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Skin cancer

A place for people affected by any type of skin cancer, including basal cell carcinoma and squamous cell carcinoma, to support one another, ask questions, and share their experiences.

Mohs or Aldara

bbecca14
Posted by

I have had an area of concern (to me) on my nose for over 3 years.  Have been to the dermatologist numerous times during this period and she said it was nothing.  I finally insisted on a biopsy and it came back as superficial basal cell.  

They are recommending Mohs surgery but I am nervous about it as it is in a location (right side tip) that could possibly require extensive reconstruction surgery.  I had a consult with the surgeon this weekend and he said the lesion appears small and probably wouldn't require reconstruction (forehead flap) but wouldn't know for sure until they did the surgery.  

I asked about using Aldara and both my dermatologist and Mohs surgeon agreed I could try that and then be reevaluated after that treatment.

Now I'm reading all the scary reviews of bad side effects online for Aldara.  

Can't decide if I should just do the Mohs or try the Aldara.

I had Mohs 13 years ago (also on my nose but on the far side-2 passes).  The closure was just 7 stitches and no scars left behind.

Mohs just freaks me out because you are lying there and you don't know what the outcome is, meanwhile they continue to cut more off your face and you have no control over what is happening.  I also don't know thnik I could handle the forehead flap agony.

Has anyone on here had a successful outcome with the Aldara without terrible side effects.  I realize the site area will get red, scabby and awful looking but i am more concerned about the systemic effects.  And did it work for you.

latchbrook
Posted by

Hi and a warm welcome to the online community

I haven't had either procedure so can't help with experiences I'm afraid but I wanted to take the opportunity to welcome you to the group.

There are quite a lot of people who have both types of treatment in this group and, while you're waiting for replies, you could use the search bar in this group to look for previous posts. Simply typing in 'Aldara' or 'Mohs' should bring up plenty of posts for you to look through and you could always respond to any that you think might be able to help you further.

Let us know what you decide to do

x

 "Never regret a day in your life, good days give you happiness, bad days give you experience"

What is a Community Champion?

Pontymel
Posted by

I have recently finished using Aldara. I haven’t had surgery so can’t comment on that. Aldara made me feel really dreadful for 3-4 weeks. So poorly I barely went out or did anything. However I am aware that not everyone feels like that. Also one of the two lesions reacted so severely I was advised to stop using Aldara on it after 5 weeks. I have had to have two bouts of antibiotics because of the infection and inflammation. It has also been extended painful. Still not out of the woods with it. However I must say the other lesion I had gave me no issues or problems. So again not everyone experiences what I did. 

After my experiences would I use Aldara again? I don’t think so. I have had a really miserable 6 weeks. In hindsight surgery would have been all over by now. However this is just my personal experience. I am sure other people will tell you using the cream was fine. You just don’t know how the cream will effect you, you may well be absolutely fine. 

bbecca14
Posted by

Thanks for the reply.  Your reaction matches a lot of reviews I have read about this drug online.  It seems a large percentage of people who use this drug have bad reactions.  

I'm leaning on going with the Mohs.  I figure if I used the Aldara for 6 weeks I will look and probably feel horrible and if it doesn't work would have to do the Mohs anyway.

I'm a bit concerned about the Mohs being this is on my nose and the probability of having some kind of reconstructive surgery is likely.  I am planning to do this in January so will be a good time just to hunker down at home until I am presentable to go out in public.

Pontymel
Posted by

Whatever you choose to do I hope it all goes well with you.

latchbrook
Posted by

Hi and happy New Year!

I wondered which treatment option you decided on in the end. It would be really useful to know what you decided and why for people who come here in future.

x

 "Never regret a day in your life, good days give you happiness, bad days give you experience"

What is a Community Champion?

bbecca14
Posted by

I guess the answer would be both.  I had a consult with the Mohs surgeon in October and scheduled the surgery for January 14.  In the interim, both the surgeon and my dermatologist said I could try the Aldara.  I began that on November 11 and did the 6 week treatment.  I saw my derm during week 3 and she thought I wasn't having enough of a reaction and increased my dosage from 5x a week to 7x a week.  That seemed to get things going and I had a pretty good reaction, although not severe.

I am going to see my derm on Jan. 8 and she is going to biopsy the site and determine if I should still go for the Mohs.  I have the feeling I will still have the Mohs.

The Aldara was tolerable but not fun.  The site first got red, then very crusty and scabby.  The scabs would fall off and then form again.  It's taken almost 2 weeks for them to heal after finishing my treatment.  I felt pretty good physically until about the 4th week when I developed a raging Urinary Tract Infection.  I don't know if that was related to the Aldara.  Once I got on antibiotics for that I started feeling better.

I'm not sure I would do Aldara again.  I walked around for 6+ weeks with an ugly looking nose.  Now I am facing the Mohs and will have to walk around with the aftermath of that for many more weeks.  Seems like a really long process.

I am at the point that I just want to get it all over with.  I am terrified I will have to have a forehead flap but if I do it's the middle of winter and I will just hibernate for a few months.

I will keep you posted.

This website is helpful.

latchbrook
Posted by

That's interesting that your consultant decided to try you on Aldara while you were waiting for the Mohs Surgery . I assume that the thinking was that if the Aldara cleared the BCC then you wouldn't need to have surgery.

I'll keep my fingers crossed on the 8th that the consultant doesn't feel that you need to have Mohs surgery.

x

 "Never regret a day in your life, good days give you happiness, bad days give you experience"

What is a Community Champion?

Camelia123
Posted by

When I had a large bcc removed from a toe and the pathology showed an involved margin I had the option of further surgery or Aldara. Chose surgery. Main reason was that I would have proof that all the cancer had been removed. Not on my face though so different situation to you.

bbecca14
Posted by

The good news is my dermatologist biopsied the site of the superficial bcc and it came back negative for basal cell!!!  It appears the Aldara did its job.  The bad news is she still wants me to go to my Mohs appt. on Tuesday and have the surgeon check areas around the site to make sure there aren't any "rogue" cells left.  I guess I'm okay with doing that, hopefully this will be just minimal scraping and it will give me peace of mind that it's all gone.  I will update after the Mohs appt.

latchbrook
Posted by

That's great news that Aldara seems to have done it's job

Let's hope that the Mohs surgeon doesn't find any rogue cells.

x

 "Never regret a day in your life, good days give you happiness, bad days give you experience"

What is a Community Champion?

Angie43
Posted by

I wanted to share my experience as a sufferer of both melanoma and bcc skin cancer. I understand the concerns around aldara and surgery . I last year had a cancerous bcc biopsy on my forehead and we opted for aldara. As a women in my early 40 I apparently reacted very well however the treatment is in my opinion harsh ( if you react well) very large  sores which are uncomfortable, they also impacted the treatment length and I was unable to do anything for 2-3months .whilst this treatment is harsh the results are fab (when it works) no scar and new skin, however I will Tuesday have more biopsies for two more expected bcc’s I too will have to consider the aldara against surgery it will in my opinion depend on the impact on scarring for the face. I would use aldara again just for the result.
I already have skin surgery on back , neck and chest which some how feels less intrusive . The face causes severe anxiety in my opinion  so I wanted to share I understand your situation and wish you well with the surgery . 

bbecca14
Posted by

I know, it's a tough decision to make when you are dealing with a bcc on your face.  If it was guaranteed that it would be an easy Mohs with a small scar on my face I would go with the Mohs over the Aldara.  The problem with Mohs is you don't know until they start digging and that's what scares me so much.  It seems one has absolutely no control over the Mohs outcome.

The Aldara is a long process.  Six weeks of treatment and then it took another two weeks to start looking normal again.  I endured this through the Thanksgiving/Christmas holidays, not looking my best at social/family gatherings.  A simple Mohs could just be a day and it's all done. 

This is my second bcc, I'm sure I have more in my future.  I wish they could come up with an easier cure.

jennaustralia
Posted by

Hey bbecca14,

I’m sorry I missed your post until now. I was in pretty much the same position as you, Aldara or MOHS. After much reading and 4 different professional opinions I went with MOHS, mainly because I didn’t want to take the chance of having Aldara and still needing surgery. As I’d had the bcc frozen off 4 years earlier and it came back, it was considered more possible to not be totally gone with Aldara. My bcc was between my nose and lip and only the size of a pin head. Dry and itchy. The specialists all told me it was nothing for 2 years until i insisted they biopsy it. 

To be honest I found the MOHS procedure quite traumatic but painless. I’d highly advise to have light sedation if you can. I had a Valium and 5 mins later they called me in so I was on high alert for the entire time. It only took two goes at it, but left me with quite a big hole in my face. And extremely swollen. Lips are known to inflame easily. It was followed by plastic surgery to graft the hole left, from my cheek, near my ear. The graft was not a problem at all, the mohs had a pad sewn on to it and then I left it covered for a couple of weeks with tape. I had 3 weeks off work. I was very self conscious for a couple of months, used silicone patches every night to hydrate the scar. and then just got used to it. Most people don’t notice until I point it out. It’s a pretty good result. I don’t think I’d be so scared in the future but would defiinitely ask for light sedation. However I’ll also be more open to using Aldara for any new spots in the future too, as had a friend who had a good result with new spots. All the best.

bbecca14
Posted by

I had my appointment for my Mohs surgery this morning.  The surgeon reviewed the results of my negative biopsy following 6 weeks of Aldara use.  Since the biopsy was negative he gave me the choice of having Mohs to see if any "rogue" cells were left or taking a "wait and see" approach.  He was a bit concerned because the biopsy they took last week was very small and could represent a sampling error.  However the original biopsy showed superficial basal cell which responds well to Aldara.  He also reviewed pictures of my nose at it's worst during the Aldara treatment and felt I  showed a strong response.  It was a no-brainer for me, I took the wait and see approach.  In the last 3 months I have had 2 nose biopsies, and 6+ weeks of a gross looking nose from the medication and I want to look normal for a while.  If it comes back in the future I will get the Mohs. 

So that's the end of my "Mohs or Aldara" saga.......for now.