Can I Wait 7 Months for Mohs for 2mm Nodular BCC on Nose?

Question

Biopsy result is 2mm nodular BCCpresent on deep and one peripheral margin. Carcinoma is composed of bland basaloid keretinocytes with peripheral pallsaded of nuclei. Due to a full calendar of raising a 16 year old daughter. I would like to wait until week of July 23rd to have my Mohs procedure done. I do not feel that I am emotionaly ready to go through recovery of my scar in January. In July I would have the privacy of healing that I do not have the luxury of now.

Adam J. Mamelak, MD · Answer

Medical studies have shown that delaying treatment of skin cancer allows them to grow and get bigger. Larger skin cancer require more extensive surgery, which often means more discomfort and scarring after the procedure. I usually recommend patients have there skin cancer treated as soon as possible. From your description, I think your procedure would be straightforward with very little downtime or recovery. I think treating the skin cancer now will leave minimal scarring, but I could not be certain this would be the case in another 7 months. Also, do you really want to stress about this until the summer? Unless you are prohibited from doing so by other circumstances, I would recommend treating it sooner rather than later.

Peyman Ghasri, MD · Answer

As you know, Basal Cell Cancer, even though not an aggressive tumor by any means, is still a cancer. Nodular BCC by defnition could be extending vertically and deep in addition to the outside periphery. Mohs surgery could remove the cancer cells entirely while sparing the uninvolved skin. If the cancer is in fact only 2mm, the potential scar and recovery could be very minimal and should not interfere with your daily activities. However, if the cancer is allowed to progress and get bigger, it would need more removal of tissue with result of a potentially larger scar.

Bryan K. Chen, MD · Answer

Although basal cell carcinoma is generally considered to be a "slow" growing tumor, the rates of growth vary considerably from tumor to tumor and person to person. While it is reasonable to wait 2-3 months, with a wait of 7 months, there is a greater risk that the growth of the tumor could be significant. I suppose the answer to your question would be yes, you can wait 7 months, but most would recommend you proceed with the Mohs procedure sooner, especially for such a cosmetically and functionally important location as the nose.

Andrew Kaufman, MD · Answer

While the final choice is yours, it is not a good idea to delay treatment of your skin cancer for such a long time. Basal cell carcinomas tend to grow slowly, but the key word is "grow." Nobody can tell you exactly how quickly it will grow, and nobody can tell you exactly how large the skin cancer is now. The best option, in my opinion, would be to consider Mohs micrographic surgery, which will start with the smallest margin possible and trace out the roots of the skin cancer, providing the highest cure rate while preserving the surrounding healthy tissue. Delay of your surgery for such a long period will result in a larger skin cancer and therefore a larger surgical defect to repair and therefore potentially a more complicated reconstruction or larger scar. Work out the details of your surgery with your doctor's office and get the skin cancer treated in the near future.

J. Charles Finn, MD · Answer

Basal cell carcinomas grow about 1 mm per month. It is likely bigger than you can see right now. If you get it taken care of now it will be a small problem. If you wait, it will become a big problem that may need a big reconstruction. Bite the bullet and get it taken care of! Your 16 year old will understand, and does NOT want to be the reason for you needing a bigger surgery.

F. Victor Rueckl, MD (in memoriam) · Answer

You can wait to do the procedure, but why?? You need to remember that your BCC will continue to grow and develop over these months, and how much can vary from person to person. What might be a simple procedure with a level or two of Mohs now, could very well be a much bigger surgery, procedure, scar, and reconstruction in July. It's best to just do it now and also not stress yourself out more over then next 7 months. While the site may not change on the surface, the underlying roots of the cancer can grow a great deal and cause much worse pain and healing for you in July. The sooner, the better.

Can I Wait 7 Months for Mohs for 2mm Nodular BCC on Nose?

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