I have just been diagnosed with a nodular bcc 3mm under my bottome eye lid following shave biopsy. It measured 4mm x 5mm. I need to have Mohs followed by reconstruction with an occular plastic surgeon however have been told the wait for Mohs is 8-10 months. This seems like a long time to wait to remove the tumour and I am worried about potential damage to my eye. What is your opinion on waiting this long?
Wait 8-10 Months for Mohs Surgery?
Doctor Answers (5)
Basal cell carcinoma of the lower eyelid
Although basal cell carcinomas grows slowly, they do, in fact, grow. They grow deeper and wider and depending where exactly it is on the eyelid, there can be a chance with deeper penetration, that it can affect a nerve which might allow the skin cancer to travel by direct extension along the nerve quite deep and even, eventually threaten the vision. Also, as the size grows, it makes it more difficult to obtain a good aesthetic aoutcome, and there can be a functional concern too. If the wound is large, then the reconstruction has to allow for contraction and prevent the eyelid from being pulled downward if it is the lower eyelid that has the skin cancer. The nature of the risk of waiting is also dependent on the type of pattern of growth your basal cell is classified as having. Infiltrative, morpheaform, micronodular and those with squamous differentiation are more aggressive than superficial basal cell carcinomas. Waiting 8 months might not be best for you. Can you seek a second opinion?
I would find another dermatologist who can get you in sooner
I would find another dermatologist who can get you in for the MOHS surgery sooner. BCC can grow so you should get it taken care of.
Sounds a little too long
8-10 months is definitely a little too long to get Mohs surgery and reconstruction. I would try to get it done in the next 2 months. Basal cell is unlikely to metastasize and spread elsewhere in your body but it can locally grow and become larger in size.
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I would not recommending waiting eight to ten months for your mohs surgery. I would suggest you find a Mohs surgeon that can do it much sooner than that. Although basal cell cancers are typically slow growing, you should address this as soon as possible since it is in a periocular location.
Would see if you can get in sooner
As said before, basal cell carcinomas (BCC) grow very slow. The fact that this is a periocular BCC makes it imperative that you get timely treatment. This is a highly cosmetically sensitive area, and you want to get the tumor out as soon as possible to make the reconstruction as simple as possible. I am not familiar with the Irish healthcare system (it says you are in Ireland), but I would see if I could get in sooner somewhere else.
My usual recommendation with BCC's is to have them treated within 2 months. No, they won't metastasize for many years, but you want your defect size to be as small as possible.
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