Infiltrating BCC treatment

Hi barleypondsgirl50%

Sorry to hear you have a basal cell.

Mine was on my nose but I was given the choice of having a wide excision or mohs. I met the mohs surgeon who was happy to do it but both him and the head and neck consultant felt that a normal excision would be enough.

The waiting list for mohs was ten months.

As far as I know, mohs cannot be fast tracked on the nhs but I could be wrong.

As regards the size of the wound a lot depends on the size of the lesion and where it is and whether a flap or graft needs to be used or if they can suture the wound side to side. Also, a margin of healthy skin will be taken.

How big is your basal cell?

The best thing you can do is discuss your concerns with your consultant. They're normally very happy to answer your worries.

I don't know the cost of private mohs but there are people on here who have paid privately so hopefully they'll see your post and be able to help you.

Please keep in touch and let us know how you get on 

Also, it's perfectly normal and ok to feel stressed and down about it all. Don't feel bad about that. It's all part of the process.

You'll find a lot of kindness and support on this group as we're all in or have been in a similar position

Hi BarleyPondsgirl50% 

I can't help with your questions or about how much having Mohs privately might be, but LuckyLass recently posted about having Mohs privately. I don't know if she went ahead with a private operation but I've 'tagged' her in to my reply to you in the hope that she'll pop on and share her experience with you.

While you're waiting for possible replies, you could phone your local private hospitals to see if they offer Mohs surgery and, if so, they should be able to tell you about the costs involved.

It would be great if you could pop something about your diagnosis into your profile as it really helps others when replying to you and also when looking for someone on a similar pathway. It also means that you don't have to keep repeating yourself. To do this click on your username and then select 'Profile'. You can amend it at any time and if you're not sure what to write you can take a look at mine by clicking on my username.

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Hi BarleyPondsgirl50%   I have had 2 basal cell cancers removed from my face, both done privtely at Nuffield Hospital.  I was offered MOHS surgery but my Plastic Surgeon was confident that he could remove it by skin flap and skin graft, which I elected to have, and fortunately he did manage to get all the cancer out.  MOHS is not readily avaialble at all Nhs hospitals and if having it done privately you sometimes have to go to an Nhs hospital "out of normal hours" to have it done privately which I think I would have had to do had I gone down this route.  I am sure you cant be fast tracked for it on NHS and you may have to travel to a hospital near you that does it.   How big is your bcc and what have Consultants advised.  It is natural to feel stressed, believe me, I was totally stressed until I found this site and discussed it with people in the same position. Feel free to ask us anything and someone will help you. Perhaps after your consultation younwill know more about which path to go down for treatment.  I am not sure how long I would have waited on NHS but think it would have been a while as they dont seem to consider them urgent.  Going privately I ony waited a couple of weeks for the first one, then about 10 weeks for the second one, as he wanted me to heal a bit before doing further surgery.  Feel free to ask me anything else and I will try to help you. 

Hi Barleypondsgirl50%  I am sorry that you are in this position, I was shocked and upset by how major the treatment was going to be for something which seemed so minor.  But the good thing is that this can be cured.

My BCc was on my nose.  I don’t know if yours might be more straightforward being on your scalp.  I have had a melanoma treated by WLE 10 years ago - all clear since, which is one reason for calling myself LuckyLass, because I have been very lucky.  As I recall, the WLE wasn’t a big deal at all.  It was the back of my thigh, and it was sore and the site felt vulnerable for a little while, but mostly the issue was the fear of the melanoma spreading.  The procedure was very quick under local anaesthetic and I don’t remember even having much time off work.   So a scalp bcc may be as simple as the one on my thigh - cut out the area and pull the edges together and sew it.  The problem with my BCc was the location, on the nostril.

I had MOHS privately .  It wasn’t a difficult decision for me, whether to have MOHS, because the bcc was on my nostril, and MOHS takes the minimum amount away.  Deciding to go private took a couple of weeks of hard thinking.  Please brace yourself, it was expensive.  The MOHS cost £2500.  But then I needed a two stage reconstruction, so two operations, for a total of £11,100.  Plus the consultations beforehand and a biopsy totalled about another £1000.  So getting on for £15,000  I felt sick when I found out the cost, and angry that the NHS wasn’t there for me.  I had by then been on the NHS waiting list for some months and I thought I could feel the little beastie growing and I worried that I would lose a huge part of my nose by waiting.  I have come to terms with it all pretty much now.  I count myself lucky that I could scrape up the money, and that I could get the treatment I needed.  I didn’t shop around - I couldn’t really bear to think about it, I just wanted it over and done with and once I had paid for a couple of consultations and got on the track I didn’t want to switch private hospitals and have to start all over.  So maybe I overpaid, I don’t know.  But if you don’t need the reconstructions it won’t be nearly so expensive.

Good luck, I hope that you get the treatment that is best for you.

Very many thanks for your reply. I knew it would be expensive but still got a bit of a shock. I understand when you say you couldn't bear to think about it, I feel much the same. I am so glad you can now put it behind you.. Whatever the cost, if you can manage to find the money you can't put a price on peace of mind.

Thank you for your your kind and helpful reply. We are not sure how big the bcc is at the moment as we don't know what is under the skin. Under the NHS we  have been offered a skin graft or a purse string closure with the centre left open to heal on its own which we have been told may be less noticeable and a better skin match than a graft. However we will see what the private consultant says. Just to avoid any confusion, I have always written the messages as if it was me who had the bcc but it is actually my brother. He has no hair and therefore very concerned about what it will look like and is very stressed about it. He has already had 3 bccs removed under the NHS but they were very small and although on his neck and face the scars can barely be seen.. I believe the wait time for MOHS on the NHS is between 9-12 months. I am so glad your surgery went well and you can now put it behind you.

Removal of BCC and Purse string closure cost £1300 and detailed and helpful consultation £250.  Final consultation when fully healed will be £145.  This includes all wound checks and dressings.  I feel it was worth it because I didn't have to wait around and the follow up was much better than I have received from NHS for previous removals.

Bcc removal by MOHS is tomorrow. We are having to travel quite a way and are worried about how often the dressings will need to be changed in view of the distance to travel. It will obviously need to be checked properly to see if everything is OK. Can you help at all please in view of your experience. I hope you are ok and have a good Easter.