worried over basal cell carcinoma treatment

Posted , 4 users are following.

I have had for around two years a small reddish bump on my forehead that I thought at first was an insect bite and then when it persisted assumed was a cyst.

When I eventually got round to seeing the GP she sent me off to community dermatology where a GP with a special interest in dermatology thought it was a Basal Cell Carcinoma (BCC). I was then sent a couple of days ago to a small local hospital that I guess under NHS reorganisation is now a community health facility of some kind and the dermatologist immediately said by looking - without a biopsy - that she was sure it was BCC - she said this without doing a biopsy - and gave me a choice of excision, curettage and cautery, or a cream. I asked about Mohs but she said it is used only for hard to treat areas of the face such as nose or eyelids. She did not recommend excision, said the scar would be worse as it involves stiches and generally was not encouraging about it, so the choice was between cream or curettage and cautery. I chose the latter over a cream as I thought there would at least be a biopsy involved and I wasn't sure a cream would be as effective. She said my BCC was particularly flat. I had the curettage and cautery yesterday, but now read on the Patient.co.uk detailed briefing on Basal Cell Carcinoma that curettage and cautery is NOT recommended for the face. Also, I am worried that the margins of burnt out tissue may not have been wide or deep enough, making recurrence or spread. Can this be checked? I am supposed to go back to the doctor, or perhaps just a nurse, in two weeks. Could the fact I'm in my mid-60s have been a factor why eg Mohs was not offered? Is Mohs not freely available on the NHS?

In retrospect I wish I had been given more time to consider the treatments the doctor offered. I feel I was rushed into a decision - and as I said, I had not had a biopsy previously, though she did a scrape during the procedure that I assume will be biopsied. Would I have done better to have gone with the excision? - I wonder know if she discouraged it in order to save time in a busy clinic, or for NHS financial reasons. Should I have tried to scrape together savings and tried to go privately? - if say rationing of some kind is affecting recommendations of treatments?

Another thing is that although I know BCC is generally not fatal, and I took it all in my stride up to now - felt strangely calm about it - now I have had the curettage and cautery, and have a red circular wound on my forehead, I am suddenly very anxious and even a bit depressed. I have not told anyone in my wider family (I am single) or friends about the BCC - partly not wanting to be seen through a cancer "lens" even though BCC is less serious than many other cancers.

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  • Posted

    Hello. foggy day here  ! Now ,I'm not quite sure what all your technical jargon

    means, but here' my two penn'orth  for what it's worth, might stop you going

    ""bonkers "  I had a couple of nuiscance bits. and was duly sent to the cancer dept 

    for an explanation .One on my hip,was biopsy'd and was duly told it was a 

    Bowen's cancer ,but the biopsy had removed it . A reddish patch on my leg 

    about the size of  a 5p which never went away and bled on occassion was

    ignored .The one on my hip started to be sore ,as it was right where my belts

    caught Duly went to my Doc who suggeted he froze ot off and did so, it has 

    subsequently gone The one on my leg ,he was sure that one was the Bowen's

    cancer ,and we went down the Cream Road .The thing fades  daily. I cream it

    daily,and can't belive the cancer knowledgables got it so wrong. The cream treatment is now on it's last week 'a month is the allotted time,as the cream is

    powerful stuff. I also have a lump on my hairline (widow's Peak ) area, which 

    was regarded as a nothing lump, which has remained a nothing lump for

    over 20 years. under the skin

    That's it end of story ,hope you  gained something from it all. I did not jump in

    with the suggested cures,  but thought about them first .after all. the lumps and bumps can hang on a bit longer, whilst you decide RATIONALLY  what to do

    Jacqueline

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    • Posted

      Thanks Jacqueline, your sharing did reduce the going "bonkers"!  especially as I haven't told anyone in "real life" about the basal cell carcinoma (BCC). I hadn't come across Bowen's before, during my Googling about BCC. Reading your post and your experience with the cream I now rather wish I'd gone down the Cream Road - I suppose I could always have had a different method afterwards if it didn't work.  I was just so keen to have the thing taken away while I was with the dermatology doctor that the curettage and cautery --  ie cutting and sealing with heat (or electricity?) yet with no stitches so less scarring than full excision -- seemed the way to go. My lesion was just slightly to the side of  widow's peak area and hopefully I'll be able to conceal the eventual scar with hair to some extent.

      Sheila

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  • Posted

    Hi Sheila,  I find that these Consultants can gauge by just looking at one of these BCCs whether it is ne or not these days.  As you will have seen I have just had a large amount of quite horrible surgery on my face to remove one which was supposed to have been removed 10 years ago which has been growing all the time because they didn't get all of it.  In order for them to get all of it this time they certainly did put me through it to make sure.  Consequently, I don't just have a patch I have a large scar down my forehead and a skin graft on my nose.  Thankfully, it is fading with the help of Vitamin E cream night and morning but it will always be there and I can see it.  I am sure that the patch you describe can be covered up with what they call camouflage make-up.  I don't think I am allowed to mention any names on here but you put these on ynder your own make-up and they are very good.  It even makes mine lok presentable when I go out.  I wasn't offered any other course than the one I went down with any of the others I have had (5 in all in the last 15 years).  Don't be down hearted about it because time really does make things better.  If people stare at me I lok right back and just want to say 'If you want to know, please ask me'.  Ireally don't think that the treatment you had was taking less time, I think it was what they thought was the right course for you.  I wish you luck and in 12 months time I am sure you won't be feeling the same about it as you do now.  Take care.
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    • Posted

      Sorry to hear of all you've been going through, Annette. It certainly puts my relatively small circular post-procedure wound in perspective.  I wondered what "ne" stands for, as in consultants being able to gauge by looking whether a BCC is "ne or not."

      Wishing you all the best

      Sheila

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  • Posted

    Hi Sheila, I also have a BCC which I was diagnosed with in May of this year, I am going in in the 19th Oct to have it removed, mine is on my nose almost in the crease of my eye, my doctor did take a biopsy even though he said he was 99% sure it was a BCC, he is cutting from my eye down my natural line to my top lip which he called a flap and had told me is was my best option or I could have radio therapy to get rid of it, I opted for the surgery, my surgeon also told me after me saying I wouldn't have it done that if I didn't have it removed it would eat into my face, I have had this which to me looked like a spot for a year, I have looked through the Internet fir advice as well but have also met up with a couple of people who have had exactly the same op and who now 6-12months down the line you can hardly see the scar, I hope all goes well and you find the best resolution for yourself.

    regards Karen

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    • Posted

      Hi Karen - I hope your surgery and recovery period will go very well. It sounds good that you've been able to meet others who've had the same operation and to see the encouraging result.

      In my case I was a bit surprised that I wasn't given a biopsy first, and then treatment at a later date, leaving some time in between for reflection and choice. In fact I though I was going in just for a biopsy, but this turned out to be a treatment (the curettage and cautery) at the same time. 

      Our BCC experiences show one should always take note of a persistent spot.  Now I'm getting paranoid that I may have a BCC hidden under hair at the back of my scalp, where I feel a scab. I guess one will forever be vigilant.

      best

      Sheila

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