Moh's Surgery or Blue Light to Treat Basal Cell Carcenoma?

I agree with my colleagues that Mohs excision will be your most effective option for complete removal of your basal cell carcinoma. This also will have the lowest rate of recurrence which is important given your history of recurrent facial skin cancers. Your Dermatologist alone or working with a Facial Plastic Surgeon should be able to give you a relatively aesthetic closure of your facial skin cancer defects. I hope this information is helpful.Stephen Weber MD, FACS

Moh's surgery is the gold standard treatment for most types of skin cancers, including basal cell and squamous cell carcinomas.  It usually involves a trained dermatologist whereby the lesion is removed layer by layer, with confirmation under microscope in the same setting, to insure its complete removal while preserving the greatest normal tissue possible.  The reconstructive surgeon then will reconstruct the hole/defect in the tissue.  It is the most effective treatment method.

Blue light photodynamic therapy can be used to treat superficial basal cell carcinomas. For other types of basal cell carcinoma, the results are not nearly as good. In addition, this treatment is not commonly used in the United States for the treatment of basal cell carcinoma.

Although there are multiple types of treatments for different kinds of skin cancers surgical excision is still the mainstay of treatment for most skin cancers. Being that said every patient is different and it would be very difficult for me to advise you against blue light therapy without knowing the full story. Like I stated, surgery is still the mainstay of therapy but you should discuss other options with your MOHS surgeon.

Mohs micrographic surgery is the treatment of choice for recurrent basal cell carcinoma. According to prior data in the scientific literature, the cure rate for Mohs surgery for a recurrent basal cell carcinoma is approximately 95%, which is much higher than the cure rates with surgical excision, curettage and electrodesiccation, and radiation therapy.

Levulan and blue light would not be a good option for treatment of a recurrent basal cell carcinoma. While this procedure might be a good alternative for selected cases of actinic keratoses, I would recommend Mohs for recurrent basal cell carcinomas as well as basal cell carcinomas on the nose/eyelids/lips/ears and poorly defined basal cell carcinomas and agressive types of basal cell carcinoma (e.g. perineural, infiltrative, sclerosing, metatypical).

Best plan is to meet with your doctor; discuss your options and choose an appropriate treatment. Good luck.