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Wondering about this because the first time I had basal cell skin cancer, the dermatologist just froze it off. I have a little flat white scar on my leg and that's all. It was done at the time of diagnosis--no making another appointment to get it done. He explained that it was only basal cell, that the damage was probably done 20 years ago, that it wasn't anything to cause immediate concern.
Fast forward to last year and a new medical team in a new state. Dermatologist found two tiny skin cancers, said they looked like basal cell and performed a biopsy. I had never even noticed them but they looked exactly like the previous one. The dr. had me make an appointment at the hospital with a surgeon who confirmed that the biopsy said basal cell and there was no urgency to get the surgery. A few months later I had the surgery--it took all afternoon and was mohs surgery. I still have two inch long red scars from where they cut on my arm and my leg. I had to deal with bandages, keeping it sterile, and all that.
So why did my former dr simply freeze it off and that was it. Why did the second experience turn into a long drawn out sort of scary experience with surgery and scarring? My neighbor goes to the same surgeon and he is constantly bandaged and scarred on his arms and face.
Recently the dermatologist and associated mohs surgeon have quit and started their own business. My neighbor who goes to them and really likes them, says they told him they want to make more money than they could make working for the hospital. I can understand that.
Thing is, it's time for my annual check up. The dermatologist and surgeon opened their brand new office and three surgical locations July 1st. Should I go back to them or are there still dermatologists who will use the freezing technique? What are the advantages and disadvantages? This mohs surgery seems like it could be "overkill" for what my original dermatologist said was a very common, non dangerous skin cancer. When they know in advance that it's only basal cell, why do they do the mohs surgery? Thanks for any insight.
If it's frozen off there is no tissue sample to confirm the diagnosis.
The Mohs procedure is designed to remove the entire abnormal area without having to take a large chunk of normal tissue to ensure getting it all. That results in a high cure rate and the smallest scar.
If it's frozen off there is no tissue sample to confirm the diagnosis.
The Mohs procedure is designed to remove the entire abnormal area without having to take a large chunk of normal tissue to ensure getting it all. That results in a high cure rate and the smallest scar.
^^^What Suzy says is true. I've had 42 basil cell carcinoma MOHS surgeries over the past 10 years. You would never tell though because you can't see any scaring. A good MOHS surgeon can do this.
Wondering about this because the first time I had basal cell skin cancer, the dermatologist just froze it off. I have a little flat white scar on my leg and that's all. It was done at the time of diagnosis--no making another appointment to get it done. He explained that it was only basal cell, that the damage was probably done 20 years ago, that it wasn't anything to cause immediate concern.
Fast forward to last year and a new medical team in a new state. Dermatologist found two tiny skin cancers, said they looked like basal cell and performed a biopsy. I had never even noticed them but they looked exactly like the previous one. The dr. had me make an appointment at the hospital with a surgeon who confirmed that the biopsy said basal cell and there was no urgency to get the surgery. A few months later I had the surgery--it took all afternoon and was mohs surgery. I still have two inch long red scars from where they cut on my arm and my leg. I had to deal with bandages, keeping it sterile, and all that.
So why did my former dr simply freeze it off and that was it. Why did the second experience turn into a long drawn out sort of scary experience with surgery and scarring? My neighbor goes to the same surgeon and he is constantly bandaged and scarred on his arms and face.
Recently the dermatologist and associated mohs surgeon have quit and started their own business. My neighbor who goes to them and really likes them, says they told him they want to make more money than they could make working for the hospital. I can understand that.
Thing is, it's time for my annual check up. The dermatologist and surgeon opened their brand new office and three surgical locations July 1st. Should I go back to them or are there still dermatologists who will use the freezing technique? What are the advantages and disadvantages? This mohs surgery seems like it could be "overkill" for what my original dermatologist said was a very common, non dangerous skin cancer. When they know in advance that it's only basal cell, why do they do the mohs surgery? Thanks for any insight.
never had the Mohs procedure for basil cell cancers. I know suzi knows what she is talking about as I am pretty sure she is in the medical field, but still our dermatologist does not do Mohs for something as simple as basil cell and ours in Dallas did not either.
^^^What Suzy says is true. I've had 42 basil cell carcinoma MOHS surgeries over the past 10 years. You would never tell though because you can't see any scaring. A good MOHS surgeon can do this.
I'll agree with this. I've had several basal cell cancers frozen off my face. I've also had one removed by MOHS surgery from my right facial cheek and unless you touch the skin it's not detectable.
Basal cell above my upper lip. 5 years ago scraped and no issue. It came back, re-scraped and they say the scrape technique is only 40% effective, meaning their is a 60% chance it will return. They want to do MOHS, if it was on my arm or back, no problem but since it is on my face, I'd like other options to consider. They can radiate the area, like 20 visits in 20 days but you run the risk of scarring the area making any additional work much harder.
My wife has had 3 Moh’s surgeries on her face, two basal cell carcinomas and one squamous cell carcinoma, one on her forehead, one on her eyelid and the one she’s recovering from now in her nose. She has a small nose and was very concerned about it. The surgeon gave her 4 options in terms of treating the site. We chose a conservative one which involved extending the site from a circular wound to a longer wound which allowed for better closing and healing, no “puckering” of the skin around the site from trying to close a round wound.
I can barely see it already and would not notice if I didn’t already know about it. The surgeon made sure to explain that he was using the same tools and techniques that a plastic surgeon would use to treat the wound. Talk to your surgeon, discuss the options. Moh’s surgery, if it’s available to you, is considered the gold standard for basal cell carcinoma.
BTW, a simple scrape is not the same as Moh’s. During most surgeries, excised tissue is processed for histological examination by a pathologist. Depending on the finding, and it might take a week or so, further surgery might be required to be schedule at a later date (my wife had to have a second breast cancer surgery for this reason).
With Moh’s surgery, the excised tissue is immediately frozen, sectioned on a cryostat, sections mounted and stained on a slide and microscopically examined to see if there are still cancerous cells showing in the margins of the tissue. If there are, the surgeon knows exactly where they are and can go back and remove tissue only from that area, preserving as much of the normal tissue as possible. This is why it takes a while. There’s a lot of back and forth as they do basically a complete tissue work up after each excision.
I have had moh's surgery on my face twice and no scar. (One spot was forehead which can be difficult since the skin is so tight; the other was nose and close to nostril.) My moh's surgeon was fellowship trained and all he does is moh's surgery. I don't think a plastic surgeon could have done a better job. On my face I would insist on a moh's surgeon and fellowship trained. On other areas I would consider other options. https://www.mohscollege.org/about/about-mohs-surgery
If it's frozen off there is no tissue sample to confirm the diagnosis.
The Mohs procedure is designed to remove the entire abnormal area without having to take a large chunk of normal tissue to ensure getting it all. That results in a high cure rate and the smallest scar.
Quote:
Originally Posted by wit-nit
^^^What Suzy says is true. I've had 42 basil cell carcinoma MOHS surgeries over the past 10 years. You would never tell though because you can't see any scaring. A good MOHS surgeon can do this.
Quote:
Originally Posted by nmnita
never had the Mohs procedure for basil cell cancers. I know suzi knows what she is talking about as I am pretty sure she is in the medical field, but still our dermatologist does not do Mohs for something as simple as basil cell and ours in Dallas did not either.
Thanks for all the replies. Before I had the mohs procedure, they had already done a biopsy and confirmed that it was basal cell. So I had my diagnosis already. What I would have like was to have it frozen off once they knew what it was. I don't see the need to endure the mohs procedure when they already know it is only basal.
OMG, wit-nit, 42 mohs? You are lucky you have no scarring, and that's another thing I don't understand. The scars I have are long and "ropey." I'm glad they're not on my face! I would have VERY much preferred to simply have it frozen off as long as they already knew it was only basal cell.
nmita, that's what I mean. But I don't think I have a choice. Even if it's just basal cell, you get sent for mohs surgery, the long and somewhat painful procedure, and the big scar. What for? I'd rather be able to choose for myself and for basal cell I would definitely choose the painless, simple, quick, in office procedure of just freezing it off.
I know if I go back to this same dermatologist, it'll be mohs no matter what. As I said, they already have three surgical centers up and running. My insurance pays for most of it but it was very expensive too. I would rather have the choice.
I was told by my MOHS doc that most MOHS procedures are done on the face, where scarring is a factor.
I had MOHS done and it was a 6 hour event. You bring magazines and snacks but the doctors office had all that for you free: like donuts, coffee, chips, soda. So plan to spend part of your day there.
Mine was removed in one pass. That means some people have multiple passes until they get all the cancer. Mine did leave a tiny crater on my nose, it has sat there 5 years and I had ignored it. Despite sitting 5 years I only had one pass, otherwise, you can sit there far longer until they get all the cancer. Not cheap either, $3,000 for the doc.
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