My Mother is 80 Years Old. Since She is in Her 80s Can She Skip the Surgery? She Likes Her Nose!

The Basal Cell is 5mm on the tip of her nose. Since she is elderly can she skip this procedure? What is the chance of it growing into a problem in 5 years time?

Doctor Answers 9

Mohs Surgery for Elderly

Thank you for your question. Basal cell carcinomas are typically very slow growing cancers, and may not be noticed by a health care provider or the patient for months or sometimes several years. Every case decision must be made on a patient by patient basis. Sometimes, in an elderly patient depending on the patient's overall general health and other co-morbidities, a decision might be made to not intervene surgically. Sometimes, radiation is a more optimal choice for the patient depending on the size and the location of the tumor. Chemotherapy sometimes also has a place, depending on the case. I would recommend reviewing these questions with your Fellowship Trained Mohs Micrographic Surgeon. I hope this helps.

Bay Area Dermatologist
3.9 out of 5 stars 12 reviews

Mohs surgery may be the best option for her skin cancer

This is a tough question, and is best answered only after you and your mother have received all the necessary information from your Mohs Surgeon. There are so many factors that play a role in determining what the best treatment for her skin cancer may be, including her current overall health status.

Typically, basal cell carcinomas are slow-growing and will very rarely spread to other parts of the body. However, being a cancer, it will not go away by itself and will develop into an ulcer over time, possibly within a year or two. This would affect her quality of life because she has to then do dressing changes for it every day. Also, as the cancer grows, it will start to disfigure her nose.

Ultimately, only she can decide what will be best for her, but I would encourage you to get all the necessary information from your Mohs Surgeon first, including alternatives to Mohs surgery, before making any decision. Hope this helps!

Dieter Schmidt, MD, FAAD, FACMS
Bothell Dermatologic Surgeon
5.0 out of 5 stars 4 reviews

My mother is old, can she skip a Mohs procedure

All cancers grow at different rates, though BCCs do grow at slower rates overall. Even though your mother is elderly, this cancer will grow. Ultimately, if your mom is healthy, avoiding this procedure could end up affecting her much worse in the coming years and could be more disfiguring and painful. A good surgeon should be able to minimize what needs to be removed and still give your mom a good-looking nose.

F. Victor Rueckl, MD
Las Vegas Dermatologist
4.6 out of 5 stars 17 reviews

Basal Cell Cancer

These do grow larger, so if she likes her nose, she may not like it as the cancer grows.  The options of treatment usually do not involve much significant physical stress.  As long as an 80 year old is fairly healthy, most would benefits from treatment.

Richard W. Maack, MD
Saint Louis Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

My Mother is 80 Years Old. Since She is in Her 80s Can She Skip the Surgery? She Likes Her Nose!

Basal cell carcinoma grows slowly. It very, very rarely spreads elsewhere in the body. Thus, the main issue is that the skin cancer will grow over time and become larger necessitating a larger procedure to remove it. Choosing not to have it removed is a personal decision. Most Dermatologists and Facial Plastic Surgeons will recommend having it removed as it is very small and reconstruction can produce a very nice result, in most cases. Further, this can be performed in the office with very little downtime. If your mother choose to watch it, I would recommend that she followup every six months or sooner if the tumor appears to be enlarging. I hope this information is helpful.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Mohs surgery in elderly.

Basal cell carcinoma is a slow growing tumor and is difficult to predict in any given patient how fast it will grow.

In elderly patients who are not expected to live more than a year or two, I'd likely not treat a basal cell carcinoma that was not causing symptoms.  If one has reasonable expectations of several years or more of life, then the danger in leaving it is that it will develop symptoms (pain, bleeding) and be much more difficult to treat later.

Generally Mohs surgery and repair for small spots on the nose is well tolerated so there is not too much risk in treating at this stage.  Other options like radiation can be considered but that is quite time-consuming and often saved for patients who have reasons they won't tolerate the surgery.

This is an excellent discussion to have with the doctor who did the biopsy or the doctor recommending the surgery.

Daniel Berg, MD
Seattle Dermatologic Surgeon
4.0 out of 5 stars 4 reviews

Do I really need surgery for basal cell carcinoma

Small problems have simple solutions. Big problems have complicated solutions. For healthy adults, even elderly, treatment is recommended. There are non-surgical options too. Delaying treatment can lead to bigger problems and a non-so-simple solution.  If you are against having surgery, radiation is a great option. Mohs' is a great option as it is all done at one time, has the highest cure rate, and may have a good cosmetic result, but this is very dependent upon the surgeon--choose wisely.

Robert S. Bader, MD
Boca Raton Dermatologic Surgeon
5.0 out of 5 stars 3 reviews

Mohs surgery is the best option for tissue sparing and cosmetic outcome

Basal cell cancers are unlikely to spread. However many people live into their 90s and 100s without any issues so if this lesion is not treated, it can grow larger and larger with time and become a much bigger issue. I would recommend seeing a American College of Mohs Surgery physician. They are formally trained in Mohs and Reconstructive surgery and can spare as much normal skin as possible and reconstruct the defect in a way to optimize the cosmetic outcome. 

Omar Ibrahimi, MD, PhD
Stamford Dermatologic Surgeon
4.8 out of 5 stars 26 reviews

Basal Cell Carcinoma: Surgery or No

Basal cell carcinoma is the most common form of skin cancer, generally very slow growing with minimal metastatic potential.  When diagnosed, the universal recommendation is to treat so that a relatively small issue does not develop into a painful, disfiguring mess. Excision and reconstruction remains the best and most expeditious treatment option, unless the patient is unable to have a surgical procedure due to poor health.  Radiation and/or several other non-operative options are usually employed in these circumstances.  Anecdotally, I have seen many healthy, active 80 plus year old patients with BCCA who have elected to have surgery and reconstruction who were very happy to have done so.  I would evaluate the situation with your Surgeon based on your Mother's health and concerns about appearance.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 95 reviews

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.