Basal cell skin cancer is common and curable

By , Herald-Tribune

/ Monday, September 17, 2012

Editor’s note: Dr. Paul Donohue’s column, long a popular feature in the Sarasota Herald-Tribune, now has an online home, as well. Check out the medical questions and answers Mondays through Fridays on Health + Fitness. CLICK HERE TO READ MORE DR. DONOHUE COLUMNS.

DEAR DR. DONOHUE: I have just been diagnosed with a second basal cell cancer on my forehead. I haven’t seen this discussed in your column. I wonder if you will tell me about basal cell cancers. Is there a way to avoid them?

Dr. Donohue

I am treating mine twice a day. I wash it twice a day with soap and then put on polysporin ointment and cover it with a Band-Aid. How long will it take to dry up? — J.B.

ANSWER: Who made the diagnosis of basal cell cancer? Was it a doctor? Who prescribed the treatment? It’s not one of the standard treatments. Polysporin is an antibiotic used for infected skin.

Basal cell skin cancers are the most common kind of skin cancer. They most often occur at older ages, happen to those with fair complexions and are closely related to the level of lifetime sunlight exposure with its ultraviolet rays.

These cancers arise from the lowest layer of skin cells, the basal layer. At first, they are red, scaly, slightly raised areas of skin about the size of a mosquito bite or larger. Most of the time they appear on the face. As time passes, an ulcer (an open sore) forms, and the cancer grows larger.

Removal of the cancer is the proper treatment, and that is done in a number of ways. It can be dried up with electric current (electrodesiccation), frozen, surgically removed or treated with a laser. A cream containing 5-fluorouracil, applied twice daily, for three to six weeks or more is another approved method.

Mohs surgery is a special technique in which thin slices of the cancer are cut and immediately examined with a microscope to find any cancer cells. Removal of slices continues until no cancer cells are seen.

A dermatologist is the doctor to see to confirm the diagnosis and help you choose the appropriate treatment.

For prevention, always apply sunblock to your face when you are outside, even briefly.

Electrodessication, freezing and surgery get rid of the cancer immediately. Healing takes a couple of weeks.

DEAR DR. DONOHUE: I had a cataract operation with replacement of both eyes’ lenses, and the operation cleared my vision dramatically. Recently, my vision became less clear. The capsule that holds the artificial lenses in place clouded up. My doctor treated me with a laser. It took only 20 minutes. You might want to discuss this in your column. — W.W.

ANSWER: What many people call a second cataract really isn’t a second cataract. A cataract is a smudge on the eye’s lens. The lens is directly behind the pupil. It focuses light on the retina for a clear image. When the clouded lens is removed, its backmost part, the capsule, is left in place to support the artificial lens. Often, cells grow on the capsule and vision blurs — the so-called second cataract. A laser beam clears the capsule of those cells, and vision is restored. As you say, it’s a quick and painless procedure, done in the doctor’s office

DEAR DR. DONOHUE: Will you explain a neuroendocrine carcinoid tumor? I am 59-year-old woman who recently had a small one removed from my right lung. I am confused about my prognosis. — J.H.

ANSWER: “Neuroendocrine” indicates that the tumor is made up of cells that resemble nerve cells, and the “endocrine” part indicates that the tumor produces hormonelike materials; serotonin is one of them. Neuroendocrine tumors, when they release their hormone products, can cause carcinoid syndrome. That consists of facial flushing, diarrhea, asthma-like attacks and damage to valves on the right side of the heart. Not all tumors bring on such symptoms. Yours was one that did not. A lung carcinoid neuroendocrine tumor has a low incidence of spreading to other sites and a low incidence of causing carcinoid symptoms. Your tumor was small and caused no problems. That bodes well for you. In all likelihood, you are cured.

I can’t reliably make such a statement firmly, since I don’t know all the facts of your case. The only one who can give you a definite answer is your doctor or the doctor who removed the small tumor.

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Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from

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