Basal cell carcinoma and melanoma: what to know

Basal cell carcinoma often develops on sun-exposed skin and mainly damages nearby tissue. Melanoma begins in pigment-producing cells and has a greater potential to spread. Their appearance can overlap, so a dermatologist may need dermoscopy and a biopsy rather than relying on a photograph or visual description.

A basal cell carcinoma may look like a pearly bump, a sore that repeatedly crusts or bleeds, or a flat scar-like patch. Melanoma may appear as a new pigmented mark or as an existing mole changing in shape, colour, size or sensation. Neither cancer can be identified safely from colour alone: basal cell lesions may contain pigment, while melanoma is not always dark.

The pathology report names the cancer and describes features that guide management. For melanoma, thickness and other microscopic findings help determine whether staging procedures such as sentinel lymph node biopsy should be discussed. For basal cell carcinoma, subtype, borders, location and whether the lesion has returned influence the removal method.

Arrange a skin assessment if a spot is new, changing, persistently scabbed or not healing. Note when you first noticed it, photograph it in consistent lighting, and mention bleeding, itching or tenderness. Avoid picking or applying corrosive remedies because irritation can obscure its surface without treating a cancer.

If biopsy confirms cancer, ask how the diagnosis, anatomical site and pathology findings shape the plan. Surgical excision is used for many lesions. Melanoma care can also involve staging and, when indicated, systemic treatment; basal cell treatment focuses primarily on controlling the tumour at its site.

Book a prompt appointment for a rapidly changing mole, a growing skin lesion, unexplained bleeding, repeated ulceration, or a mark that looks unlike your other marks. Seek urgent assessment if bleeding will not stop with firm pressure or if a lesion is accompanied by a new persistent lump in a nearby lymph-node area. These features call for examination; they do not establish the diagnosis by themselves.

Ask whether the whole lesion or a sample will be biopsied, when the pathology result will be available, and which report findings affect treatment. If cancer is confirmed, clarify the proposed margins, likely reconstruction, whether staging is appropriate, and how your skin and lymph nodes will be checked after treatment.