I'm sure that there are a lot of people out there with basal and squamos cell cancers out there. What really happens if they never get them removed?
What Happens to a BCC Left Unremoved?
Doctor Answers 15
As others have already mentioned, BCCA is generally slow growing and indolent. However, if given long enough, a basal cell carcinoma on the face will spread locally and can eventually affect nerves and even the brain. Patients with chronic immunosuppression, such as with chronic lymphocytic leukemia (CLL), develop much more aggressive variants. Given the cumulative solar exposure in SW Florida and an aging patient population, I have seen a number of patients with CLL and squamous/ basal cell carcinoma die from skin cancers. If you have an SCCA/BCCA, it should be surgically removed within a reasonable time frame of diagnosis.
Should I let a Basal Cell Carcinoma alone?
Neglecting any cancer is a bad idea. Of the three commonest skin cancers (basal cell, squamous cell and melanoma) if neglected basal cell will take the longest to be fatal. Unlike the other two which spread through the lymphatic vessels and through the blood and lymphatics resulting in higher and quicker fatalities, basal cell spreads locally and invades and destroys local structures. Every Plastic surgeon has seen the horrendous facial destruction of neglected basal cell carcinoma : it leads to facial destruction making going out in public impossible and ends when the tumor erodes into a major facial blood vessel resulting in unstoppable ( and quite messy) blood loss and death.
Please get the basal cell off when it still is a minor surgical procedure.
Basal Cell Carcinoma, Squamous Cell Carcinoma Left Untreated
Leaving either basal cell carcinoma or squamous cell carcinoma untreated is not a good idea. Basal cell carcinoma grows slowly, destroying the normal healthy tissue around it. It can travel along nerves and destroy important structures so it's better to treat it with one of many techniques available. Rarely after years of no treatment or inadequate treatment it can metastasize or spread to other organs.
Squamous cell carcinoma does have a risk to metastasis. The risk is higher for recurrent cancers and cancers that are more aggressive under the microscope. The risk is also higher for squamous cell carcinoma on certain locations such as the lips, ears and genitalia.
There are many good options available for treatment of these skin cancers. Talk to your dermatologist about how to prevent skin cancer, what to look for, and if you develop a skin cancer, what are your options for treatment. The American Academy of Dermatology and the American College of Mohs Surgery has a lot of good resources available to help.
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Does Basal Cell Carcinoma Need Treatment?
Basal cell carcinoma is the most common form of skin cancer. While this rarely spreads to other parts of the body, if it is left untreated it will not go away. These skin cancers will continue to grow and destroy the surrounding tissue, creating a giant sore or ulcer that never heals on the skin. Because the majority of basal cell carcinoma appear on the head and neck, you can imagine how disfiguring these cancers can be if they start growing on your nose, cheek or eyelid. I have had patient lose 2/3rds of their ears to these cancers.
Squamous cell carcinoma also tends to arise in sun exposed areas but can be more aggressive. in 2-6% of cases, these cancers can metastasize and spread to other parts of the body. This is especially true if the squamous cell cancer arises on the lips or ears.
It is for these reasons, I always recommend patients get their skin cancers treated as soon as possible. Treating these cancers when they are small also minimized the extent of surgery or other form of treatment that you need.
The Brutal Truth
The brutal truth about cancers is they never stop growing. Basal cell carcinomas will destroy anything they touch. I routinely see patients whose basal cell skin cancers were neglected leading to a much larger surgery. You cannot see cancer roots by eye - only with a microscope. What you see by eye is often only the tip of the iceberg. During the Mohs procedure, I track the skin cancer and remove all the roots. Squamous cell carcinomas behave similarly but have the added potential to spread to the lymph nodes. Skin cancer should be treated promptly and accurately, most often this requires Mohs micrographic surgery.
Untreated Skin Cancers
It is rare for someone to die from non-melanoma skin cancers. Nonetheless they can be aggressive. If left untreated basal cell cancers can erode deep into cartilage and bone and are very locally destructive. squamous cell cancers can be more aggressive and sometimes can metastasize to local lymph nodes. It is best to treat these as soon as they are diagnosed.
Basal cell carcinoma is a very slow growing malignancy. It's mode of progression is mostly by local destruction of the tissue. This usually happens over a very long period of time (months to even years). There are multiple subtypes of this cancer and the more agressive types can grow faster and even metastasis to lymph nodes in rare cases.
Thus, even though this is not the type of cancer to usually shorten the patient's lifespan, if neglected, particularly in sensitive areas such as facial structures, it can cause significant morbidly or deformity.
They get bigger
In general, not removing it means that unless you die before it becomes symptomatic, spreads, or otherwise causes trouble, you will eventually require a larger surgery, have a bigger scar, in some cases need radiation or chemo, and in the very very very worst cases reach a point where treatment is no longer possible.
In general, you will have a better outcome with fewer complications and lower cost if you get rid of these when they are small.
Untreated skin cancers keep growing
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.