Basal Cell and Mohs Surgery

[Disappointed]

Quote:

Originally Posted by CRLLS From what I read, Mohs is the gold standard of treatments for Basil Cell. I have had 2 occurrences of Basil Cell and both had been removed with Mohs without any reoccurrence. One was in my hairline and hidden, the other was at the tip of my ear lobe and grafting was necessary. According to https://www.mohssurgery.org/blog/ski...er-recurrence/ I'd rather have BCC treated with Mohs and be up to 10X more confidant that it will not reoccur (in the same spot) than use some other, less expensive and less successful method. No matter what method is used, reconstruction may be necessary.

How did they discover the one in your hairline?

[Disappointed]

Quote:

Originally Posted by ronin Had Mohs on the nose over the left nostril. Needed a skin graft from behind the ear to plug the hole (about the size of a button). Graft mostly took, a little scarring noticeable up close but altogether not too bad. Have had 2 other Mohs since (forehead and scalp) plus a couple of non-Mohs cut and stitch procedures along with numerous freezing spritzes. Going for a scrape and cauterize on BCC on the forearm in a week or so. I guess those contests to see who could burn and get the biggest patch of peel back as a kid were pretty stupid. Living near the equator for a couple of years didn't help either. Hope your procedure goes smoothly and you have a super recovery!

How was the one on the scalp discovered?
I had one on the bridge of the nose four years ago. My scalp seems to itch from time to time which never happened before. I am also using Neutrogina T-gel which prevents itching on the scalp.

[CRLLS]

Quote:

Originally Posted by Disappointed How did they discover the one in your hairline?

I found it. I had a constant scab that bled occasionally. My comb would catch on it too. I am prone to hitting my head on things occasionally. They normally heal pretty quickly . This one wasn't from a contusion and wouldn't heal for several months after I noticed it. they took out an area about the size of a quarter. I still have a concave area there. I felt good that the Mohs process looks at the tissue removed and determines if there is any cancerous cells in the periphery. they sometimes need to dig more out and checking before closing the wound. In both my cases, they got it all on the first try.

I had another suspicious area which I had them look at. I told them to take a generous sized razor biopsy so if they found any cancer, maybe they would get it all in that sample. Fortunately, this one was not cancerous.

[MrsHaloFIRE]

Been thru a mohs on the forehead and a huge (deep!) excision on the leg with DH. Mohs was a walk in the park compared to the handsized excision. I think we will insist on mohs next time regardless of location. Bar of soap looking bandage for a while on his head. Only a hint of a scar. Be bold. Head up. It's surgically precise and you are done with it when they close. What a modern time we live in.

[rkser]

I have Squamous Cell Carcinoma on my outside ankle.

Not many brown people get it, but I guess I was the lucky one, no one in my family had any skin cancers.

I am 63 & have lived in Florida for 30 yrs, never used any Sun Screen, & am seeing a Plastic Surgeon next week, will bring up Mohs for sure.
I have had circulation issues in that leg, I just hope the healing wont be a long drawn affair.

Wishing a speedy recovery to OP after surgery.

[Badger]

I'm not sure what the concern is about Mohs surgery. It is so much better than regular surgery that generally removes more tissue to make sure they get all the cancer. I have had 7 Mohs surgeries (upper chest, back, scalp, face and ear. Also 4 regular skin surgeries. No pain during the surgery and minimal to none after surgery.



Take a book to read if after the first round they need to remove a little more to make sure they get it all.



Evidently I have a lot of pre-cancer that has to be monitored. 3 or more visits to the dermatologist each year for the past 20 years or more. Used a variety of treatments on my scalp including Efudex cream which starts burning after a few days as you continue for 3 weeks or more. Very painful. Also had a "Blue Light" treatment that involves a chemical application. Then you wait for an hour or two before an 18 minute exposure to a blue light. That is so painful that they even have a blower with cool air to help get through the treatment. The up side is after staying out of the sun for a few days you are good to go. All of those treatments leave you with looking like you have the plague for a couple of weeks. At least with the Mohs you have one small area covered by a bandage for a few days and you are done.


I've been lucky to have a great dermatologist that keeps on top of all this.



Cheers!

[ronin]

Quote:

Originally Posted by Disappointed How was the one on the scalp discovered? I had one on the bridge of the nose four years ago. My scalp seems to itch from time to time which never happened before. I am also using Neutrogina T-gel which prevents itching on the scalp.

The dermatologist exams my scalp. Sometimes things will scab over and bleed a little. I let her know and she zooms in on it. So far everything except the one on my hair line/forehead has been basal cell. That one was squamous cell.

[kannon]

Quote:

Originally Posted by Peter I'm scheduled for Mohs on my nose this coming Monday. The more I read about it, the more I'm not looking forward to the experience. Will report back this time next week. If I can see past all the bandages, that is ....

Just a lesson learned from me, Moh's on the nose. On hindsight, if had to do it again, would have it done by a plastic surgeon vice a dermatologist. While the dermatologist was specifically trained in Moh's, the cutting required a followup plastic surgery reconstruction. I think if it was all done by a plastic surgeon, the results would have been better and less medical intervention. Just my two cents. Best of luck.

[bmcgonig]

Quote:

Originally Posted by kannon Just a lesson learned from me, Moh's on the nose. On hindsight, if had to do it again, would have it done by a plastic surgeon vice a dermatologist. While the dermatologist was specifically trained in Moh's, the cutting required a followup plastic surgery reconstruction. I think if it was all done by a plastic surgeon, the results would have been better and less medical intervention. Just my two cents. Best of luck.

Many if not all Mohs surgeons are skilled in reconstruction. Of course the skill can vary. Anyway a plastic surgeon can't do Mohs surgery. Has to be a specially trained dermatologist.

I do know of a case where the Mohs guy referred someone to a plastic surgeon after the surgery because he felt that it would be better. So you could possibly do that.

[ronin]

I was fortunate in that I was referred by my dermatologist to another dermatologist who is also a board certified plastic surgeon so it was all done in one (long) session.

[bmcgonig]

I've had a number of Mohs too. Be careful, some of the basal cells come and then disappear on their own. Very strange. But they can be still growing underneath undetected.

I had one excised by regular dermatologist a few years back. It was seemingly gone then it came back two years later. Went for Mohs and what looked like a pimple on top was literally the size of a quarter underneath. I was stunned. It was on my side forehead and he did a great job of stretching the skin to make it now undetectable with no graft. Although the area is still numb three years later.

[pacergal]

Quote:

Originally Posted by VFK57 My wife had multiple basil skin spots removed and one melanoma surgery. However her younger sister (52) needs our prayers because she has only few month to live. Liver cancer quietly spread to lymph nodes, lungs, bones and her oncologist gives her no more then few month. No treatment could do anything. She worked at Stanford and had best medical coverage, planned to retire by 55 on Standford pension but now this. Our family is devastated.

My prayers to your family, so sorry to read this.

[MrsHaloFIRE]

So sorry to hear of the sister's illness. Prayers for your family during this time

[jcretire77]

Two Mohs, One in the middle of my forehead and one on the crown. I am one of the biggest medical babies around, but both of these worked out just fine. The forehead does not look like there was ever anything done. Blended perfectly with normal lines.

Good Luck.

[TeeRuh]

I went to a MOHS specialist for surgery on my nose. He described the rather scary surgery and follow-up reconstruction and then offered the subject alternative. 5 weeks of twice a week radiation. Some pain and bleeding towards the end. Now no evidence of any scarring or discoloration. Would recommend you look into this latest alternative. Supposedly about 95% success versus 98% for MOHS.


t.r.

[bmcgonig]

Quote:

Originally Posted by TeeRuh I went to a MOHS specialist for surgery on my nose. He described the rather scary surgery and follow-up reconstruction and then offered the subject alternative. 5 weeks of twice a week radiation. Some pain and bleeding towards the end. Now no evidence of any scarring or discoloration. Would recommend you look into this latest alternative. Supposedly about 95% success versus 98% for MOHS. t.r.

Given that in mohs they need to keep cutting until no cancer is found i.e., they don't know how far the cancer extends until they test each cut, I wonder how they know how far and wide to aim the radiation?

[Potstickers]

Quote:

Originally Posted by VFK57 My wife had multiple basil skin spots removed and one melanoma surgery. However her younger sister (52) needs our prayers because she has only few month to live. Liver cancer quietly spread to lymph nodes, lungs, bones and her oncologist gives her no more then few month. No treatment could do anything. She worked at Stanford and had best medical coverage, planned to retire by 55 on Standford pension but now this. Our family is devastated.

I'm so sorry. That is a tough reality.

[Potstickers]

Quote:

Originally Posted by kannon Just a lesson learned from me, Moh's on the nose. On hindsight, if had to do it again, would have it done by a plastic surgeon vice a dermatologist. While the dermatologist was specifically trained in Moh's, the cutting required a followup plastic surgery reconstruction. I think if it was all done by a plastic surgeon, the results would have been better and less medical intervention. Just my two cents. Best of luck.

The nurse at the derm's office casually mentioned that some patients with Mohs surgical sites like mine preferred to have a plastic surgeons do the repair. I took the hint, had a consult with a local plastic surgeon, and arraned for the repair to be done the day after the Mohs surgery. Insurance paid for it. Interestingly, the plastic surgeon had me knocked out for the repair -- he said he didn't want his patients talking to him during surgery. My Moh's surgery took out a chunk around the size of a nickel or a bit larger extending up to my cheekbone. The repair took time to heal, but is basically invisible.

There ae some nifty silicone patches you can use after the initial healing to reduce scarring and flatten the area. I wore them at night for several months.

[Dtail]

Had melanoma on my back at age 40. Had regular surgery, but was stitched up by a plastic surgeon.
Nevertheless, have a 4 inch scar now. No issues, as I wasn't going to be a back model anyway.
Understanding that the face surgery is a scarier proposal in one's mind.

[ShadowBloom]

If you choose to see a plastic surgeon, try to see one with a sub-specialty in facial plastic surgery, not a general plastic surgeon who also does breast enhancements and tummy tucks.