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Expert Q&A

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Could my new 'freckle' be another basal cell carcinoma?

Asked by Paula, Illinois

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I have basal cell carcinoma. I have had two surgeries on my face. I have had a few frozen off as well. Was to go back to the doctor to get a checkup on the ones he has frozen off. I have canceled every appointment since then. I am just tired of always getting cut on and things frozen off. I always seem to get bad news every time I go. Now, I have noticed a new light brown spot on my face. It looks like a freckle. Yes, I do have them and also am a redhead. I'm 35. So I don't think I'm still getting freckles. I used to tan seven days a week 365 days a year. I always went 25-30 minutes a day. I was just wondering what that spot might be. It's the size of a pencil eraser. Can this cancer spead to my organs'? I told my husband that I would listen to you! He's very TICKED at me for not listening. Thanks for your time.

Expert Bio Picture

Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear Paula:

Basal cell carcinoma of the skin is one of the most common cancers in the U.S. We often talk about lung cancer as the most common non-skin cancer in the U.S., because basal cell of the skin and squamous cell carcinoma of the skin are the most common cancers in the U.S. Basal and squamous cell cancer are not nearly as deadly as lung cancer, because treatment can be highly effective when the cancer is detected early. I encourage you to talk with your doctor about your concerns and stick with some type of surveillance and treatment.

These cancers often present as discoloration and scaling and can cause ulceration or sores. They can get very large and unsightly. They can also metastasize or spread to internal organs and cause organ dysfunction leading to death.

Like the other skin cancer, melanoma, these diseases are very much related to sun exposure and sunburn. Fair-skinned people and people who have freckles and/or red hair are especially at risk. Someone with basal cell is also at increased risk for squamous cell or melanoma. In someone who has significant risk factors, I suggest a good relationship with a dermatologist or a family practice or internal medicine specialist who is comfortable with taking care of these skin diseases. Removal of suspicious lesions as your dermatologist is doing is clearly the thing to do and it does help decrease risk of systemic spread of the disease. Many people have small lesions burned or cut off several times a year. It is an inconvenience but it truly can be beneficial.

Clearly the best approach is to avoid sun exposure and especially sunburn. A sun block or clothing should always be used to keep sun off the skin. Attention should be paid to the scalp; a hat with a wide brim should be used to protect the scalp and face.

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