What is better for treatment of basal skin cancer radiation or Mohs?

Thank you

For me it depends where it is located. I had 35 treatments to get rid of a Basel cell on my Achilles’ tendon. I have lymphedema and a Mohs procedure would have been hard to heal.

@legeke: Glad to hear all of this! Well thought out and executed. Continued good health to you and in caring for your mom.

Hi @grammato3
There is a dermatologist and radiation tech in the group I used for the Mohs surgery. The consensus of the group is to get a cure by actual tissue examination at time of surgery given the possible devastation if margins arent clear. This friday marks 2 weeks and I have been well healed by day 7. After day 3, I could move, bend as usual but was to avoid sunlight on incision until after a week. The plastic/reconstruction surgeon did a beautiful job and most people cant tell I had surgery. When I was thinking about pros-cons of each procedure, I also felt that 3 trips a week = 9 hrs of time traveling back/forth x6.5 weeks…easy to have something come up and miss an appointment. I take care of my mom, so time is valuable given the current demands on me. I am very happy with the surgical choice and would probably only opt for the radiation therapy if I weren't a surgical candidate.
Thank you for checking back on me!

@legeke: it's been a few weeks since your post and I was checking back to see how you're doing since you've decided upon Mohs to treat your basal cell carcinoma (BCC). Personally, I've had several to treat both BCCs as well as squamous cell carcinomas (SCC) without incident, however, in neither case have I required reconstruction - although I did have that for melanoma and healed well.

I wonder if both of the dermatologists with whom you consulted were more in favor of Mohs due to the location of the BCC, or perhaps due the difficulty in locating radiation oncologists or dermatologic oncologists who specialize in this procedure in your immediate area. You did well in performing your research and hope you're pleased with the outcome.

Definately Mohs

I would recommend Mohs. I have had multiple basil cell carcinoma taken off..

I have a lower eyelid basal cell that derm recommended mohs followed by plastic reconstructive surgery following mohs. Neither said anything about IG-SRT to me either. A friend suggested I look into it and as you said, the papers are split, but professional organizations have said Mohs surgery is the gold standard currently. Some research says depends on lesion size, type of basal cell. I spokecto the rep. From Gentle cure (gentlecure.com) to locate a rep in your area. Their view is that in our area, there is a push to train Mohs surgeons and IG-SRT has equal cure rates, less risk. So for me, I have to decided to go with Mohs given the professional associations Gold standard of treatment designation—since I was having issues interpreting the research. Very interested in everyones thoughts..

Ginger,
I certainly agree with the things you said about discussing treatment with your doctor. And, you are absolutely correct in the headaches around the head area. A lady at my dentists office gave me a pointer about restoring the normal feeling regarding the sensitivity of the scar areas after surgery on the head area. She said to take a wet terry cloth dish rag and lightly run it back and forth of the scar that has the kind of numb feeling and it helps bring the normal feeling back quicker. I have to admit it has helped mine since starting it. It’s so nice to find little tidbits of information from others that have been through this journey.

I also am so sorry you have and continue to deal with the cancers. One never knows when something you might think is just a blemish that will go away ends up as cancer.

Im hoping Medicare will pay the rest of the bill that the insurance through my wife’s employment won’t cover. Radiation is between $5K to $50K depending on how large and how much radiation is required. Cancer is expensive in many ways for sure. Thinking about how much of an inconvenience to go in four days a week for five weeks can be, versus the one long day of MOHS and recovery is more important or efficient. Especially in these nice summer days when I stay so busy taking care of the outside of my house. I wouldn’t really care in the winter.

Again, thank you for your insight and valuable information regarding skin cancer treatments.

@elteec98 Welcome to Mayo Clinic Connect and thank you for your service!

Yes, OHSU is considered an awesome place to go, definitely. I had squamous cell cancer removed from the middle of my forehead, and agree the headaches afterwards were no fun. You got to wonder if the thinner skin/less extra skin/closer to your pain center of the brain may be contributing factors for the discomfort? In the past couple of years my face has had several skin cancers removed, and two more MOHs procedures are scheduled mid-July, one on each eyebrow for squamous cell tumors that will not respond to fluorouracil or liquid nitrogen.

It certainly is worth a good conversation with our doctors to determine the best course of treatment for various skin cancers. We are part of the team, so our thoughts do indeed count!
Ginger