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BCC of ALA. How Long Can I Wait for Mohs? (photo)

I saw a P.A. who said it did not look like Mohs but to come back in three months. Not wanting the cost of another office visit, I asked him to cut it off. Biopsy came back positive for BCC. I asked for a copy of the lab report which had the wrong birthdate listed for me and found that the dermatologist who would do the surgery was the pathologist for the tissue sample. I made a new appt with another doc. Medicare kicks in next year (10 mos.) I can't afford the $5,000 deductible. Can I wait?

Doctor Answers (5)

BCC on the nose - how long can I wait for Mohs

+2

I understand your issue and it's one that comes up frequently, quite frankly. The cost of procedures is expensive....but the cost of a messed up nose, might not be so great either. BCCs tend to be smaller and localized, but the issue lies in fact that cancers can have "roots" growing below the surface, which can make waiting for a procedure for 10 months, more likely to be a longer, harder procedure and recovery. I try to tell my patients not to wait more than 2 months for a Mohs procedure, or they risk the procedure being harder and more likely that larger portions of skin may need to be removed. You also need to remember that Medicare too has a deductible (obviously lower) but will also have co-insurance associated that will be a minimum of several hundred dollars in this case. You could also opt to try to pay cash for the procedure, rather than go through your insurance. Most physicians will provide a discount, and you can opt to use a program like CareCredit which is meant for large procedures like this - and with good credit - could give you up to 24 months of no interest. It's worth looking into.


Las Vegas Dermatologist
4.5 out of 5 stars 7 reviews

BCC on the nose

+2

While basal cell tumors are generally slow-growing and non life-threatening cancers, yours happens to be on a functionally and cosmetically important area, the ala of your nose.  In principal, the sooner you take care of the lesion the better.  Waiting 3-4 months to treatment seems reasonable.  The tumor could grow considerably in size (resulting in a larger surgery and more complicated reconstruction) over a 10 month period.

 

I hope this feedback is helpful to you.

Bryan K. Chen, MD
San Diego Dermatologist
5.0 out of 5 stars 4 reviews

Basal cell cancer of the Nose

+1

There are many ways to treat this basal cell. A plastic surgeon can excise and repair the tumor simultaneously. Waiting is not a good option if there is tumor left behind.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

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How Long Can You Wait For Treatment of a Basal Cell Carcinoma on the Nose

+1

Basal cell carcinomas tend to be slow growing, but the operative word is "growing." In my opinion 10 months is too long to wait for treatment of your skin cancer. During that time the skin cancer will continue to grow slowly, replacing or destroying the normal healthy tissue. I would recommend that you see a fellowship-trained Mohs surgeon (member of the ACMS) and talk about your options. Good luck.

Andrew Kaufman, MD
Los Angeles Dermatologic Surgeon
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BCCA: Don't Wait Too Long

+1

Most basal cell cancers are small and localized.  However, when ignored they can become larger, more invasive and more problematic to treat and reconstruct. Whenever I see a patient with BCCA, I recommend they have it addressed as expeditiously as possible. The Mohs technique is a tissue sparing procedure and I would recommend you see a reputable Mohs College trained Surgeon. Waiting may affect the size of the lesion and the nature of potential reconstruction. 

Stephen Prendiville, MD
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.