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Basal Cell and Mohs Surgery
Old 12-31-2019, 11:48 AM   #1
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Basal Cell and Mohs Surgery

I am facing Mohs in a couple of weeks on my nose and just dreading it. I have done it before and it was not fun and this one might be considerably worse and require extensive reconstruction. I have used a topical cream on it, but the jury is out on whether it worked.

I guess I understand being diagnosed with basal cell at my age (67). My first one was at age 54. But recently both my daughter and daughter-in-law have been diagnosed with Basal Cell, both in their early 30s....and they are advised to have Mohs. These girls used sunscreen all their lives, I did not (not available in my youth). Why are young people getting basal cell.....maybe because people are seeing a dermatologist at a younger age and the dermatologists biopsy everything?

I don't recall my grandparents or parents having skin cancer. My dad was raised on a farm, a golfer in later life and lived to be 96....and if he had basal cell it was never diagnosed or treated.

I am beginning to think that Mohs might be another medical money making machine and everyone who gets diagnosed with a tiny basal cell is sent directly to the Mohs surgeon when a less drastic (and expensive) treatment could be used.
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Old 12-31-2019, 11:55 AM   #2
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My Dad also was a farmer-- outside all his life, red headed and fair skin. He had Mohs x2 and multiple other spots treated with cream or burned off. Luckily the areas with the mohs did not have much scarring.
I definitely would want suspicious spots biopsied to make sure it is not a melanoma.
I see a dermatologist every year and have had a few spots cut and biopsied. So far, so good.
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Old 12-31-2019, 12:35 PM   #3
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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/

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Research has indicated that, among other factors, the type of treatment that is performed affects a person’s risk for future BCCs (within a 5-year period after treatment). For example, the recurrence risk is:
Approximately 10% after surgical excision.
Just under 8% after electrodesiccation and curettage.
Approximately 7.5% after cryotherapy.
Less than 1% after Mohs.
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.
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Old 12-31-2019, 12:58 PM   #4
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DW has had 2 basal cell cancers treated with Mohs surgery. Both her parents died from cancer so we're pretty cautious about it.

As far as us old folks who survived living without sunscreen Yeah but..... My DF was a fisherman and golfer who never used sunscreen, hats or anything else. At the time of his death, at 96, the tops of his ears were missing from all the surgeries to remove cancers.
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Old 12-31-2019, 01:35 PM   #5
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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 ....
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Old 12-31-2019, 02:24 PM   #6
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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 ....
I'm sure it's very individual, but mine went okay. I was shocked when I got home and realized just how large the incision/removal was, but now that it's healed, I can hardly tell anything was ever done. I think mine was caught early and they did get it all on the first pass. I was grateful for that.

As with most surgeries and especially cancer, sucks a lot, but better than the alternative. Good luck.
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Old 12-31-2019, 03:26 PM   #7
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Thanks for the reassurance, Jerry!
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Old 12-31-2019, 03:27 PM   #8
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My first Moh's was on my nose. It was my first dermatologist visit and I had obvious (now) signs of skin cancer. The doctor who did it wasn't confident in a good repair so he sent me to an ENT specialist. I had a "flap" repair, a flap of nearby skin on the nose stretched enough to cover the original spot. Barely visible to me, and no one is looking that close.

While it does seem like the doctors do it at the drop of a hat, Moh's is simply a way to remove as little skin as possible while ensuring all of the cancer is taken. Can't complain about that. I've had a few biopsies come out positive but the biopsy itself had removed all the cancer and I didn't need any further work. And a few more Moh's, including another on my nose, even less visible.

I had an option once to do a Moh's or a plain excision on my arm. I did the excision since it seemed quicker. But the cut was more extensive than my typical Moh's, so I'd probably go with Moh's next time.

It's always fun to go grocery shopping with a big compression bandage on your nose! DW goes in for a nose Moh's early January, so we're all in good company.
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Old 12-31-2019, 03:34 PM   #9
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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 ....
Let me know how it goes
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Old 12-31-2019, 03:38 PM   #10
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I don’t know why I am so freaked out about this Mohs. Maybe I've been looking at too many the scary, gross pictures of forehead flaps done after mohs surgery on the nose. Dr. Google can be pretty frightening.

I have to keep reminding myself of so many people I know who have serious illnesses.

I will survive this.
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Old 12-31-2019, 04:10 PM   #11
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I have an approx 1 inch diam divot on my back shoulder where an early stage melanoma was removed. Same basic principle as Mohs, take enough margin to ensure it is all removed, except the melanoma margins are bigger. I have had 3 basal cell spots removed, but not with Mohs. Just the traditional cut out.
Just tell yourself that getting the cancer removed is better than the alternative of it getting bigger and deeper.
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Old 12-31-2019, 04:15 PM   #12
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DW just had mohs on her nose right by the bridge, which is a difficult spot. Be aware that they cut a little, then you wait while they examine the tissue. Then they cut a little, and you wait. This cycle can continue for quite some time, like over 5 hours for our recent experience. Make sure you take snacks and something to read to occupy your time.
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Old 12-31-2019, 04:30 PM   #13
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I don't know your situation, but do avoid Dr. Google's horrible photos. They may bear no relation to your reality at all! Mr. A had a big round divot cut out of his forehead (he looked like John Dillinger had drilled him at close range) and another big one from the back of his hand. Both have healed with barely a visible scar line - the surgeon was really, really good.

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Originally Posted by becca View Post
I don’t know why I am so freaked out about this Mohs. Maybe I've been looking at too many the scary, gross pictures of forehead flaps done after mohs surgery on the nose. Dr. Google can be pretty frightening.

I have to keep reminding myself of so many people I know who have serious illnesses.

I will survive this.
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Old 12-31-2019, 04:43 PM   #14
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Originally Posted by Amethyst View Post
I don't know your situation, but do avoid Dr. Google's horrible photos. They may bear no relation to your reality at all! Mr. A had a big round divot cut out of his forehead (he looked like John Dillinger had drilled him at close range) and another big one from the back of his hand. Both have healed with barely a visible scar line - the surgeon was really, really good.
+1000

DW was absolutely terrified about hers. Yes the first days were yucky but they healed up to be almost unnoticeable.
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Old 12-31-2019, 05:44 PM   #15
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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.
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Basal Cell and Mohs Surgery
Old 12-31-2019, 10:17 PM   #16
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Basal Cell and Mohs Surgery

I have only had one Mohs but it was tiresome because it took several tries before the surgeon found clear edges. It seemed like I had a white bandage on my nose for a long time but it did protect the area from the sun. I have had yearly skin checks ever since with no more problems. I do wear spf 30 cream every day so lesson learned.
Best wishes for a quick recovery.
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Old 01-01-2020, 08:01 AM   #17
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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!
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Old 01-01-2020, 08:08 AM   #18
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Originally Posted by VFK57 View Post
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 for your sister-in-law and all your family.
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Old 01-01-2020, 08:19 AM   #19
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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.
Very sorry to hear. We’ve had some of this in our family. It was definitely a consideration for me to retire early. You just never know what tomorrow brings or when the last day will be.
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Old 01-01-2020, 04:37 PM   #20
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My mom and grandpa both had skin cancer including melonoma for 40 years each. They had it either burned off with a cream they put on daily for a month or cut out. The cream process turns your face raw and is very painful.
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