What Are the Odds of a Basal Cell Carcinoma Metastasizing?
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.
Some Considerations
Logic says that if left untreated, it will metastasize if the patient lives long enough.
The bump near the nostril is an early BCC. KarmoutsosV, CreativeCommons
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.
Closing Thoughts
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.
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Top image: Shutterstock/Dermatology11
Sources:
cdc.gov/cancer/skin/statistics/index.htm
mdedge.com/cutis/article/67545/nonmelanoma-skin-cancer/extensive-basal-cell-carcinoma-probable-bone-metastasis
dermatologytimes.modernmedicine.com/dermatology-times/news/modernmedicine/modern-medicine-feature-articles/metastatic-basal-cell-carcino
sciencedirect.com/science/article/pii/S019096220701328X
pediatricsconsultantlive.com/articles/multiple-basal-cell-carcinomas
jamanetwork.com/journals/jamadermatology/fullarticle/2478036
dermatologytimes.modernmedicine.com/dermatology-times/content/tags/advanced-basal-cell-carcinoma/role-dermatologist-diagnosing-managing-?page=full
Cause of Sudden Pain in Dog Ear Many Weeks after Mastectomy
That little dog ear has caused you no problems but suddenly it’s painful—many weeks after your mastectomy.
What could this mean? First of all, even though the pain may have a sudden barb-like quality, there’s no reason to panic – assuming that you’re many weeks out from your mastectomy and have not had any infections or other complications. (more…)
Dread Turning 50? How to Celebrate the Big 5-0 & Feel Young
Are you becoming increasingly despondent because your 50th birthday is coming up?
It’s one thing to hear people tell you things like, “Some people never make it to 50,” or, “Pretend a decade is 12 years; you’ll be forty-ten!” (more…)
Can a Mole Be Stretched and Permanently Lengthened?
A mole that appears to be elongating or stretching out may make you fear melanoma.
So in an attempt to reassure yourself, you convince yourself that normal moles can be stretched permanently if the skin has been stretched. (more…)
Mole Grew Back Rapidly After Shave Biopsy Was Normal
You recently had a mole removed with a shave technique; the biopsy was normal; and now the mole is already growing back quite fast.
Melanoma could very well be the first thing that pops into your mind, as you did not expect the mole to grow back, let alone so quickly, after a shave removal. (more…)
Maximum Number of Moles that Can Be Removed at the Same Time
Your body is peppered in moles and you’re scared of melanoma or just hate the look, so just how many of your moles can be removed at the same time by a dermatologist? (more…)
Can Melanoma Grow Inside a Pimple?
What makes the question of can melanoma grow inside a pimple even more confounding is that there are some melanomas that can easily pass for a typical pimple.
Melanoma Growing Inside a Pimple
“Melanomas and pimples (acne) are two completely unrelated skin diseases,” begins Estee Williams, MD, a board certified medical, cosmetic and surgical dermatologist and assistant clinical professor in dermatology at Mount Sinai Medical Center.
She explains, “It would be a rare coincidence if a melanoma were to grow within an ordinary pimple.”
Can pimples cause melanoma?
Never. A pimple, no matter how many you have or how “bad” your acne is, will never raise the risk of melanoma.
“I do want to mention that any ‘pimple’ that does not heal after one month or so should be checked by a dermatologist since, sometimes, melanoma can look like a red bump and be mistaken for a pimple,” says Dr. Williams.
The type of melanoma that often looks very much like an innocent pimple is the nodular type, below.
Basal cell carcinoma, the most common cancer in the world, can also easily look like a pimple – but its development is never related to the presence of pimples or acne.
Do not confuse the concept of “cause” with “arise within by coincidence.”
A melanoma can grow anywhere on the skin. A pimple is not protective against DNA mutations that lead to cancer.
Thus, check your pimples – or rather, what appear to be benign blemishes – for suspicious signs, which, as Dr. Williams mentioned, include inability to heal.
If a melanoma is actually growing inside a pimple, this is a coincidence only.
Acne can obscure visible signs of any skin cancer, so take extra care to inspect portions of your skin that are covered with acne.
Dr. Williams strives to be at the forefront of her field, being active in local, national and international medical and cosmetic dermatology conferences.
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.
Can Bra Strap Irritation Turn a Mole into Melanoma?
If your bra strap keeps irritating a mole, can this make it turn into a deadly melanoma?
Many women are worried that continuous irritation from a bra strap can cause a mole to develop into melanoma. (more…)
A Natural Way to Make Your Period Come 2 Weeks Sooner?
There’s a way that just might induce a period two weeks sooner than when you’re expecting it.
It worked for me, though at the time, I didn’t know it was going to happen.
Normally, my period had intervals ranging from 24 to 32 days.
There were a handful of intervals between 21 and 23 days, but most were 26 to 30 days.
Some years ago I arranged to go on a trip to Hawaii for 10 days with my parents.
When my parents told me the departure date, I immediately checked it against the time range for the start of my next menstrual cycle.
I was mortified to learn that day 26 would be the first day of the Hawaii trip!
This meant that if my period came at any point during its typical interval range, the entire cycle would be during my Hawaii vacation!
I was livid. For the next two weeks, I just fumed over this. To have an entire period while vacationing in Hawaii would totally ruin everything.
It’s not that I planned on going swimming. I didn’t. But due to vaginismus, I was not able to use a tampon.
I was anticipating:
• Hassling with always having sanitary pads on me to prevent soaking.
• Worrying I’d be somewhere where it wasn’t convenient to just traipse off and change a pad, like on a boat for a whale watching excursion or at Disneyland.
• Agonizing abdominal cramps with the potential for confining me to bed for several hours.
• Nausea, possible vomiting.
• Low backache, upper leg ache.
Every day that got closer to the departure date, I grew increasingly infuriated. How could this happen to me, with this once-in-a-lifetime opportunity?
And no, it was impossible to change the date.
I mean really, I was p’d to no end.
Then I began spotting. A few days later I was flowing: my period! It was 14 days after the first day of my previous menstrual cycle!
This was unheard of. Other than the two week headstart, there was nothing remarkable about this menstrual cycle. It felt and behaved like any other period.
I had stopped flowing by the time my vacation began. I’ll never forget sitting on the plane on the way to the islands, still in disbelief that I would be free of the burden and pain of my menstrual cycle.
What made my period come two weeks sooner?
Common Sense 101 tells me that my fury over its projected coinciding with my vacation somehow altered my body chemistry.
It seems that the mind—the amazing machine it is—reset my hormones so that my next period would start two weeks sooner than usual.
I’m postmenopausal now, and this two week sooner period occurred many years ago.
So since then, there were many opportunities for this odd event to repeat itself — if it was just a coincidental fluke, that is.
But it never repeated itself. I can only conclude that my frequent stewing over my menstrual cycle ruining my vacation triggered hormonal changes in my body: mind over matter — without my consciously making this happen.
Nevertheless, if you’re anticipating menstruation coinciding with a planned vacation — you’ll want to discuss solutions with your OBGYN.
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.
Knee Pain Using Staircase but not Running: Cause, Solution
Isn’t that the oddest thing:
Your knee hurts climbing stairs but you can run all day long without any pain.
There’s a condition that can explain this.
“Chondromalacia, a degeneration of the underside of the knee cap, is often suspect,” says Dr. Tom Carpenter, corrective exercise specialist, certified personal trainer and chiropractor, inventor of Stand Corrected™, a portable harness-like stretching tool that helps alleviate back, neck and shoulder pain.
Chondromalacia is the wearing down of the cartilage located under the kneecap and is also known as “runner’s knee.”
Another name is “jumper’s knee,” as it’s no secret that volleyball and basketball players sometimes develop chondromalacia. But you need not be a jumping athlete to get this condition.
When the cartilage wears down, there is less cushioning of the joint, resulting in a dull aching type of pain under the kneecap.
Chondromalacia pain is not sharp, piercing or stabbing, but can range from a weakly dull ache to a strong ache. I know; I’ve had this condition, and I’ve cured it.
But in my case, it was running that brought on the knee pain, yet while climbing stairs — even bounding up steps two at a time — was painless.
Pain in the Knee Climbing Stairs
Freepik.com, jcomp
The increased flexion or bending of the joint forces the kneecap to glide up and down over the thigh bone (femur) more so than when you’re running.
For some people with chondromalacia, this will result in discomfort.
There are those especially unlucky people who experience pain with both climbing stairs and running.
In fact, there’s a third motion that chondromalacia infamously affects: kneeling so that your butt is against your ankles — a common position when gardening, in martial arts or in yoga. Even a deep squat can incite pain in some individuals.
Freepik.com
The cartilage is supposed to be smooth, and when it is, there is no pain.
Sometimes the cause of chondromalacia cannot be pinpointed, including in athletes who develop it gradually over time.
In my case, my first bout with chondromalacia was when I slipped on wet grass at age 17 when running to a base during softball.
The other knee developed it in a gradual fashion with no definitive cause.
You’re at risk for chondromalacia if you do a lot of running and/or jumping, and you already have less-than-ideal tracking of your patella (kneecap).
Additional Risk Factors
• Weak quadriceps muscles
• Hamstrings disproportionately weak, relative to quadriceps. A weightlifter may neglect hamstring workouts and focus too much on building the quads.
• Obesity
Very Effective Cure for Chondromalacia — Works Like a Charm
Leg extensions done against resistance will cure or at least really improve chondromalacia for many people who are patient and committed.
To get the ball rolling, sit on a chair that’s high enough so that your feet are not touching the floor.
Ideally the chair or stool will allow you to bend your legs further back so that your shin bone is past vertical.
Extend (straighten) both legs at once, aiming to get them parallel to the floor, but do not hyperextend. Toes should be pointing to ceiling (feet perpendicular to shins).
Lower to the start position. Repeat 10 times for three sets. Once you can do these without pain, move on to a leg extension machine (you’ll need to join a gym) where you can lift against resistance, beginning with the lightest load possible.
In short, a very effective treatment for chondromalacia is weighted leg extensions.
George Stepanek
This strengthens the quadriceps muscles, which in turn yield greater support to the knee. In my case the condition was outright cured.
However, you may have to do leg extensions for the rest of your life, or the chondromalacia may return.
But hey, with lifelong leg extensions, you’ll get shapelier and firmer legs!
While you’re rehabbing, avoid jumping, running or other activities that aggravate the knee pain.
Second Exercise for Chondromalacia
• Place a fitness ball against a wall.
• Stand back against it, back upright (don’t lean forward).
• Have feet out in front of you, shoulder-width apart, legs straight, wearing supportive footwear.
• Lift front of feet off floor, keeping legs straight, so that only your heels are in contact with the floor; then place front of feet back on floor.
• Repeat 20 times. Do three sets.
If these two exercises don’t work, a physical therapist can help you.
Being overweight is an impediment to recovering from chondromalacia, so it’s important to lose excess body fat.
Dr. Carpenter recommends ice and rest, but keep in mind that you will need to inherently improve the integrity of the joint with the right exercises.
In addition to the above, an overall fitness regimen is your best weapon against pain in the knee when climbing stairs but not during running.
So if you’re an avid runner who hasn’t been strength training, it’s time to strength train.
In addition to the leg extension do hamstring curls, leg presses, walking lunges (as tolerated) and half-squats — in which your thighs are parallel to the floor.
There’s no need to go deeper if it hurts your knees.
Never try to “run through” knee pain if your chondromalacia begins acting up when running.
Additional Causes of Knee Pain when Climbing Stairs but Not During Running
“If the pain occurs going down stairs, it could be an ACL, patellar tendon or arthritis issue,” says Dr. Carpenter.
As for pain in the knee when going up a staircase but not when you run, Dr. Carpenter says that “other causes should be considered, such as an imbalance of the supporting muscles involved with the knee, over-tightening of the IT band, Osgood-Schlatter disease, displacement of the kneecap which could be related to an arch problem of the foot, or bursitis in the knee.”
Photo credit: Aleesia Forni
