50/50% chance of morpheoform BCC -or sun damage, nothing in between.

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I live in Shetland and this is what I have been told by the visiting dermatologist. The barely visible legion on my nose is either sun damage - relatively easily treated - or morpheoform BCC, nothing in between. He has referred me for a 3mm punch biopsy, to be done by a doctor at the island’s hospital, and said that if it is morpheoform BCC, I will need plastic surgery, 4mm clearances  and skin graft, which would be done at Aberdeen. He has said nothing of Mohs surgery, which I believe to be the best option as far as recurrence and scarring is concerned, so I don’t think it’s been considered for me. Living  in Shetland, I am having great difficulty in finding anyone here who can give me any information as to what my options will be if I do get the BCC diagnosis, what I will be offered or other options that may be available to me, or what the results are likely to be. My GP was unable to give any opinion or advice whatsoever and there is no dermatology department,  or dermatologists, at the island’s hospital.

As I have keloids, I am very anxious - more so because of I do not seem to be able to have access to a professional who can give me this information. I wish to make a well informed choice - I made some poorly informed choices when I was treated for breast cancer here in 2016 and subsequently, due to the lack of professional advice and treatment here, and have to live with the consequences.

I am hopeful that if I need to go to Aberdeen that I will then have access to better information - but it would be very helpful if I knew what to expect and what my options might be, beforehand.

 I would be very grateful if anyone can point me in the right direction.Smirk

  • Hi MMrs C Sorry to read your post. It is always scary when we are first diagnosed with bcc.  I have had 2 on my face, one near my nostril where I had skin flap surgery and another by my eye where I had a skin graft. Both are healing fine and all margins are cancer free.  I elected not to have MOHS surgery as my plastic surgeon told my the ordinary way was 96% chance of getting it the first time, which he did.  I have scasrs - yes - but the are getting less each day and I was told it takes 12 months for them to fade almost completely and I am not there yet.  I have bad days still and get upset by it all, but this site is brilliant for advice.  Feel free to ask me any questions you want to and good luck x

  • Hi Harlan,

    Thank you for your reply,
    Sorry I seem to be having trouble with using the “reply” - I couldn’t get it to work - I only hope that I have not accidentally pressed the “flag to moderator” in my efforts to get the “reply” work Face palm tone1‍♀️  - if so, please accept my apologies.
    I was “diagnosed” by my GP on 8 April this year and told that it was a non urgent BCC - that I was referred to the dermatology clinic that would be coming up to Shetland in 6-8 weeks, where it - and a cyst on my back - would be removed. I was fine with that, though a bit concerned with any scarring on my nose.
    However, when the clinic came in May and I saw the dermatologist, he had apparently only been informed of the cyst on my back. He also said that this clinic was not equipped to do any treatment - so no surgery which I had prepared myself for.
    When he looked at my nose, he told me that it was not “what I had been told it was” and that he “wouldn’t touch it with a barge pole”. He said that it was either morpheoform BCC - which would require 4mm clearances and skin grafts, plastic surgery - rather a lot of my nose - or that it was actinic keratosis. He gave it 50/50 and said it was definitely one or the other. The area is about 1cm square on the bridge of my nose, barely discernible by colour and the edges are not well defined. You can hardly see it.
    When I called to find out when my referral might be some 2 weeks later, there was initially no record of any. Eventually, a week later, I found that I had been referred to the hospital here for a punch biopsy - non urgent - so that would be about 4 weeks, and then another 4 weeks before getting the results - before even finding out what or when my treatment/surgery might be.
    I am afraid my previous experiences of the care and support I received for breast cancer are all being triggered. The scars from the mastectomies can be hidden, my nose can’t. Scars take more than 5 years to settle for me.Though the visible effects of the scars are not the biggest problem - it is the effects of the tightness of the internal scarring, which eventually broke my ribs subsequent to my surgeries. I had no idea what was happening or that this could happen and because it was not a recurrence of cancer - thankfully - I had no help with this at all. Which is why I am so anxious - understatement - and the lack of being able to speak to any professional here isn’t helping.
    I am glad that you are healing well and that the surgery seems to have worked well for you - that your recovery continues well. I perhaps need to wait longer until I have an appointment to speak with the dermatologist again - it’s hard when this has been ongoing for so long.

     Mrs. C