Basal Cell Carcinoma

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I have been recently diagnosed with BCC which is a lump growing on the side of my nose. It’s been there around 19 months and just appeared as a lump. However, since about February it had started to grow and is branching upwards. I went to the Dermatologist at hospital who said it was too big for him to deal with and would need attending by a plastic surgeon. I saw a plastic surgeon at the end of June and surgery to remove it is scheduled to take place at the end of the month. He said it was very large although doesn’t seem that large to me but according to them it’s considered large in medical terms. The surgeon said he will need to do a skin graft at the same time and will take the skin graft at the same time. I asked how long the operation would take and he said about 1 hour. But he said he is not going to give me a GA or any sedation. I am worried about this as it seems to cut this thing out and do skin graft is going to be very painful and there is going to be lots of blood and other unpleasant things happening. I think a 1 hour operation without any anaesthetic or sedation is a bit much. What is your opinion on this? Is this common to do this whilst wide awake? Is it going to be very painful? It certainly sounds so and I am very scared about this. 

  • Hello steveb56,

    Thanks for getting in touch and a warm welcome to the Online Community. I’m Heidi one of the Cancer Information Nurses here on the Macmillan Support Line.

    I am sorry to hear that the procedure to remove the Basal cell carcinoma (BCC) has been causing you to worry, and it is understandable that you are feeling nervous about having surgery. I hope the following information helps.

    BCCs are the most common type of skin cancer developing from the basal cells that are found in the epidermis, the deepest part of the outer layer of the skin. You might have also heard them called rodent ulcers.   

    There are different types of BCCs, and each can appear and behave differently. BCCs rarely spread to other parts of the body, and most are very slow-growing.  

    The most usual treatment for BCCs is surgery, and most BCCs are treated using a local a local anaesthetic to number the area. A local anaesthetic can be used when a smaller skin graft is needed.

    You should have a nurse with you throughout the procedure who can provide reassurance and let the surgeon know if you are feeling uncomfortable. They will keep you distracted and help to keep you feeling relaxed. If you feel that the procedure will be difficult to cope with, you could speak with your plastic surgeon or dermatology team again, or talk to your GP.

    The procedure should not be painful, nor should there be lots of blood, to reassure you. Your dermatologist will talk to you about wound care following the procedure. The area to your nose and the skin graft may feel sore once the local anaesthetic has worn off and your surgeon can advise about pain relief while you are recovering and the areas are healing.

    Nearly everyone who has treatment for a BCC is cured, only very occasionally, if left untreated, they may spread more deeply.

    Most BCCs are caused by skin damage and your dermatology team can advise you about how to protect your skin and reduce your risk of further BCCs developing.

    We would encourage you to have a further conversation with your surgeon, or the dermatology team about your surgery. It is important that they know how scared this is making you feel. They can tell you more about what to expect and support you throughout.

    Dealing with cancer can be an emotional time and you might find it helpful to read our web pages about getting emotional support. You can also check our webpage to find details of support and information organisations in your area.

    Sometimes talking things through helps so please don’t hesitate to contact the nurses on 0808 808 0000, we are here 8am to 8pm every day. We also have a welcoming Skin cancer forum, talking to others who understand can be very supportive.

    I wish you the very best for your surgery and please don’t hesitate to get in touch again if we can support you further.

    With best wishes

    Heidi

    Cancer Information Nurse Specialist 

     

    You can also speak with the Macmillan Support Line team of experts. Phone free on 0808 808 0000 (7 days a week, 8am-8pm) or email us. 

    Ref/FH/HC