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The Dangers of Delaying Treatment for Basal Cell Carcinoma

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How Putting Off Mohs Surgery Can Lead to Recurrence, Disfigurement, and Worse

Basal cell carcinoma (BCC) is the most common form of skin cancer in the U.S. According to the Skin Cancer Foundation, more than 2 people die of skin cancer every hour. While BCC grows slowly and rarely spreads to other parts of the body, it can grow deep into tissues and bones if left untreated, causing damage and disfigurement. 

The most effective treatment for BCC is Mohs surgery, a specialized technique that removes the entire tumor layer by layer while minimizing the amount of healthy tissue removed. But what happens if you don’t have this surgery to fully extract a BCC tumor?

At Dermatology and Skin Health, we want our patients to understand the consequences of delaying treatment for basal cell carcinoma. Putting off Mohs surgery can allow the cancer time to advance, recur after incomplete removal, and potentially lead to metastasis in very rare cases. 

Our medical director Dr. Gary Mendese explains the risks and why prompt treatment is so important.

Take control of your skin health today - schedule a consultation with our expert dermatologists and start your journey towards effective treatment

The Risks of Incomplete Removal

Close-up of a small, open wound on skin.
Close-up of a small, open wound on skin.

Mohs micrographic surgery has the highest cure rate of all BCC treatments, as high as 99% for certain tumors. It involves progressively removing layers of tissue and examining them under a microscope during the procedure until no cancer cells remain. This allows complete removal of all roots and extensions of the tumor.

If a BCC is not fully extracted, whether due to patient delay or from another treatment, there are several possible negative outcomes:

  • Recurrence - Any remaining cancer cells can multiply and lead to the tumor coming back, especially in sensitive areas on the head and neck. Recurrence requires undergoing additional surgery and increases complications.
  • Progression - In rare cases, partially removed BCCs can turn into more aggressive squamous cell carcinomas or melanomas over time.
  • Local Destruction - Untreated BCC slowly destroys surrounding tissues like cartilage and bone over years or decades. This can lead to disfigurement and loss of function in the affected area.
  • Metastasis - There is a very small risk that an incompletely excised BCC could eventually spread to distant sites like the lymph nodes or lungs. This occurs in an estimated 0.0028% to 0.55% of cases.

Why Catching Skin Cancer Early Is Critical

Because BCC grows slowly, patients sometimes put off having it treated. But even though most cases don’t become life-threatening, delaying care allows destruction and complications to progress. It’s crucial to have BCC completely removed as soon as possible after diagnosis through Mohs surgery.

At Dermatology and Skin Health, Dr. Mendese performs Mohs surgery within just days or weeks after biopsy confirms BCC. This protects patients and prevents avoidable harm. Other facilities sometimes have long waiting lists, but delaying surgery even a few months provides a window for possible recurrence or spread.

Don’t take chances with your health - seek prompt BCC treatment

What to Expect During the Mohs Surgery Process

Many patients feel anxious about undergoing Mohs surgery. Understanding the step-by-step process can help ease some of this apprehension:

  1. After arriving, you will meet with Dr. Mendese to discuss the procedure and answer any last minute questions.
  2. The visible tumor will be numbed with a local anesthetic, so you will not feel pain during the procedure.
  3. Using a specialized technique, the doctor removes the first thin layer of tissue containing the tumor.
  4. This layer is color coded and transported to our on-site lab for freezing and examination under a microscope.
  5. If any cancer cells are seen at the edges, Dr. Mendese removes another tissue layer, and the process repeats until the margins are completely clear.
  6. Most cases resolve after 1-2 layers, but complicated sites may require additional stages. Mohs allows cancerous cells to be mapped and precisely targeted.
  7. Once clear margins are achieved, the wound is ready to be closed with sutures or a reconstructive technique.
  8. The procedure from start to finish typically lasts 1-3 hours depending on the tumor size and location.
  9. You will receive post-op instructions about rest, care for the site, medications, and follow up.
Recovering After Mohs Surgery
1. Mild pain, swelling, and bruising that typically resolves within 1-2 weeks with OTC pain relievers.
2. Keeping the site clean and dry for proper healing and changing bandages as directed.
3. Some restricted activity for 1-2 days to avoid re-bleeding from the surgical site.
4. Potential temporary numbness around the wound as the local anesthetic wears off.
5. Follow up appointment in 1-2 weeks to monitor healing and remove any stitches.
6. Use sun protection diligently on the site for at least a year as it heals to avoid complications.
7. The wound may leave a small scar, but precise Mohs removal minimizes disfigurement.

Call the office if you experience excessive pain, bleeding, swelling, pus, fever or other signs of possible infection. Most patients recover well within two weeks.

When Mohs Surgery May Not Be Recommended

A medical professional stitches a wound on a patient's neck.
A medical professional stitches a wound on a patient's neck.

While Mohs micrographic surgery is highly effective for treating most basal cell and squamous cell carcinomas, there are times it may not be the best option:

  • For very large skin tumors that have grown deeper, traditional surgical excision may remove tissue more quickly.
  • If the BCC has spread to lymph nodes, additional treatments like radiation or immunotherapy may be recommended along with limited surgery.
  • In rare cases of basal cell carcinoma on the trunk, observation may be reasonable if the patient is elderly or has other health conditions.
  • Recurrent BCCs that come back after previous radiation treatment can be challenging for Mohs to remove entirely.
  • Melanoma and other rare skin cancers require different treatments like wider excision. Mohs is only used for BCCs and SCCs.
  • Patients who are not good surgical candidates due to health issues may need alternate treatments.

Take control of your skin health today - schedule a consultation with Dr. Mendese and start your journey towards effective treatment

Frequently Asked Questions About Mohs Surgery for Basal Cell Carcinoma

Many patients have questions about Mohs surgery and what happens if they don’t undergo this specialized treatment for basal cell carcinoma. Here we provide answers to some frequently asked questions.

What is Mohs Surgery and Why Is It Important for BCC?

Mohs surgery, developed in the 1930s by Dr. Frederic Mohs, is a precise technique for removing certain skin cancers layer by layer. After each thin layer is taken out, it is immediately examined under a microscope to check for cancer cells at the margins. More layers are removed until no cancer remains. This allows complete removal while preserving healthy tissue.

For basal cell carcinoma, Mohs has the highest cure rate of all treatments, as high as 99% for some tumors. It helps remove the entire cancer while minimizing recurrence risk. Mohs is especially useful for BCCs in sensitive facial areas near the eyes, nose, and lips where precision is vital.

What Are the Benefits of Prompt Mohs Surgery?

Getting Mohs surgery shortly after BCC diagnosis provides the following advantages:

  • Highest chance of eliminating all cancer cells before they can multiply
  • Preventing local tissue destruction or disfigurement early
  • Lower recurrence rates compared to delayed treatment
  • Smaller removal area by eliminating BCC before it enlarges
  • Reduced need for reconstructive surgery after removal
  • Avoiding progression to more dangerous skin cancer types
  • Peace of mind knowing the cancer is treated

Our team schedules Mohs surgery as soon as possible after diagnosis to ensure successful outcomes. Any delays could reduce the effectiveness of treatment and require more extensive surgery.

What Should I Do If My BCC Surgery Is Delayed?

If circumstances cause your Mohs surgery to be delayed more than a month after skin biopsy, talk to your dermatologist. They may recommend techniques to help monitor the cancer in the interim:

  • Digital photography to track growth or changes
  • Repeating biopsy to check margins of BCC
  • Temporary topical treatment to potentially slow cancer spread

While Mohs surgery should not be delayed indefinitely, these methods can provide some oversight if a short postponement is unavoidable. But remember, BCC will continue growing during any delay, so treatment should occur as soon as realistically possible.

What Are the Risks of Not Treating a BCC Promptly?

Delaying treatment of basal cell carcinoma allows the cancer time to extend deeper and wider. Possible risks include:

  • Lower chance of complete BCC removal
  • Increased likelihood of recurrence
  • More extensive surgery needed
  • Slow destruction of surrounding tissues
  • Eventual disfigurement or loss of function
  • Small chance of metastasis years later

While most untreated BCCs will not be fatal, postponing care allows avoidable local tissue damage. Our doctors recommend scheduled Mohs surgery within weeks of diagnosis for the best outcomes.

Get Specialized BCC Treatment From Our Experts

A group of six individuals posing for a photo in an office setting with signage indicating a dermatology and skin health clinic.
A group of six individuals posing for a photo in an office setting with signage indicating a dermatology and skin health clinic.

Dermatology and Skin Health provides unmatched expertise in skin cancer treatment. Dr. Gary Mendese has advanced fellowship training in Mohs surgery and performs over 2,000 cases annually, including treatment of complex facial tumors. If you’ve been diagnosed with basal cell carcinoma, we offer trusted care with prompt surgical options.

To schedule an appointment and learn about the advantages of our Top-Rated BCC Removal, contact Dermatology and Skin Health today. With multiple New Hampshire and Massachusetts locations, we provide compassionate care and the most successful approaches. 

Don’t delay - call us now to start treatment within weeks. Your skin health is our priority.

DOVER - (603) 742-5556

NEWINGTON - (603) 742-5556

PEABODY - (978) 525-0100

LONDONDERRY - (603) 742-5556

BEDFORD - (603) 742-5556

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