Non-surgical Option to Remove Basal Cell Cancer?

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.

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.

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.