Aa
To cut or not to cut
I'm 66. My face has been exposed to the sun all my life and I developed moderately extensive actinic keratosis years ago, but I've neglected it until quite recently. I also developed a basal cell lesion on my right cheek starting with a small area 10 years or more ago. The BCC slowly grew until it became about 6 MM in diameter with a surprisingly deep pit that would fill in with a crusty material. I finally decided I needed to have it removed, but before the dermatologist would consider that, he put me on a regime of Efudex. I survived the Efudex treatment with relatively minimum trauma and my AK is cleared up. As bad as it is, Efudex really is wonderful stuff and I'm very glad I did the treatment. While using the Efudex, my BCC showed some remarkable improvement too.
Last week I was supposed to go in and have a large chunk of my right cheek (site of the BCC) removed, but in light of how much smaller and improved the original lesion is, I wanted the surgery postponed to see if the lesion would continue to clear up with continued Efudex treatment. The doctor would not discuss it and, in fact, rudely showed me the door while handing me my medical records and told me to go elsewhere. He was all set to cut my face, but became angry when I indicated I didn't want to have it done just then. He would not discuss any other course of action besides his own. To say that he acted pigheaded is an insult to the porcine species, in my opinion.
For a week now I have continued the Efudex treatment twice daily and the lesion is down to about 4 MM long and 2 MM wide with only a shallow pit and it seems to shrink almost daily. The border is also appearing quite normal (to my eye).
My question is this. Since this lesion has a history of slow growth, it is not considered particularly dangerous and since it seems to respond well to this very conservative treatment, what is wrong with what I am doing? Can I not just try Efudex and wait for a result one way or another? If it enlarges, can I not, at that time, have it surgically removed (by another surgeon) or must it be done just as soon as possible?
By the way, I know that Efudex is effective in "only" 92% of cases of BCC while surgery is effective 98% of the time. The highly negative aspects of surgery greatly outweighs its slightly greater efficacy -- at least in my mind -- but, am I wrong and if so, why?
Last week I was supposed to go in and have a large chunk of my right cheek (site of the BCC) removed, but in light of how much smaller and improved the original lesion is, I wanted the surgery postponed to see if the lesion would continue to clear up with continued Efudex treatment. The doctor would not discuss it and, in fact, rudely showed me the door while handing me my medical records and told me to go elsewhere. He was all set to cut my face, but became angry when I indicated I didn't want to have it done just then. He would not discuss any other course of action besides his own. To say that he acted pigheaded is an insult to the porcine species, in my opinion.
For a week now I have continued the Efudex treatment twice daily and the lesion is down to about 4 MM long and 2 MM wide with only a shallow pit and it seems to shrink almost daily. The border is also appearing quite normal (to my eye).
My question is this. Since this lesion has a history of slow growth, it is not considered particularly dangerous and since it seems to respond well to this very conservative treatment, what is wrong with what I am doing? Can I not just try Efudex and wait for a result one way or another? If it enlarges, can I not, at that time, have it surgically removed (by another surgeon) or must it be done just as soon as possible?
By the way, I know that Efudex is effective in "only" 92% of cases of BCC while surgery is effective 98% of the time. The highly negative aspects of surgery greatly outweighs its slightly greater efficacy -- at least in my mind -- but, am I wrong and if so, why?
OK, it has been eight days now since I posted my questions and not a single informed reply from a medical expert and only one reply that I did not find at all helpful.
My conclusion is that this is a totally worthless site and obviously not worth even the time I am now taking to say so. However I must say that I am extremely disappointed.
My conclusion is that this is a totally worthless site and obviously not worth even the time I am now taking to say so. However I must say that I am extremely disappointed.
Oh please!
What you are saying is that we are to blindly and without a hint of skepticism or common sense, follow only what the AMA and our doctors tell us. Over the years I have been forced into the firm conviction that informed and healthy skepticism is actually superior to the pontifications of the learned. All science, engineering and medicine has advanced only by being skeptical of the pronouncements of the Master Savants of the day. Untold times I have witnessed where skepticism has prevented great error by others and by myself too. The skeptic must be skeptical even of himself and that is why I wrote my original post.
I'm sorry if this is hurtful to say this, but I think yours is the very attitude that makes it possible for so many auto mechanics to shamelessly rip-off women as they are so justly notorious for. I would like to suggest you develop a sense of informed partnership rather than simply relying on others to make the right decisions.
Lord, if this is the rapidity, volume and quality of the responses here, I'm sorry I spent so much time composing my original post.
What you are saying is that we are to blindly and without a hint of skepticism or common sense, follow only what the AMA and our doctors tell us. Over the years I have been forced into the firm conviction that informed and healthy skepticism is actually superior to the pontifications of the learned. All science, engineering and medicine has advanced only by being skeptical of the pronouncements of the Master Savants of the day. Untold times I have witnessed where skepticism has prevented great error by others and by myself too. The skeptic must be skeptical even of himself and that is why I wrote my original post.
I'm sorry if this is hurtful to say this, but I think yours is the very attitude that makes it possible for so many auto mechanics to shamelessly rip-off women as they are so justly notorious for. I would like to suggest you develop a sense of informed partnership rather than simply relying on others to make the right decisions.
Lord, if this is the rapidity, volume and quality of the responses here, I'm sorry I spent so much time composing my original post.
Your dermatologist is following recommended AMA guidelines regarding skin cancers. How about a second opinion? In the end you are going to do what you want to so....
BTW...I don't know anything about the medication you are using, so impossible to comment on its efficacy..
BTW...I don't know anything about the medication you are using, so impossible to comment on its efficacy..
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