I have had for around two years a small reddish bump on my forehead that I thought at first was an insect bite and then when it persisted assumed was a cyst.
When I eventually got round to seeing the GP she sent me off to community dermatology where a GP with a special interest in dermatology thought it was a Basal Cell Carcinoma (BCC). I was then sent a couple of days ago to a small local hospital that I guess under NHS reorganisation is now a community health facility of some kind and the dermatologist immediately said by looking - without a biopsy - that she was sure it was BCC - she said this without doing a biopsy - and gave me a choice of excision, curettage and cautery, or a cream. I asked about Mohs but she said it is used only for hard to treat areas of the face such as nose or eyelids. She did not recommend excision, said the scar would be worse as it involves stiches and generally was not encouraging about it, so the choice was between cream or curettage and cautery. I chose the latter over a cream as I thought there would at least be a biopsy involved and I wasn't sure a cream would be as effective. She said my BCC was particularly flat. I had the curettage and cautery yesterday, but now read on the Patient.co.uk detailed briefing on Basal Cell Carcinoma that curettage and cautery is NOT recommended for the face. Also, I am worried that the margins of burnt out tissue may not have been wide or deep enough, making recurrence or spread. Can this be checked? I am supposed to go back to the doctor, or perhaps just a nurse, in two weeks. Could the fact I'm in my mid-60s have been a factor why eg Mohs was not offered? Is Mohs not freely available on the NHS?
In retrospect I wish I had been given more time to consider the treatments the doctor offered. I feel I was rushed into a decision - and as I said, I had not had a biopsy previously, though she did a scrape during the procedure that I assume will be biopsied. Would I have done better to have gone with the excision? - I wonder know if she discouraged it in order to save time in a busy clinic, or for NHS financial reasons. Should I have tried to scrape together savings and tried to go privately? - if say rationing of some kind is affecting recommendations of treatments?
Another thing is that although I know BCC is generally not fatal, and I took it all in my stride up to now - felt strangely calm about it - now I have had the curettage and cautery, and have a red circular wound on my forehead, I am suddenly very anxious and even a bit depressed. I have not told anyone in my wider family (I am single) or friends about the BCC - partly not wanting to be seen through a cancer "lens" even though BCC is less serious than many other cancers.