Relapse of basal cell carcinoma
Family doctors regularly face the identification, treatment and counseling of patients with epithelial neoplasms, the most common of which is basal - cellular cancer. Unfortunately, even surgical excision of the primary focus does not always produce the expected effect, andrecurrent basal cell carcinoma. Despite the fact that they tend to grow slowly, with minimal metastatic potential, the effect of predisposing factors contributes to the aggressive development of the tumor of this species.
Why does the disease come back?
The neoplasm, affecting the epidermis, is characterized slowly but steadily to grow into the thickness of the tissue, so the therapeutic intervention is aimed at the complete destruction of all malignant cells. However, it is established that local relapse is a consequence of inadequate therapy. The recurrence of basal cell carcinoma is predetermined by the type of surgery used to treat skin cancer.
Complete eradication is especially important, because when returning, the tumor becomes larger in size and much more aggressive than the primary cancerous lesion.
Most basalts are found at a stage where their diameter is less than 1 cm. As a rule, primary tumors up to 1 cm in size, located on the face and not more than 2 cm. Those that are localized on the body, have a low probability of recurrence.
The risk of relapse depends on several factors that must be taken into account.
- stage of pathology;
- the patient's sex;
- the type of his skin;
- Immunological status;
- individual treatment strategy conducted earlier.
One of the factors contributing to the growth of new formations is the location of the first tumor. To relapse prone include areas of skin of the lips, nose and ears, so these areas should be carefully observed after treatment.
Another aspect that increases the risk of a return to cancer is the presence of keratosis, which is the breeding ground for future tumor lesions. Some studies show that genetics can also play a role in the risk of developing squamous cell carcinoma of the skin, especially the head and neck.
The chances that the disease will return after a certain time increase in people whose age at the time of diagnosis primary tumor is less than 65 years, if the patient is naturally red hair and the initial formation is located on the surface of the upper extremities.
What is the risk of a recurrence of basal cell disease for human life and health?
About 80% of cases of relapse occur in the scalp and neck, and at least 25% belong to the epidermis of the nose. The danger is not only the fact of the repeated activation of the tumor process, but also the need to conduct therapy again. The fact is that the structures of the central part of the face, having cosmetic and functional importance, extremely vulnerable to the destructive effects of radiotherapy, which eliminates basal cell carcinoma.
Tumors of the parotid canal are a particular anxiety, as the structure is expanded inside the skull, than provides access to these tumors to the brain (an aggressive form of therapy is justified in this case).
Recurrent tumors are more difficult to treat, and in comparison with primary, require more aggressive therapies.
The first signs of relapse
Most recurring lesions develop within the first two years after treatment. Symptoms are classified into local and general.
- Basal cell carcinoma often appears as a slightly transparent cone on the skin, although it can take other forms. Neoplasm is formed on those parts of the skin that are exposed to the sun - more often it's head and neck. Superficial cancer lesions are often localized on the trunk and extremities, appearing as a scaling plaque, in appearance resembling eczema or psoriasis. It has a pearl shade and is characterized by soreness, the patient experiences a feeling of tightness of the skin around the hearth.
- Against the backdrop of pathological changes, the patient develops general weakness, insomnia, and a growing pain syndrome.
Simultaneously with these clinical manifestations laboratory parameters change, anemia increases.
Necessary analyzes and examinations
Standard basic examination: the patient is assigned to take a blood test for clinical and biochemical analysis. Visual inspection of the affected area of the skin is performed, auxiliary methods are used to prescribe dermatoscopy and ultrasound investigation of the localization of the alleged tumor recurrence.
In the diagnostic process, the role of histological examination is irreplaceable, because the statement of the correct diagnosis is impossible without determining the exact morphological parameters.
Adequate biopsy is also crucial in assessing the tumor. The tumor growth model is an important information that can not be determined by superficial examination or laboratory types of research - it is possible to establish, only by transferring a fragment of a cancerous tissue for research.
For a better microscopic evaluation of tumor tissue and identifying the type of its growth (aggressive or slow), special histochemical diagnostic methods are prescribed.
Treatment of recurrence of basal cell carcinoma
There is a wide range of approaches to treatment, including standard excision, and from destructive alternatives - cryosurgery, curettage, photodynamic and radiotherapy. What method will be applicable in each specific case - the doctor appoints, proceeding from many indicators of a condition of an organism of the patient. The decision on which therapy to use is better, the oncologist takes into account four factors:
- the size of the tumor;
- data of the histology;
- features of primary basal cell neoplasm.
Many therapeutic alternatives are available for the treatment of recurrence of basal cell carcinoma, but general surgical excision is still considered a "gold standard". Almost all tumors of this species can be cured if the diagnosis and treatment are performed as soon as possible.
Micrographic surgery allows you to remove the lesion without affecting healthy tissue. The process involves translational radial sectioning and inspection of the edges of the defect in real time. The method is preferable because it is able to maintain the sensitivity of the scalp and neck.
Prevention of re-emergence of the disease
After elimination of the primary form of this epithelial tumor, patients should be observed clinically and regularly monitored. Only 50% of relapses occur within the first 2 years after surgical treatment of basal cell carcinoma, 66% after 3 years and 18% after 5 years.
Having undergone a therapeutic intervention, it is necessary to remember that the damaged skin retains its susceptibility to the sun's rays, therefore it is absolutely impossible to expose itself to ultraviolet radiation.
Forecast and how many live such patients?
Ifrecurrent basal cell carcinomanot bypassed, and metastases involved in the tumor process regional lymph nodes, bones, lungs and liver, life expectancy, unfortunately, can not be prolonged. Therefore, having a history of neoplasm of this type, it is important to visit the doctor regularly..