Oncologist or dermatologist on recurring bcc

Posted by al6 @al6, Aug 11 5:30pm

The wife had a spot on her back that was BCC. Removed by Mohl 6 months later it is back in same spot which dermatologist think could possibly be a sign that its melanoma. She wants to remove again by mohl and test but also asked if she wanted to see oncologist instead? Thoughts

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Having input from an oncologist sounds like a good idea.

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@al6 I see you've posted a few inquiries so I'd like to address those concerning BCC - basal cell carcinoma - as I've personally had several; I've also had squamous cell carcinoma (SCC) and am currently undergoing immunotherapy for metastatic melanoma following a wide local excision for a skin melanoma 5 years ago.

A Mohs procedure - or Mohs micrograhic surgery - is when the area that has tested positive removed along with a very thin layer of surrounding tissue, then immediately examined under a microscope in an adjoining lab. If additional cancer cells are detected, especially along the margins, additional thin layers need to be removed. This process needs to be repeated until no more cancer cells are detected.

I'm not aware of BCC turning into melanoma so I'm uncertain as to the basis of your dermatologist's current concern based upon the past diagnosis. I'm wondering if you could obtain the pathology report from the dermatologist who conducted the initial Mohs and seek a second opinion by a highly recommended dermatologist in your area and consider treatment based on the assessment rendered? This may be the step to take prior to oncology, especially if melanoma has not yet been confirmed. Does that sound like a reasonable option?

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That’s a good suggestion on the pathology of previous Mohs for this recurring lesion. And I hope your correct that BCC doesn’t not normally return as Melanoma. The dermatologist did not like the look of it and asked my wife if she would like to have it seen by an Oncologist which is what she is doing.
Thank you for your info and ai wish you the very best in your journey.

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@al6: I'm pleased to hear your wife is obtaining a higher level of care for this lesion which perhaps is new. That was a wise course of action for the referral by the dermatologist as one would not expect basal cell carcinoma to turn into melanoma, as also noted by this highly regarded cancer center: https://www.moffitt.org/taking-care-of-your-health/taking-care-of-your-health-story-archive/can-basal-cell-carcinoma-turn-into-melanoma/

I appreciate the well wishes on my journey! I've been responding very favorably to the immunotherapy I've been receiving at Mayo; so many encouraging advances have been made in treatment for this condition in the past several years I feel very optimistic about my prognosis as well as others who have impacted by this diagnosis. I'm interested to hear what your wife finds out at her upcoming visit. Best of luck and could you let me know after her appointment?

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