Wait 8 Months for MOHS Surgery?

Question

I have been diagnosed with basal cell carcinoma on my scalp, the spot is about 2 by 2 cm in size, it has been their for four years, I thought at first it was an infection and therefore did not go and get it seen to immediatley. My doctor sent a referral for MOHS surgery and the closest date they can get me in is 8 months from now. Is that too long to wait? even though basal cell carcinoma is slow growing, it is on my scalp and therefore could waiting that long increase my risk for any complications?

Callum Faris, MD · Answer

Thanks for the question. The benefit of Mohs is that it is tissue sparing and has slightly higher clearance rates (99% versus 95% for BCC). The fact that you have to wait 8 months even for a slow growing tumour is too long. It would be better to find an alternative Mohs surgeon. It is also quite possible a standard non-Mohs excision done in a timely fashion would leave you with a smaller defect than Mohs surgery which is delayed 8 months. Best of luck.

Sonia Badreshia-Bansal, MD · Answer

Thank you for your question. While BCC is indeed a slow growing tumor, now that your lesion has been biopsy-proven, a timely excision of this tumor is recommended.  While your lesion has been there for years and it may not be detrimental to wait an extended time to remove the remaining tumor, most dermatologists and surgeons would encourage this be done within at least 2-3 months after receipt of diagnosis.  This said, each case must be considered with both the input from patient and the physician, and should be decided on a case-by-case basis, as there could be other variables involved that may dictate dates and the timing for excisions.  I hope this helps.

Lisa Chipps, MD · Answer

I agree with my colleagues here. Eight months is too long to wait for Mohs surgery. You should look for another fellowship-trained Mohs surgeon to treat your cancer within the next month or two.

Daniel Berg, MD · Answer

The issue of how long to wait for treatment of a basal cell carcinoma (BCC) is not perfectly understood and in Canada it is influenced by availability of Mohs surgery.

	For a spot with minimal symptoms that is not growing noticeably, waiting a few months is not likely to change things much.  In the US, with the ready availability of Mohs surgery, most patients in your situation would be treated within a month - this may reflect more the availability rather than the need.  In British Columbia, there are currently only two Mohs surgeons in full time practice (in Vancouver); hence the long wait.

	Basal cell carcinoma grows slowly over years often and it is not uncommon to see patients with lesions untreated for 2-3 years that they ignored.  They only very rarely spread from the skin so their risk to your general health is low.  They can grow deeply (eventually into bone), so they are typically removed like any other cancer.

	 

	In conclusion, there is no right answer especially in a system with limited availability, though most would say 8 months is long.  If you are concerned, you can try and be seen sooner in Alberta or Washington State, or alternatively you can get the opinion from the dermatologist who did the biopsy.

Richard Ort, MD · Answer

Eight months is too long to wait for treatment of your basal cell cancer.  It will continue to grow during that time.  It sounds like it has already been there for quite a while and is already larger in size.  You should have it treated within the next month.  If they can't get you in sooner, then you should see another doctor.

Wait 8 Months for MOHS Surgery?

Answers (8)

Answer: Timing of Mohs surgery

Answer: Timing of Mohs surgery

Answer: Basal cell cancer on scalp

Answer: Basal cell cancer on scalp

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Wait 8 Months for MOHS Surgery?

Answers (8)

Answer: Timing of Mohs surgery

Answer: Timing of Mohs surgery

Answer: Basal cell cancer on scalp

Answer: Basal cell cancer on scalp

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Recommended reading

Everything you need to know about Mohs Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.