Basal cell on face - how to get biopsy?

[Zuppla]

Hi everyone. I had a ''mark'' on face appear in Jul/August. Went to doctor in September, saw dermatologist in October who thought it suspicious - but am now failing to get NHS referral appointment for hospital treatment. I need a biopsy. Everything is booked up. I am waiting to get on ''waiting list''. I had a basal cell on nose removed 12 years ago in Dubai and although I had to pay - it was dealt with very quickly and not that expensive. This new one is near old one. I am concerned having read cases on face book skin cancer site about how extensively growth can be under the skin. Does anyone know which NHS London hospitals do private skin cancer treatments? Thanks

[Hidden]

The short answer is all of them, probably. but I’m confused by your post. Why didn’t the original dermatologist do a biopsy? If they were a private practitioner, why not go back to them if you want private care? To be precise, NHS hospitals don’t “do” private care, but they often have a facility in which their consultants can offer private practice. This isn’t really any different from seeing someone in their private rooms elsewhere. You could just see a plastic surgeon who specialises in skin cancer and who will be able to advise about its removal which may be a little more complex if it is very close to the old one. Whoever you see would probably welcome sight of your lab test report from Dubai. Alternatively ask your GP to request an expedited appt in the NHS. BCCs are common and much lower risk than other types of skin cancer and grow very slowly and so are not seen as quickly as other types, which is probably why you feel you have waited a bit.

[Zuppla in reply to Hidden]

Thanks for reply. My NHS GP referred me to an NHS dermatologist at another nearby NHS Health Centre as my one did not have one. I also was expecting him to do biopsy but he said he did not do that -just examination -that was October. (the GP had already said she thought it was a basal cell so I do not know why she did not just refer me to a treatment for biopsy). Since then I have been waiting to get on waiting list for Dermatology at St Mary's Hospital, Paddington but there are no appointments available and once on waiting list I was told it can take 15 -18 weeks for actual appointment. I have phoned frequently trying for a cancellation. I found out yesterday from another hospital's reply to my enquiries that Guys Hospital do have Head and Neck Oncology private treatment so have emailed asking for appointment as it seems this condition comes under that department. I do not have the details of my treatment 12 years ago in Dubai as I was not expecting to need it. There are Facebook groups for skin cancer and it seems getting NHS appointments are quite difficult if it is not melanoma.

[Hidden in reply to Zuppla]

Hi. Thanks for the explanation. Yes skin cancer on the face would be within a H&N oncology team's remit (although they will do much other stuff too). Getting appointments for melanoma and SCC is pretty quick even in the NHS, as you say: its BCC that has the wait because it never spreads (except in very rare circumstances) and grows very slowly, so changes little, even in the space of a few months. In fact some people don't even think it should be called skin cancer, because it is unnecessarily alarming, although technically it is malignant and should usually be treated as it can eventually become larger and deeper.

In the first instance you would benefit, I suspect from a confirmed diagnosis (either a biopsy or a confident clinician). Then you can decide whether to stay as a private patient or revert to the NHS for your definitive treatment. If it is very close to the original, it could possibly be a bit of that which wasn't fully removed at one edge (hence the question about your lab result).

In general, it's a good idea to keep a copy of ones private care records and results because it can be hard to access them in the future, particularly, but not only if the treatment was abroad.

I hope it all gets sorted for you.

[Zuppla in reply to Hidden]

Thanks very much. I need to go to France but have been delayed by this matter - that's why I want to get a biopsy ASAP. I had previous basal cell for 2 years by the time I had it treated and had a large section of my nose cut away. It had spread quite a lot.

[Hidden in reply to Zuppla]

My imprecision. Sorry. By “never spread” I was referring to metastasis (ie spread elsewhere in the body). They do usually get bigger by slowly “spreading out”: in fact by slowly involving the normal tissues around the edge and underneath. They sometimes also form an ulcer in the middle, which can develop a scab on it. This is why they used to be called “rodent ulcers”: slowly nibbling away around the edges. To be as certain as possible of removing it all, a rim of normal tissue is removed during surgery as well. That means that a bigger bit of tissue is taken away than people often expect.

Sounds like you would be best served by having a biopsy privately to get to a plan quickly and then arranging any treatment around your travels.

[Hidden]

Know the feeling. If you look up private clinics such as Nuffield and Bupa you can pay for consultants fees and treatment. I had a photoscan as I was so worried about a lesion which had grown. The photoscan was through a pharmacy. The tests were sent to a dermatologist and the results were then checked and a recommendation was made to see the GP. I had visited the Gps for three years. They did not recognise the symptoms of melanoma. I had stage 3 and it was caught because of the paid photscan. I had one biopsy and thought all was well. I had to have another..since then I have good preventative treatment.

Basal cell cancer should be urgently attended. An NHS clinic should be able to refer you to a skin clinic for a scan. I could not explain that my family had a history of skin cancer. They did not ask and were not interested. You have to see a nurse may be first, and explain to him her that you have a history of skin cancer and want an urgent referral. You ask them to dicuss a referral with the GP. If your doctors are too busy and are fobbing you off this is vile. The Mole clinic at Argyll street London and at at 7 Moorgate London are listed with call numbers for contact. I looked up pharmacists with mole scanning facilities and The Mole clinic came up with branches in London. Am sure there are other chemists and pharmacies that have a mole scan and Alphega website has a location of branches throughout London. I had mine through an alphega linked chemist.

[Zuppla in reply to Hidden]

Sorry to learn of your experience. Hope the treatment you had is effective. I am going to make some phone calls tomorrow to try to get private appointment for eventual biopsy ( now holidays are over) - as nothing has come through from NHS.

[Hidden in reply to Zuppla]

Hope you are successful. The major teaching hospitals such as Guys and St Thomas have websites which list all their consultants and specialties. You can find their names and then look at the main private centres where they work as well as for the national health. I had a suspected basal cell carcinoma and was prescribed some caner cream. It has disappeared. I have increased vitamin d3 and k and zinc andiron levels in my diet, so think that may have helped as well. I did have surgery, for many lesions along the spine and it was successful. You have to fight for treatment where we live. Hope you will be fast tracked.

[Zuppla in reply to Hidden]

I sent email to Guys re. private consultation (with anybody) just before Xmas but got reply they were closed till 6/1/20.

[Hidden in reply to Zuppla]

Yes that's standard. There are others.Kent and Sussex hospital ,St Georges Tooting, Royal Free and Middlesex. Best of luck