Base cell carcinoma

[Chungy]

I have a small base cell carcinoma.

The dermatologist had prescribed a cream which by all accounts sounds like 6 weeks of sore inflamed skin ( it’s on my face between my eyes ) .

I have private health care and I’m wondering if it would be better to have Mohs surgery instead.

Any advice gratefully received.

Sally

[nellie237]

Hi Chungy,

Go for the Mohs. Basal cell grows under the skin (in the basal layer)....so may be larger under the surface.

I had a patch on my rib cage about the size of a pin-head. I saw my GP about it on several occasions over about 6 years until I was eventually referred to an NHS dermatologist who sent me to a clinic (I didn't know until I got there that this would be performed by a GP 'with an interest' but without supervision) for minor surgery to have it removed.

It was a complete fiasco. The GP was asking the nurses for advice on stitching, whilst her favourite CD was playing in the back-ground. The scene was set like something you see in a medical drama on TV, but the nurses rather than the surgeon were directing the action, because the GP was completely clueless/ incompetent,.............but she felt great/important.

10 days later the nurse at my surgery couldn't remove the continuous stitch......the dermatologist refused to surgically remove it.......she was French and very arrogant. When I queried that I had heard that it was important to remove stitches to avoid infection her response was "Pah, either it will come out on its own or it will stay there forever, it doesn't matter. No, I will not remove it."

. .........it got infected (imagine a boil being strangled by fishing line)......finally agreed to send me to 'plastics' who removed the stitch in about 10 seconds.

7 years later it broke the skin again, and I opted for Mohs at St Thomas's in 2014. I now have a very neat six inch scar that you can't really see.

[humanbean]

My mother had a basal cell carcinoma on her face. The NHS were unsympathetic and useless (this was back in the 1980s so nothing changes) and made a horrendous mess of the job of getting rid of it.

Definitely go for the Mohs, in my non-medical opinion, but please do as much research as you can before going ahead so there are no surprises.

[bookish in reply to humanbean]

Can't help but wonder how many of us are autoimmune, which I read raises your risk for basal cell. Suspect I may have one although not yet done anything about it, Dad has now had two, Aunt one, all on faces. Multiple autoimmune and red hair in the family. Never heard of Mohs, so thanks for that. Is it an NHS treatment? Cheers

[humanbean in reply to bookish]

I've never heard of the NHS doing it but I've never looked into it in recent years. I have another relative who had some issue with cancer on her face (although I can't remember the details now) and she went for Mohs done privately because the NHS offered nothing she wanted to live with afterwards.

[nellie237 in reply to humanbean]

bookish humanbean

My Mohs was NHS, but I think I was only given the option because they made such a hash of it the 1st time round, and I think it probably also depends where you live. I live in Herts, and had to go into London for it. Everybody else there was having facial surgery, but I've no idea if they had more aggressive forms. The guy that did mine was a plastic surgeon from Canada who was here learning how to do Mohs.

[Astridnova]

I'm from Australia where basal cell carcinomas are very common and I have had several removed, as have other members of my family. Generally a biopsy is taken in order to make an accurate diagnosis and, if it is a BCC, then a surgeon removes it. If it is on your face, then it is removed by a plastic surgeon. Although these are slow growing cancers, they can be left for too long and provoke metastasis, leading to possibly fatal conditions. Here is a link to a review of the treatment of non-melanoma skin cancers by an Australian GP association: racgp.org.au/afp/2012/july/...

[Pookie50]

Definitely go for Mohs surgery. I have just had my 10th BCC removed below my eye (previous 9 done over a period of 20 years). The Maxillofacial team at my local hospital did an amazing job. Stitches are out and its healing well. In the past I’ve had Mohs at Cardiff and also Exeter hospitals. I was given the cream at one point but it didn’t work and I actually felt quite unwell on it - check out the side effects online if you do decide to try the cream.

I hope it goes well for you whatever you decide to do. In good hands its a very simple procedure.

Best wishes.

[susanmhall62]

I also had Moh's surgery for a small base cell carcinoma at the bridge of my nose this past April. As it turned out it was a lot bigger than the surgeon initially thought. It took three passes to clear the borders and remove all of the cancer and resulted in about a 1-inch scar.

I was being treated with acupuncture for another medical issue at the time and the acupuncturist treated the scar as well. It's barely noticeable. Address it promptly so that it doesn't spread.

As an aside, I was also advised that people with red hair in their families are more susceptible to skin cancer.