What is the best and safest treatment of basal cell carcinoma in elderly patients?

Could someone who reaches old age with perfect functional and mental status, with no medical problems despite his age, be treated with a surgical procedure to remove basal cell carcinoma (like Mohs) instead of topical chemotherapy (5-FU)? What's the incidence of metastatic from BCC in older adults? Is this carcinoma hereditary? I'm very concerned about these topics so I'd appreciate some honest opinions and any information will be helpful. Thank you in advance for your time and attention.

Doctor Answers 2

Treatment of basal cell carcinoma in the elderly

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Although there have been reports of basal cell carcinoma metastasizing, they are so incredibly rare that this should not factor into one's decision on treatment options.

Basal cell carcinoma is a locally destructive tumor, meaning that it will enlarge and destroy any local tissue over many years. It is typically a slow growing tumor.

There are several different types of basal cell carcinoma, which all have different treatment options. In short, there is not one treatment that is "best" for all tumors, for all locations, in all persons. Smaller tumors in non-critical areas can be observed, not treated, in very elderly patients as they pose little to no risk, but this should be under the supervision of a Dermatologist.

emedicine, now medscape, is a great reference for more information as is the aad website as well as others. 

Boca Raton Dermatologic Surgeon
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Basal call cancer in elderly

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every patient is different, every basal cell is different, and treatment approaches include topical creams, mild surgeries like EDC and excisions to Mohs for bad tumors. 

I recommend you to discuss specific issues regarding your questions with your dermatologist. 

Steven Hacker, MD
West Palm Beach Dermatologic Surgeon

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.