Basal Cell Carcinoma (BCC) is the most common type of skin cancer, originating from basal cells in the skin’s outermost layer, the epidermis. While generally slow-growing and rarely life-threatening, BCC does not resolve on its own and progressively worsens if left untreated. Early detection and treatment are important to prevent serious outcomes.
Local Growth and Tissue Destruction
When basal cell carcinoma remains untreated, it expands locally, invading the surrounding skin and underlying tissues. The tumor can erode into cartilage, bone, nerves, and blood vessels over time, leading to significant local damage at the primary site. This growth process is slow but relentless, meaning the tumor continues to advance.
As the carcinoma grows, it can become a raised lesion, sometimes with visible blood vessels, or present as an open sore that does not heal. This invasive growth displaces and destroys normal cells, physically disrupting the skin’s architecture. The lesion may ulcerate and bleed, leading to persistent open wounds that are difficult to treat.
Impact on Function and Appearance
The local growth and tissue destruction caused by untreated basal cell carcinoma can lead to significant functional impairments and cosmetic issues. The specific problems depend heavily on the tumor’s location. For instance, a BCC near the eye can invade the orbit, potentially impairing vision or leading to blindness if treatment is delayed.
If the tumor is located near the nose or mouth, its continued growth can affect critical functions like breathing, eating, or speaking. Untreated BCC on the ear can result in disfigurement or hearing issues. Beyond functional compromise, the visible nature of skin cancer, particularly on the face, means that untreated BCC can cause severe scarring and disfigurement, leading to psychological distress.
The Risk of Metastasis
While basal cell carcinoma is known primarily for its local invasiveness, there is a very rare possibility of it spreading to distant parts of the body if left untreated for an extended period. This metastasis can involve distant sites such as lymph nodes, lungs, or bones. The incidence of metastatic BCC is exceptionally uncommon, estimated to be less than 0.1% of cases.
Despite its rarity, the risk of metastasis increases with prolonged neglect and extensive local disease. When metastasis occurs, it represents a severe form of the disease. The prognosis for metastatic BCC is poor, with a median survival of approximately 8-14 months after diagnosis of distant metastasis.
Complexity of Treating Advanced Cases
When basal cell carcinoma is left untreated and progresses to an advanced stage, its removal and subsequent reconstruction become more complex, invasive, and potentially disfiguring compared to early intervention. Larger, deeper tumors necessitate more extensive surgical procedures. This can involve tissue removal, often requiring skin grafts, flaps, or the involvement of multidisciplinary surgical teams, such as plastic surgeons or ophthalmologists, especially for tumors on the face or near sensitive areas.
Treating neglected, advanced BCC carries an increased risk of complications, including infection, nerve damage, and greater disfigurement. The recovery times associated with these extensive procedures are longer and more arduous. Early detection and removal simplify treatment, often allowing for less invasive procedures with better cosmetic and functional outcomes.