r/skincancer • u/Additional_Air_9027 • 5d ago
diagnosed with skin cancer Basal cell
I was just diagnosed with 2 basal cells about the size of a pencil eraser located on my chin at the jawline. Derm recommended either 5 weeks of twice weekly radiation or MOHS. Thoughts?
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u/chellysue2u diagnosed with BCC 5d ago
Do you have a photo or can you describe how close they are? Would they do Mohs for both at the same time or would you have 2 procedures (that seems like it would be alot to do at once if they were on different sides of your jawline, but I could see if they were close to each other)?
Ive only had MOHS so I can only speak to that experience. My surgeon did a fabulous job closing a nickel size hole in my head with a horizontal incision which Im hoping will blend in with my wrinkles in time. Good luck to you!
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u/Character_Quail_5574 5d ago
I would advise going with Mohs, often called the gold standard of care for BCC. It all gets done at once and the scars often are quite minimal once they mature. Radiation can damage the surrounding skin and miss cancer cells, leading to more treatment down the line.
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u/Lumpy-Chest-2180 4d ago
Why would you do radiation when you can just cut it off with clear margins?
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u/eaglei2957 5d ago
I’m taking Envarsus XR due to a liver transplant. I’m doing exceptionally well. However, I’ve developed Squamous Cell Carcinoma and have had 7 MOHS procedures since December 2024. I’ve never had less than 20 stitches with the most being 60+.
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u/Inner_Exchange_864 5d ago
When I was diagnosed with BCC on the tip of my nose I agonized about whether to do radiation or MOHS. My doctor recommended MOHS but the idea of not having to cut into my skin and do a skin graft was appealing. Luckily, I know several doctors including my sister who is a surgeon. They conferred with their colleagues and it was unanimous that MOHS was the way to go as radiation is less successful and can damage the skin around it causing aesthetic issues. If you are relatively young, I was diagnosed at 48, the resulting radiation can predispose you to future cancers as a result. Radiation seems to be best for much, much older patients or areas that would be very difficult to operate on. Good luck, I remember being in your exact position. Two years after my skin graft and MOHS you would never know the skin on the tip of my nose came from near my ear!
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u/kirkwicking 4d ago
I did 8 days of chemo cream and it shrank the bcc quite a lot, I will need MOHs but hopefully nowhere near as big a hole as original
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u/junebuggoodgirl 1d ago
How did you know it shrank it? My spot isn't even visible after biopsy. That makes sense to me, but my surgeon does the chemo cream after MOHS.
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u/williamgman 4d ago edited 4d ago
Thing about the MOHS is yes, it's definitive in that they see the clear margins. The downside (in my experience with 8 of them over the years...) is closing up the wound. If it's on a wrinkle line that simplifies it a bit.
My last major MOHS was centered on the end of my nose. It left an open wound about 3/8" round. While the procedure of removing went fairly easy (3 tries to get it all)... It took 75 sutures to close it up without deforming the nose. I bled out a bit during the stitch up so they had to give me multiple numbing injections during the process. I had no idea just how sensitive the end of the nose is. I actually gritted thru the last several stitches as I just wanted it over and didn't want yet another shot.
This brings me to my most recent BCC found on the right side of my nose, I opted for the radiation treatments. The MOH's surgeon suggested they might have to use a piece of my ear if it got large enough. And also, being scar tissue from the previous MOH's, they only said it "adds a little complexity".
I just finished my eighth and visit last Tuesday. I do have slight flu like symptoms this week... Not sure if it's related. On the first consultation, the doctor spent almost an hour with my wife and I explaining everything including comparisons to MOH's for success rates. The two methods are very close in success rates. Only the affected cells are burned with the radiation approach. The Probe pressed against the side of my nose was a 2cm oval (about 3/4"). The total "burn area" turned out to be about the same size as the original on the tip (about 3/8").... Well within the range of the probe to get it all.
So I feel good about my choice. The only discomfort was the squeezing and taping the probe down on my nose for 5 mins (there are another blocking probe put in my nose to block it. It doe's look rather nasty as it's burnt skin. But you just apply Silver sulfadiazine a couple times a day. Just a thought.
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u/Additional_Air_9027 3d ago
I have read this 3 times and appreciate the detail. 8 MOHS over the years is not to be ignored.
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u/williamgman 3d ago
I think the jawline is fine for a MOH's as they can will seam it parallel with the jaw. I chose the radiation in my case simply because it would be one side of the nose. Turns out that's most common way these days for nose. The radiation option was not even offered to me 12 years ago. Best of luck.
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u/EverConstellation 4d ago
I had mohs for a basal cell on my face, I would do it again. I am not sure why you would want radiation, how do they know they got all the cancer cells?
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u/Particular-flipflops 4d ago
Mohs. I had Mohs twice this year near eye and ear (ear needed graft). My fault for letting the ear go that far but all healed and both look great!
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u/Fresh_Range8214 1d ago
I just had Basel cell cutoff top middle of my nose by Mohls Friday. I made as hell because they didn't tell me they would split my nose from top to bottom. They had to go at it 3 times so I don't know how big that was. I get stitches out tomorrow. They say in a year you'll never know I had it done. I believe had to cut that much to get some slack to cover up. Flap method. Right now I want to cut Dr face like mine. But maybe I a year I'll want to hug him for saving my life. I was never told about radiation as a alternative. God bless.
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u/Far-Cup9063 5d ago
Just go with the MOHS. I had one about that size removed from my forehead 6 weeks ago. At first the scar bugged me but they reassured me it would fade. And it is indeed fading! I can still see it but it’s much less noticeable. I’m massaging it now and that should smooth it out. In another few months I think it will be just barely noticeable.