@sef26
I have had MOHS surgery 4 times. I also have had non MOHS surgeries. I am not familiar with the IG-SRT treatment. Is that radiation? If so I have had radiation treatments for prostate cancer but not skin.

Basal cell carcinoma (BCC) is very common especially for those of us who grew up in the sun. I probably have had 4-5 BCC over the years and now 4 SCCs. I was told the cause was what I did 30-40 years ago and damaged caused by skin burns and constant UV damage to my skin.

I have not had problem with MOHS on my nose and other areas. Healed quickly and skin not a problem. But the recent two on my hand a different issue. I am 78 so my skin is very thin on my hand. The first MOHS there I had stitches to close. They were the dissolving ones. Took about 2 weeks for stitches to start coming out and area along incision not pretty.

The second surgery on same had they used regular stitches. After on week had them removed and immediately the incision site started to separate. I was told this was normal but has caused a long longer healing process.

But that is the negative the positive is that MOHS surgery removes the cancer at that office visit. The surgeon will remove enough skin around the biopsy and then study under microscope with a dye. If there is not sign of cancer around the margins of the removed skin you are done. If there is any sign then they remove more and this process continues until no sign of cancer.

If you have radiation that is not the method done and the radiation is used to kill the BCC. The type of radiation used is important (Photon, Proton) and can cause radiation damage to surrounding tissues. Since never had radiation for BCC best to talk about the pros and cons of the other procedure.

The MOHS surgery will remove the cancer and will only take enough tissue to get all of it out. Good luck on your decision.

@sef26 My mom had mohs on her shin in her early eighties. She's tiny petite and nobody has thinner skin. The end results was a golf ball size hole which took a good six months to heal. And yes, was painful. Our dermatologist has never offered radiation in lieu of mohs procedure.

@sef26 Welcome to Mayo Clinic Connect! I see that @jc76 and others have already responded to you. Each person is unique, as is the site of nodular BCC. Mine was right near my collarbone, and was done with MOHS procedure. There was quite an adjustment period to get the skin to heal, and stretch. My mammogram done 6 months later was a painful one! I have never had a radiation treatment in lieu of a MOHS. The [several] procedure sites have been on my face, hands, arms, and at the collarbone.

It sounds like so much is based on if there is enough skin left behind to confidently do a MOHS surgery. Has your doctor suggested a skin graft after the MOHS?
Ginger