Choice of treatment for superficial BCC on face

Hi - I was given a choice of surgical treatment or radiotherapy, with firm recommendation that I had the radiotherapy, as mine is micronodular and invasive. My GP originally diagnosed my BCC as superficial and prescribed Aldira (iquamod) which has a good success rate for superficial BCCs. I have read that other treatments are sometimes recommended, such as cryotherapy, phototherapy, laser etc. Perhaps you could do some online research into the different treatment options before your appointment so you have time to consider what would be best for you. Good luck, let us know how you get on x

Hopefully you will be guided by the specialist as to what is the appropriate and best treatment for your situation, can’t imagine they will offer you the choices and you pick one. Go with whichever your specialist recommends is my best advice.

I will be guided by the specialist - in fact I'm really hoping they give me firm guidance rather than a choice! But the phrase in the letter, further treatment that is 'not necessarily surgical', sounds as if there is some doubt/choice involved.

Thankyou Didi - I'm sorry to read you had an earlier misdiagnosis (of superficial bcc) which delayed your treatment. I assume that my diagnosis is ok since I had the biopsy first. I have been reading about all the possible treatments so I do know what they are and official pros and cons, but there is no clear 'first choice' it seems which is why I was wondering how the decision would be made.

It's difficult to have received a diagnosis by letter with no explanation, and then have to wait 6 weeks before I can talk to anyone about it. The consultant who I saw initially said very little, walked away without answering questions, and just said he would refer me for a punch biopsy. I am afraid I will be seeing the same person to 'discuss' treatment, in which case I doubt I will get much explanation of treatment decisions or options. I would very much appreciate reading something by someone else who has had a superficial bcc on the face, perhaps near the eye.

It isn't ideal to get a diagnosis by letter, and then have to wait 6 weeks before anyone discusses it with you. I'm finding the lack of information hard to deal with. I have trawled the internet but it is confusing because of the number of options for superficial bcc, and the complication of being near the eye. The consultant I saw initially said very little to me, walked away without answering questions and just referred me for a biopsy, so if I am seeing the same person next week I doubt I will get much in the way of explanation. It would be really helpful to read the experience of someone else who has had a superficial bcc on the face that couldn't just be removed by a first excision or biopsy.

It may not be in your nature but go with a list of possible questions etc and be a bit more forceful and don’t let him/her leave until YOU are satisfied. 

Hi Greyowl - I was offered the choice of surgery or radiotherapy, with a recommendation to go for radiotherapy, but my records show it as my decision. There are always pros and cons with any treatment, so it is best to get all the information, including the doctors recommendation, and decide what is best for you. 

A superficial BCC confirmed by biopsy is a good one to have, with an excellent chance of being cured completely. I hope your appointment goes well. x

Yes I agree this is the way to do it, and had planned this. However, I saw at my first appt that the dermatologist wasn't going to respond well to questions. And indeed that was right. At my appointment today, my first since receiving a bcc diagnosis by letter, the dermatologist towered over me on a treatment couch and announced that he would use cryotherapy and then prescribe 'some cream'. I was a little taken aback that there was no discussion offered at all about my diagnosis, or about possible treatment options, or about why this was the best treatment option in his view.

Naturally I said I would just like to ask a few questions - but his answers were all very non-committal and unclear, and he seemed very irritated. He said he couldn't discuss other options - if I wanted he could refer me for surgery but he didn't express an opinion on this. (After a bcc diagnosis by letter, shouldn't consultant discuss the options with you and explain what they are?)

I felt I needed to agree to get the treatment started so I said ok to the cryotherapy plus cream, fearing long delays if nothing got decided. He started preparing me for the treatment, and then he remembered I had to sign a consent form. I saw that this form asked me to confirm I had received printed information about the treatment, which I had not. He pointed to a leaflet that he'd put aside for me, so I asked to have a look at it before I signed. He had told me that the treatment would not lead to a scar, or to blisters both of which were listed as likely in the leaflet.

When I was reading the leaflet and before I had said anything more he suggested I take it away and come back for another appointment another time ie I was wasting his time. I could see the leaflet only told me what I knew already so I said no I'd best get on with it and have the treatment. I felt so desperate at this point to get something done, and thought I would regret the delay if I went away - and also I thought I should have had the right to this discussion before treatment. But he was so irritated with my questions at this point that he then refused to give me any treatment at all and said I should see someone else. Humiliatingly I pleaded with him but he refused to treat me - said he need to refer me to a colleague but wouldn't say why (I accepted the treatment, and the diagnosis was clear, he could give no rational reason).

So going in intending to ask intelligent questions doesn't always work....

So sorry to hear that your doctor was so unhelpful. I really don't think that it is an acceptable way to treat a patient. You are entitled to be fully informed about the treatment you are receiving, including the possible side effects.  Hopefully you'll get an appointment with a more reasonable doctor soon. Di x