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  • Q&A with Australian Health Practitioners

    Should I opt for BCC surgery?

    Related Topic
    Skin Cancer
    I've had a positive BCC biopsy. Should I undergo surgery or just wait and watch?
    • 2 answers
    • Dr Walter Flapper
    • Dr Daniel Bothma
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    Dr Walter Flapper

    Plastic Surgeon

    Dr Flapper is a craniofacial surgeon in Adelaide. Following the completion of his training as a plastic and reconstructive surgeon, Dr Flapper completed a post … View Profile

    BCCs are generally slow growing tumours and do not tend to metastasize(spread to distant sites) and are therefore considered to be non-malignant. They do, however grow and eventually erode surrounding structures and cam become ulcerated and infected. Surgical removal is much easier when they are small and the resulting scar is also smaller.

    I would recommend surgical excision if you have a biopsy proven BCC.

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    Dr Daniel Bothma

    GP (General Practitioner)

    An accredited and experienced skin cancer specialist, Dr. Daniel Bothma holds a Master's Degree in Clinical Dermatology and is a Fellow of the Skin Cancer … View Profile

    I would add to Dr Flapper's post that it also depends on the subtype of BCC diagnosed. All BCCs do need treatment, yet superficial BCC may be treated with a cream called Aldara (imiquimod) for about 6-10 weeks depending on the response. And this superficial BCCs can also be treated with curettage and cautery, which is a bit less invasive than conventional surgery.

    So, you do have some treatment options for superficial BCCs. 

    Some other forms of BCCs, namely morphoeic, or micronodular ones, are quite aggressive, and can invade little nerves and bloodvessels. This is very dangerous if the cancer starts close to the eye, as it can spread into the eye. And this type of cancer sometimes requires very specialised surgery, called micrographic (or MOHS) to completely clear out. It is most definetely not a good idea to delay treatment of an aggressive form of BCC like that.

    So, the short answer: all BCCs need treatment, while some can be treated by topical creams and others require very specialized forms of surgery. BCCs are not benign, they are locally destructive cancers that can leave you looking very disfigured if not treated.

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