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Basal Cell Carcinoma on Leg

Posted by beatrixflower @beatrixflower, Aug 3, 2020

Hello, I was just diagnosed with basal cell carcinoma on my leg. I did not know I had it until I had ongoing pain in my calf that began during covid. When I was seen by the doctor after re-opening, I told her I was worried about a blood clot but she ruled that out. She asked about a lesion on my leg that I had been told by a dermatologist 15 years ago in my 30's that it was "absolutely nothing and didn't need to be followed". She sent me for a biopsy that came back as basal cell carcinoma. The dermatologist who did the biopsy said that maybe years ago it was "nothing" but it had recently changed. My main worry is that the pain in my calf is a sign that it has spread to the lymph nodes. Is there any other reason why basal cell carcinoma would cause pain if it was not being caused by spread to lymph nodes? Following the biopsy, I feel a substantial relief in the pain which makes me think it was pressing on something.

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jnb | @jnb | Apr 23, 2022
In reply to @colleenyoung "Hi @jnb, welcome. Topical fluorouracil (5-FU) is commonly used to treat skin lesions after surgery for..." + (show)
@colleenyoung

Hi @jnb, welcome. Topical fluorouracil (5-FU) is commonly used to treat skin lesions after surgery for basal cell cancer. The changes you are experiencing, like itching, burning, angry red areas, raised bumps, are also common.

You can read more in this article:
- Fluorouracil cream (DermNet) https://dermnetnz.org/topics/5-fluorouracil-cream

@mermaid7272 @gingerw @shamrock5jeg may also be able to share their experiences with 5-FU cream.

As to your question about whether to apply the cream only to raised scabs or also to flat, brown skin discolorations. I'm not sure. This is a question for your doctor. Are you able to contact them through a patient portal or by phone? Does your insurance help cover the cost of the cream?

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Thank you very much for your reply. The DermNet link was very helpful.
I will call my dermatologist tomorrow to clarify how much area to treat.
With this treatment, it appears that one must get worse before one gets better, so it’s helpful to know that the changes I’m seeing are normal.
My drug insurance has a high deductible that I must pay before it begins to pay a portion of the cost.I’m on my second tube and should trigger some help for my third tube.

REPLY
jnb | @jnb | Apr 23, 2022
In reply to @gingerw "@jnb Ah, flourouracil! I have used it, also! I am subject to skin cancers, and have..." + (show)
@gingerw

@jnb Ah, flourouracil! I have used it, also! I am subject to skin cancers, and have have basal cell, squamous, amelanotic [uncolored] melanoma, and nodular basal cell.

The first time I used flourouracil, my face broke out like you are describing. remember, it takes a very little of this cream to use. Fortunately I was able to get in to see the PA at my dermatologist's office. The reaction you are seeing is the medication working on an area that needs to be addressed. More than likely you will experience these symptoms for the first few weeks, then they will simmer down and go away.

As far as where to apply it, that is your doctor's decision. What did they say on the label? When my face broke out, it was explained that even if I applied it only to areas of question that I could see, there would be a response from any place on my face that needed the medication.

I hope this relieves some of the anxiety you might be feeling?
Ginger

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Thanks for sharing your experience with this drug.
The label says “Do not apply to good skin.”
It’s helpful to know that you saw a response beyond the area you originally treated. The label and the inserted drug facts that came with the tube do not mention that.
This drug is not for the weak. It takes fortitude to apply a substance that is going to make you worse before you get better!

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1 reply
Mentor
Ginger, Volunteer Mentor | @gingerw | Apr 24, 2022
In reply to @jnb "Thanks for sharing your experience with this drug. The label says “Do not apply to good..." + (show)
@jnb

Thanks for sharing your experience with this drug.
The label says “Do not apply to good skin.”
It’s helpful to know that you saw a response beyond the area you originally treated. The label and the inserted drug facts that came with the tube do not mention that.
This drug is not for the weak. It takes fortitude to apply a substance that is going to make you worse before you get better!

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@jnb The drug goes after an area that needs help, even when it is not visible to our naked eye. That is what had freaked me out the first time I used it! My dermatologst's PA seemed amused by my anxiety, I was not. It was on my face and I had to really do a bit of coverup to go to work!

You could ask your pharmacist for a generic, if one is available. I know the last tube I got was over $100 out of my pocket.

Hope to hear from you, giving me good news in the not too distant future. You reminded me I need to get my tube out and treat some areas. The PA I see at my current dermatologist says she I should not use any topical chemo while I am on systemic chemo for cancer, but my oncologist says, "It's fine to use." Think I will go with his opinion.
Ginger

REPLY
cmcp | @cmcp | May 5, 2022
In reply to @gingerw "@beatrixflower I'm glad you sought out a diagnosis on this. I have had everything from pre-cancer..." + (show)
@gingerw

@beatrixflower I'm glad you sought out a diagnosis on this. I have had everything from pre-cancer to melanoma, and you're smart to be checking for changes in sores or lesions. You know your skin the best! What was done for the basal cell carcinoma on your leg? I would ask your dermatologist their recommendation, then follow that. While basal cell rarely metasticize they do often grow slowly in place. And I am sure your medical team has advised you to watch your skin carefully, perhaps with a full-body check twice a year.
Here is a link from Mayo Clinic about types of skin cancer https://www.mayoclinic.org/diseases-conditions/skin-cancer/symptoms-causes/syc-20377605
Ginger

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@gingerw I was recently diagnosed with squamous cell, basal cell, and two precancers. You noted that you have had multiple skin cancer and precancer diagnoses. How have you changed your lifestyle as a result? I have always been a sunscreen fanatic, very frequently applying chemical sunscreen. I have now moved to mineral sunscreen since reading more about skin cancer after my excisions. This recent experience has me a bit fearful of the sun now, which I used to enjoy as an active person, not as a sun worshipper (I never lay out because I don’t get tan anyway). I bought lots of UPF 50+ shirts and am going to Disney with the grandkids in a few weeks and I am wondering if short sleeves with sunscreen would be an okay alternative. My skin cancers are on my hand neck and my precancers are in my nose and hand. I have two other suspicious areas on my forearms. Any advice is welcomed.

REPLY
1 reply
Mentor
Ginger, Volunteer Mentor | @gingerw | May 5, 2022
In reply to @cmcp "@Gingerw I was recently diagnosed with squamous cell, basal cell, and two precancers. You noted that..." + (show)
@cmcp

@gingerw I was recently diagnosed with squamous cell, basal cell, and two precancers. You noted that you have had multiple skin cancer and precancer diagnoses. How have you changed your lifestyle as a result? I have always been a sunscreen fanatic, very frequently applying chemical sunscreen. I have now moved to mineral sunscreen since reading more about skin cancer after my excisions. This recent experience has me a bit fearful of the sun now, which I used to enjoy as an active person, not as a sun worshipper (I never lay out because I don’t get tan anyway). I bought lots of UPF 50+ shirts and am going to Disney with the grandkids in a few weeks and I am wondering if short sleeves with sunscreen would be an okay alternative. My skin cancers are on my hand neck and my precancers are in my nose and hand. I have two other suspicious areas on my forearms. Any advice is welcomed.

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@cmcp First, welcome to Mayo Clinic Connect! I'm glad to see you have been reading the discussions here and found useful information. Back in younger years, you and I were probably part of the same generation who worshipped the sun. Like you, I didn't lay out, but I did a lot of outdoor activities, with no thought to sunscreen.

After dealing with the various skin cancer issues, I now apply a sunscreen everyday, regardless of the weather. Careful to wash my face and hands thoroughly every night before bed. I use a hat to provide as much shade as possible, too. Long sleeves. Staying out of the sun's strongest hours, remembering that even if it is foggy/overcast there is still a UV risk. Don't forget your hands for sunscreen, too. I often wear lightweight white cotton gloves. You will need to make that decision about long sleeves or short sleeves with sunscreen!

My melanoma was on right forearm. Squamous on forehead and left eyebrow. Nodular basal cell near right collarbone. Precancers various places on face/ears/arms.

Hope this helps? Enjoy your trip to Disney - Florida or California?
Ginger

REPLY
1 reply
cmcp | @cmcp | May 10, 2022
In reply to @gingerw "@cmcp First, welcome to Mayo Clinic Connect! I'm glad to see you have been reading the..." + (show)
@gingerw

@cmcp First, welcome to Mayo Clinic Connect! I'm glad to see you have been reading the discussions here and found useful information. Back in younger years, you and I were probably part of the same generation who worshipped the sun. Like you, I didn't lay out, but I did a lot of outdoor activities, with no thought to sunscreen.

After dealing with the various skin cancer issues, I now apply a sunscreen everyday, regardless of the weather. Careful to wash my face and hands thoroughly every night before bed. I use a hat to provide as much shade as possible, too. Long sleeves. Staying out of the sun's strongest hours, remembering that even if it is foggy/overcast there is still a UV risk. Don't forget your hands for sunscreen, too. I often wear lightweight white cotton gloves. You will need to make that decision about long sleeves or short sleeves with sunscreen!

My melanoma was on right forearm. Squamous on forehead and left eyebrow. Nodular basal cell near right collarbone. Precancers various places on face/ears/arms.

Hope this helps? Enjoy your trip to Disney - Florida or California?
Ginger

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Thank you for replying, Ginger. We are going to Florida! It is a dream of mine to go with the kids and grandkids - I’m so excited. These diagnoses kicked me in the gut a bit, finding out pretty much right before we go but I know I’ll still have fun. Just trying to balance comfort with safety in the heat and humidity there. You say careful to wash your hands and face at night - can you expound upon that, please? Is it due to chemical sunscreen concerns or something else?

REPLY
1 reply
Mentor
Ginger, Volunteer Mentor | @gingerw | May 10, 2022
In reply to @cmcp "Thank you for replying, Ginger. We are going to Florida! It is a dream of mine..." + (show)
@cmcp

Thank you for replying, Ginger. We are going to Florida! It is a dream of mine to go with the kids and grandkids - I’m so excited. These diagnoses kicked me in the gut a bit, finding out pretty much right before we go but I know I’ll still have fun. Just trying to balance comfort with safety in the heat and humidity there. You say careful to wash your hands and face at night - can you expound upon that, please? Is it due to chemical sunscreen concerns or something else?

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@cmcp What a nice dream to have, and to get to see it happen, you sound pretty "over the moon" about it. Being smart and sensible as we live each day with regards to sun exposure, well, it takes a bit of thinking and work, and after a while it seems we get used to it. For myself, a bit of discomfort is worth the rewards of getting to do something I have been looking forward to!

My skin is pretty sensitive, being a redhead, and there are many lotions/creams that clash with me. For decades I have only used liquid castile soap as a facial cleanser, plus a quality moisturizer containing a sunscreen. At night I might use a lightweight moisturizer, it depends. What has worked for me might not be a solution for others. It's important to give my skin a rest from chemicals. I also do crafts, so I don't want any transference of oil/greasy stuff to them!

You'll have fun! Take pictures, make memories! Enjoy!
Ginger

REPLY
1 reply
cmcp | @cmcp | May 10, 2022
In reply to @gingerw "@cmcp What a nice dream to have, and to get to see it happen, you sound..." + (show)
@gingerw

@cmcp What a nice dream to have, and to get to see it happen, you sound pretty "over the moon" about it. Being smart and sensible as we live each day with regards to sun exposure, well, it takes a bit of thinking and work, and after a while it seems we get used to it. For myself, a bit of discomfort is worth the rewards of getting to do something I have been looking forward to!

My skin is pretty sensitive, being a redhead, and there are many lotions/creams that clash with me. For decades I have only used liquid castile soap as a facial cleanser, plus a quality moisturizer containing a sunscreen. At night I might use a lightweight moisturizer, it depends. What has worked for me might not be a solution for others. It's important to give my skin a rest from chemicals. I also do crafts, so I don't want any transference of oil/greasy stuff to them!

You'll have fun! Take pictures, make memories! Enjoy!
Ginger

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Thank you!

REPLY
mistymae | @mistymae | Aug 20, 2023

Hi, I have nearly the same issue with a lesion that I thought was an ingrown hair for ten years turning out to be basal cell carcinoma. I am wondering how yours was treated, as I see it is very rare to be on the leg and I’m worried that my doctor is not being aggressive enough with considering spread because I have had it for so long and it was not caught until now. Everything I read says bcc is not dangerous unless neglected, which it feels like mine has been. Any insight is very appreciated. I’m just a scared mom whose kids need her to be okay.

REPLY
1 reply
mistymae | @mistymae | Aug 20, 2023
In reply to @colleenyoung "@beatrixflower, sometimes a marking on the skin is nothing for a period of time and then..." + (show)
@colleenyoung

@beatrixflower, sometimes a marking on the skin is nothing for a period of time and then may start to change indicating cancer. I'm glad that it was sent for biopsy. According to the American Cancer Society https://www.cancer.org/cancer/basal-and-squamous-cell-skin-cancer/about/what-is-basal-and-squamous-cell.html "They tend to grow slowly. It’s very rare for a basal cell cancer to spread to other parts of the body. But if it's left untreated, basal cell cancer can grow into nearby areas and invade the bone or other tissues beneath the skin."

I'd like to also bring @gingerw @lk3xs @mermaid7272 and @kathyhg into this discussion to share their experiences with basal cell carcinoma.

Beatrix, did you notice a change in the shape of the lesion before you noticed pain? Spots can sometimes be itchy or even be a sore that doesn't heal well. What type of pain are you experiencing?

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Can you comment more on how a marking on the skin can be nothing and then turn to cancer? Do you mean any marking or more moles and beauty marks? I have bcc that I swore started as an ingrown hair that I had for ten years and got bigger over time. Is it possible that an ingrown hair turned into cancer or was it more likely cancer this whole time?

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