Hi Walker

Ive had 2 large SCC 45mm  and some smaller ones removed from my forehaed and scalp. They were removed by the plastic surgeon under local anaesthetic the 2 large ones needed a skin graft taken from my thigh. The smaller ones were pulled together. They have left large very noticible scars which have faded a bit over time. Given the size of your lesions it may worth getting them removed sooner than waiting 4 months more for MOHS. A margin of 5mm is taken around the lesion so that leaves a scar 10mm wider than the lesion. You should ask the surgeon whether a wide local excision is more effective than MOHS at removing the lesion completely. The other consideration is that although a 5mm margin can be taken around the lesion there is limited scope for depth as some flesh needs to remain on your skull. If there are cancerous cells remaining at depth a short course of radiotherapy can be used to destroy them. I hope this is of some help for you to arrive at your decision. Most importantly protect you skin from the sun if you do not want more BCC or SCC in future.

Ed

Hello, and thank you for posting,

I am sorry to learn that you are waiting to have surgery for a BCC.

Understandably, you may be feeling uncertain when faced with two very different treatment options.

Both Mohs surgery and wide local excision are effective treatments for basal cell carcinoma, but they do differ in approach. Mohs surgery uses a precise and tissue-sparing technique. However, I can appreciate that waiting until March can feel like a long time, particularly if the lesion is large or causing discomfort.

A wide local excision with a rotation flap under general anaesthetic is a more extensive procedure, but it allows for earlier removal and reconstruction in one step. I can appreciate that the need for a general anaesthetic might be overwhelming, but it’s commonly done during this type of surgery.

Often, when you are given a choice of surgery, there is no 'wrong' decision. It is doing what is right for you and balancing the benefits of earlier treatment against the preference for Mohs’ precise margin control. If you’re unsure, you may find it helpful to clarify with the team at the hospital how much of a risk there is of leaving surgery until March and clarifying the expected cosmetic outcome for each option.

Whatever you choose, both options aim to fully remove the cancer and achieve a good result. I hope this helps in some way, and you are welcome to get back to us. If you would like to speak with one of the nurses on the helpline, you can call between 9am and 5pm Monday to Friday and the freephone number to call is 0808 800 4040,

Jemma

Hi Jemma, thanks so much for your reply, it's really helpful. I have reached out to my dermatologist and he said I would likely need reconstruction anyway after the Mohs, so I think I'll just go with the plastic surgery option, they seemed confident that they would be able to remove it, and although I know Mohs has a higher % success rate of complete removal as I understand plastic surgey are also pretty high % too. I am actually a nurse myself, but sometime I think that can be more of a hindrance as you understand the potential risks/complications more. But I'm sure all will be OK and looking forward to getting it sorted. Best wishes 

Hi Ed, thanks a lot for your reply and sharing your experiences, it's always helpful to hear other people's stories. I have reached back out to my dermatologist, but I think I will just go with the plastic surgery option and get it sorted sooner rather than later. Yes I am always very careful in the sun, my BCC is actually not from sun exposure, I have a bald patch which I've had since birth, and one of the risks of those is that they can become cancerous, so unfortunately that is what's happened to mine. But yes, even though its not sun exposure related it has defo emphasised to me even more about safety with sun now that I'm having this experience with skin cancer. Thankyou and best wishes