Basal cell carcinoma (BCC) is the most prevalent type of skin cancer, making up nearly 80% of all cases of non-melanoma skin cancer. While the term “cancer” can be alarming, BCC usually has a very favorable prognosis. Most cases of BCC are cured without serious complications, and with early diagnosis and appropriate treatment, most people diagnosed with BCC should be able to live healthy lives.
This article will examine the prognosis of basal cell cancer in depth: survival rates, recurrences, treatment outcomes, and prevention strategies—to help patients and their caregivers understand what to expect once diagnosed.
Know Your Basal Cell Carcinoma
Basal cell carcinoma (BCC) originates in the basal cells found in the deepest epidermal layer (the outer layer of skin). Most commonly, this cancer occurs after prolonged exposure to ultraviolet (UV) radiation from the sun or tanning beds. BCC typically is located in an area of the body that regularly is exposed to the sun, such as the face, neck, scalp, ears, and shoulders.
Basal cell carcinoma is different from aggressive cancer types because it generally grows slowly and seldom metastasizes (spreads) to another part of the body. But, if left untreated, BCC can grow into surrounding tissues, causing disfigurement and functional loss; especially when located in areas near the eyes, nose, or mouth.
Prognosis Summary: Survival Rates are Very High
Basal cell carcinoma has a great prognosis. In summary, dermatological studies and cancer organizations (e.g., the American Academy of Dermatology and the Skin Cancer Foundation) say that:
- The 5-year survival rate for localized BCC is almost 100%.
- Metastatic basal cell carcinoma occurs in less than 0.1% of cases and is exceptionally rare.
- Most BCCs treated early have cure rates greater than 95%.
In short, a diagnosis of basal cell carcinoma with early detection and appropriate treatment, is rarely life-threatening and frequently completely curable.
Factors That Influence Prognosis
While the general outlook is good, individual prognosis can vary based on several factors:
- Tumor Size and Depth
Smaller and superficial tumors are easier to treat and are less likely to recur. Larger or deeply invasive tumors may require more aggressive treatments and carry a slightly higher risk of recurrence or complications.
- Tumor Location
Tumors on the mid-face, around the eyes, ears, nose, or scalp are considered high-risk locations due to the complexity of treatment and higher recurrence potential. These areas often need more precise surgical approaches, such as Mohs micrographic surgery.
- Patient Age and Health
Recovery may be more difficult for seniors or others with compromised immune systems but many BCCs are still highly treatable even at an older point in life.
- Previous History of Skin Cancer
Patients that had BCC previously are more likely to have another BCC which can impact long-term management and monitoring.
The Chance of Recurrent Skin Cancer
Although basal cell carcinoma is nearly always curable, it can recurrence often if:
- The tumor is incompletely removed
- The histological subtypes were aggressive
- The inadequate efficacy
- High-risk locations (e.g., face, ears, nose)
Recurrence data suggest:
- Around 5 to 10% of BCC will recur after treatment
- Patients who have one BCC have a 30 to 50% risk of developing another BCC within 5 years.
- Recurrence will usually happen at the same site or other sun-exposed sites
Regular skin examinations and follow-up appointments will help detect recurrences sooner and treat those recurrences sooner.
Long-Term Management and Prevention
Upon successful treatment of basal cell skin cancer, patients should continue to engage in ongoing strategies for skin health to help decrease their risk for recurrence and new skin cancers:
Ongoing management tips:
- Use broad-spectrum sunscreen every day (SPF 30 or greater)
- Avoid tanning beds and limit exposure to the sun
- Wear protective clothing and wide-brimmed hats
- Conduct monthly skin self-exams
- See a dermatologist every year or more, as directed.
Psychological and Cosmetic Effects
While basal cell carcinoma is not usually life threatening, it can cause psychological and cosmetic concerns, particularly for lesions located on the face or neck in visible areas. Since basal cell carcinoma is usually treated early, treatment may result in less scarring and potentially less impact on appearance. Patients with larger or disfiguring lesions potentially may benefit from reconstructive procedures or retraining emotional support, including counseling.
Conclusion
Basal cell carcinoma has one of the most favorable prognosis in all of the cancer modalities. Basal cell carcinoma is highly treatable, and when diagnosed and treated early, can have an outcome of almost 100% survival. Staying on top of diagnosis, treatment, and follow-up is important to having the best outcome.
Recurrence is possible; however, diligence with dermatological follow-up and sun safety practices can manage responsive diagnosis and BCC treatment. In the same light, for most of our patients, basal cell carcinoma is not a life sentence, but rather a reminder to practice better skin health habits, sometimes called, smarter or safer skin behaviours, for life.