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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@beatrixflower, it is quite common that 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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I can’t be a big help here. I felt like the mole either changed or appeared very suddenly and was elevated and rough. I took a photo and called my doctor who saw me in about a week. The mole had already changed in a week but my doctor was able to compare the photo with the way it looked when I saw her. I had it removed about a week after seeing my doctor. It did not hurt and it was not itchy. It was the sudden change that got my attention.

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@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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I have had numerous skin cancers- basal cell, too many to count, one squamous, and one serious Melanoma many years ago. The Melanoma left major scars, one that looked like a shark bite, the rest were from skin grafts sites & removal of lymph nodes.
The facial basal cells were removed by Moh's surgeries and also left scars. The ones on my leg, the same. The ones on my leg hurt every now & then. These
skin cancers are slow growing, and usually do not metasticize. If left for too long, you will have to have more extensive skin removed, and that will leave larger scars & longer healing time.

I have also had other cancers that were serious & required long surgeries & hospital stays & have had many lasting effects on my health.
All these varied cancers are no doubt the result of an errant gene. I have only had one gene study done, and will not have others as I am quite tired of doctors and procedures, and surgeries and pain and scars!
Please do not freak out about your skin cancers– just find a good dermatologist, and have a check-up every year.

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@mermaid7272

I have had numerous skin cancers- basal cell, too many to count, one squamous, and one serious Melanoma many years ago. The Melanoma left major scars, one that looked like a shark bite, the rest were from skin grafts sites & removal of lymph nodes.
The facial basal cells were removed by Moh's surgeries and also left scars. The ones on my leg, the same. The ones on my leg hurt every now & then. These
skin cancers are slow growing, and usually do not metasticize. If left for too long, you will have to have more extensive skin removed, and that will leave larger scars & longer healing time.

I have also had other cancers that were serious & required long surgeries & hospital stays & have had many lasting effects on my health.
All these varied cancers are no doubt the result of an errant gene. I have only had one gene study done, and will not have others as I am quite tired of doctors and procedures, and surgeries and pain and scars!
Please do not freak out about your skin cancers– just find a good dermatologist, and have a check-up every year.

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@mermaid7272, interesting that the lesions on your leg hurt where the others in different locations didn't. Can you describe the type of pain?

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@colleenyoung

@mermaid7272, interesting that the lesions on your leg hurt where the others in different locations didn't. Can you describe the type of pain?

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Colleen– The basal cells on my leg hurt after they were removed, not before. Perhaps because they were on my shin- no flesh there.
I did mention it to my dr., but he was not too worried about it. The pain now is a throbbing type, only lasts a short time. None of my skin cancers ever hurt BEFORE they were removed. I have a deep scar on my nose which is quite sensitive as well as ugly, this is from the Moh's surgery.

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After three biopsies my dermatologist performed Moh’s surgery on two scabby squamous-cell skin bumps on my shins. It took 40 days from the surgery until my scabs fell off. I thought she might then do more biopsies on other bumps and scabs that have popped up on my lower legs over the past year. Instead she has prescribed a what I would call do-it-yourself chemotherapy. I am to use a cream called flourouracil twice a day for four to six weeks. What should I expect as I use it? I’m ten days into the regimen. Angry red areas have grown larger around some bumps. Bumps become more raised and more scabby. They sometimes itch and other times burn. Should I apply the cream only to raised scabs or also to flat, brown skin discolorations? It is expensive, and one tube has been lasting me ten days.

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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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@jnb

After three biopsies my dermatologist performed Moh’s surgery on two scabby squamous-cell skin bumps on my shins. It took 40 days from the surgery until my scabs fell off. I thought she might then do more biopsies on other bumps and scabs that have popped up on my lower legs over the past year. Instead she has prescribed a what I would call do-it-yourself chemotherapy. I am to use a cream called flourouracil twice a day for four to six weeks. What should I expect as I use it? I’m ten days into the regimen. Angry red areas have grown larger around some bumps. Bumps become more raised and more scabby. They sometimes itch and other times burn. Should I apply the cream only to raised scabs or also to flat, brown skin discolorations? It is expensive, and one tube has been lasting me ten days.

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@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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@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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Sorry, but I've never been treated with 5-FU cream, in fact, I've never heard of it. My skin cancers were all surgically removed.

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@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.

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@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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