Non-surgical Option to Remove Basal Cell Cancer?

Question

I have a basal cell cancer on bridge of nose. I have an appointment in September for Mohs surgery. I haven't met with the doctor yet, but I do not know what my options are besides surgery. Can they freeze it off? I already have a hole where the cancer is from a blister and the biopsy left a bigger hole. I also scar easily, as I have a scar on my neck from carotid artery surgery. I'm only 51 years old and single and I do not need another scar. Help, I need advice. Is there a non-surgical way to remove it?

John Bitner, MD · Answer

From the sound of your situation, I would strongly recommend Mohs surgery.  Other options, freezing, dessication and curettage, creams, ointments, are usually best for:

	
		Precancerous conditions
	
		Areas that are not cosmetically sensitive
	
		In patients with poor health who are unlikely to survive longer that the cancer grows


	From the sounds of things, you have a cancer blister, which implies invasive disease and the bridge of the nose is obviously cosmetically sensitive.  The Mohs procedure is specifically designed to remove the entire cancer (recurrence rates <1%) and save as much normal skin as possible.  Further, after Mohs surgery, a good reconstructive facial plastic surgeon should be able to leave you with a result that will keep you on the dating scene.  The bridge of the nose is especially forgiving and the scars virtually disappear.  I saw a patient today in whom I had repaired a Mohs defect 1 year ago.  The scars had so completely disappeared that I couldn't find where I had done the surgery, and I was the one who made the incisions  Using non-surgical treatment has a high risk of not curing the cancer and leaving you with partially treated cancer and an eventual hole that is far larger than what you would end up with if you treat it right the first time.

	Some pieces of advice:

	
		Make sure your dermatologist is Mohs fellowship trained
	
		Make sure your reconstructive plastic surgeon is like-wise fellowship trained
	
		Make sure your Mohs surgeon and reconstructive surgeon is NOT the same person.  When the CANCER doctor is the same as the RECONSTRUCTIVE doctor, judgment is compromised.  You can't be thinking about how you're going to fix it while you're removing it.

Stephen Prendiville, MD · Answer

Although nonsurgical options such as Aldara and Radiation therapy exist, Mohs surgery remains the gold standard for treatment of any well defined skin cancer (BCCA or SCCA) on anatomically sensitive areas such as the nose, eyelids, lips, ears.  From the stand point of cosmesis and recurrence, Mohs is the better way to go.

William Ting, MD · Answer

Basal cell carcinoma (BCC) often has ill-defined borders and its true margins can sometimes fool even trained eyes of a board-certified dermatologist. Mohs Micrographic surgery remains your best bet medically and cosmetically as the tissues are examined under the microscope prior to reconstruction, ensuring least amount of healthy skin gets removed. With Mohs Micrographic surgery, you should be able to prevent potentially bigger scar down the line as the tumor is successfully eradicated at 99% cure rate versus less effective nonsurgical therapies where parts of the original BCC can be left behind and continued to grow. Nonsurgical options such as cryotherapy/freezing with liquid nitrogen, topical imiquimod (Aldara), and or radiation have significantly lower cure rate but may be considered as a last resort for an elderly patient for whom Mohs micrographic surgery is not advisable.

Vincent N. Zubowicz, MD · Answer

Basal cell cancers are easy to treat and leave almost inconspicuous scars if removed early.  If the lesion is inadequately treated, it may disappear from view for months or even years growing under the skin.  When it reemerges, it may require extensive excision and reconstruction. Therefore, the margins of excision the first time must guarantee adequate removal.
Basal cells can be treated with radiation, but this is generally limited to much older patients where the collateral from the radiation is not a consideration and surgery might be hard to tolerate.
Most Moh's surgeons work with a plastic surgeon if the excision ends up needing any formal reconstruction.  Most reconstructions in time are almost (but not completely) invisible.

Mehryar (Ray) Taban, MD, FACS · Answer

The best way to get rid of the skin cancer is to cut it out. Depeding on the size, the area can be reconstructed using adjacent skin tissue to cover the area. The scars can be put in less visible locations if possible.
Nonsurgical options, such as freezing and topical aldara and radiation, only work for certain early skin cancers and can be temporary with return of the skin cancer, only larger and deeper.
You are young and should consider removing the whole skin cancer by cutting it out (Mohs) with reconstruction.

Non-surgical Option to Remove Basal Cell Cancer?

Answers (9)

Answer: Have basal cell cancer removed, but there is other treatment

Answer: Have basal cell cancer removed, but there is other treatment

Answer: Skin cancer removal

Answer: Skin cancer removal

Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Non-surgical Option to Remove Basal Cell Cancer?

Answers (9)

Answer: Have basal cell cancer removed, but there is other treatment

Answer: Have basal cell cancer removed, but there is other treatment

Answer: Skin cancer removal

Answer: Skin cancer removal

Browse related questions

Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.