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

Definately Mohs

@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.

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

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.

Thank you

I was just "diagnosed" with bcc. The p.a. said I had 2 options, mohs or radiation (gentlecure). She seemed to recommend radiation. The lesion is on the side of my nose, very near my eye, and a second small bump near my nostril. I wonder if it is because the wait for mohs is long.

@susan49
She should have gone through the pros and cons of each for you. You can still do your own research on them going to major medical facilities web sites and WEBMD.

The reason MOHS is so long is that it takes a special ENT surgeon trained and certified to do these. Even at Mayo Jacksonville there is a wait there also as limited number of MOHS surgeons.

I did not have radiation have always had MOHS. I can comment on my experience with MOHS. There is no pain during surgery. The area is numb so you should feel nothing. That does not me you won't feel something after pain medication wears off. But for me very minor later on.

MOHS: based on your biopsies will remove the skin and very small margin. Then that is sent to pathlology to see if any signs of cancer in the margin cells. If none then surgery over. If still have cancer cells the surgeon will come back and take more tissue and the process goes on until you are clear of and sign of cancer cells. So you leave with no sign of cancer which for me was what I wanted.

I have had about 8 MOHS surgeries. Only one did they have to come back with a second surgery and that was for a SCC not a BCC. The wait for the pathology report (I was given choice to stay on table to go to waiting room) can be a litle stressful as for me I was hoping over.

Radiation. I did have radiation on my prostate cancer. I chose proton as it can be regulate how strong coming in and stops at the point physic department programs. It does not continue through the body like photon. I would thing they would use proton on the area by your eye as well as your nose so radiation does not continue into head and brain. This would be something to asked your dermatologist of which they use if you are considering radiation.

Sorry you are dealing with this @susan49. The wait wasnt long for Mohs but it does take more coordination, especially if you need the reconstruction after the mohs. Best wishes and please give us an update if you choose the radiation.

@susan49: Thank you for reaching out and commenting on Mayo Clinic Connect. As you can see, there are various options for treating the different types of skin cancers, mentioned in the discussions here and outlined in these helpful documents: https://www.mayoclinic.org/diseases-conditions/skin-cancer/diagnosis-treatment/drc-20377608 and https://www.mayoclinic.org/diseases-conditions/basal-cell-carcinoma/diagnosis-treatment/drc-20354193

I don't see that you've asked a specific question but I'm wondering if you're curious as to why your doctor has indicated a preferance towards radiation over Mohs surgery. I am presuming your doctor is a dermatologist, a specialist who is certainly well qualified to to both diagnose and treat skin cancers, including Mohs - which, as described, requires removal of skin tissue for microscopic analyisis followed by suturing. When superficial lesions - such as can be the case with BCC (basal cell) are on areas of the face which can be more subject to scarring, radiation is an acceptable and occasionally preferred option for that reason as the cosmetic effect is more desirable. This is one instance in which case a radiologist would be performing the treatment. I cannot comment on the specifics of your situation but there is potential it may be a factor influencing your doctor's recommendation.

Would it help to ask your doctor if this is the reason she has recommended radiation for your case?