people to already have benign though worrisome-looking lesions and bruises on their skin.
They may then blow off the developing skin cancer as just another part of aging.
But what about middle aged people (who don’t have age related cognitive impairment) who ignore a BCC until it causes so much local destruction that they finally see a doctor — and by then it has spread?
Again, cognitive and psychiatric issues (not necessarily age related) need to be considered as to why a person would disregard a clearly-worsening lesion on their skin, especially on their face and near their eyes — even if they do not have medical insurance or have a fear of doctors.
“Denial is a strong defense mechanism, which can lead to an amazing delay in seeking medical attention,” says Ted Rosen, MD, in an article about multiple BCCs at pediatricsconsultantlive.com.
He refers to the case below (warning: graphic image), though the 74-year-old patient’s disease was not metastatic.
Basal cell carcinoma is typically included with squamous cell carcinoma (a more serious skin cancer) when it comes to mortality statistics.
BCC is not tracked by central cancer registries, says the Centers for Disease Control website.
Though death from basal cell carcinoma has happened, it is so rare that if you’re ever diagnosed with this skin cancer, it would be quite unreasonable for you to worry for your life – unless you’ve allowed the growth to develop over many years to the point where it has caused gruesome local destruction.
These cancers are very slow growing (can grow 20 years and still not have metastasized), but time lapse doesn’t stop their growth.
Death by basal cell carcinoma does not always mean metastasis.
Locally advanced BCC can actually cause death, not to mention permanent vision loss (depending on original location).
Local destruction can involve infiltration into neighboring bone or muscle, but this does not mean metastasis.
So again, basal cell carcinoma grows at a snail’s pace, but a long-enough time lapse can result in metastasis and even deadly local destruction.
Dr. Mauricio is an internationally recognized cosmetic surgeon and the youngest woman to hold the position of President of The San Diego Society for Dermatologic Surgery.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.