Possible Basal Cell cancer - ok to leave a while?

[Mistymountain]

Last year DH had a small lump on the side of his head, near his eye socket, which kept bleeding all over the pillows. Eventually he agreed to contact the GP, because it wasn't getting better.

Our GP service now does most appointments by phone, so I took a photo of the lump and DH sent it off. To me the photo looked exactly like examples of basal cell cancer shown on the internet, although a bit smaller.

The GP prescribed Efudix cream but didn't make a referral to dermatology. DH used the cream and the area healed - no bleeding.

Today I noticed a small red dot had reappeared in the same place. DH says the lump never went away, so the cream hasn't cleared it up after all.

DH wants to wait to see if it gets bigger and starts bleeding again before contacting the GP. I think he should go now and ask for a referral, because the referral will probably take months. Obviously it's up to DH, but should I try harder to persuade him to go?

Make him go and have it removed. Skin cancer is common.

Yes try and persuade him to get it looked at although, certainly in my area, the wait will be months. I had a suspected BCC this time last year and on the NHS the wait was a good six months just to be seen by dermatology. Fortunately we are with Bupa so got it taken off and diagnosed in no time. It was on my nose and I honestly think I'd still be waiting to have it removed on the NHS.

I had squamous cell carcinoma on my arm similar to your description. I was referred and into dermatology within 8 days. It was removed and sent for biopsy. I had everywhere else on my skin checked and all was clear.

Do tell him to get checked. It is the most treatable cancer thank goodness

DH had a similar BCC. Removed quickly and painlessly on the NHS (only a three month wait) in December and he got the all clear earlier this year.

No point waiting as you'll only be worrying. I'd urge him to get it sorted out and then you can both relax.

I would probably go and get it sorted because of where it is, it's on the face, also you don't know it is definitely BCC if it hasn't been biopsied. I have a superficial BCC on my leg which I used Efudex on and it's a bit hard to tell if it's going or not, it takes a while after finishing the cream. I had a large nodular BCC removed from my leg and it was a three month wait, I was expecting longer as it wasn't in a disfiguring place

Don't wait.
My dad had that and it was intermittent so he didn't think it was serious. Sadly he lost his eye as it spread inside.

He should go before a minor op turns into a much bigger one.

He should go. In my part of the world a dermatology referral for skin cancer is very quick, not months of waiting at all.

He should go, my dad had a few BCC over a number of years removed from temple/forehead then got one on his earlobe which turned out to be squamous cell carcinoma which spread, firstly to salivary gland but then mets to lung and brain which killed him. Contrary to popular opinion it isn't just melanoma that can spread although obviously rarer with SCC.

Yes, he should go right away. Especially if it's on his face. My mother had a little bump inside her mouth that turned out to be a squamous that made it all the way in to her brain and she had two major operations and radiation because it wasn't dealt with soon enough.

I had a BCC - small on the outside but growing very large underneath unbeknown to me. Quite major surgery in the end and left with a permanent facial scar. Please get him to go and get it checked asap.

Thank you everyone who's replied. I'll try to persuade him to go sooner rather than later. He's stubborn though and not really suited to the current NHS where you have to advocate for yourself!

I had my 5th BCC removed on my forehead last week. Please tell him to go get it checked the sooner he goes to GP the sooner you can relax. Can I ask in relation to the Efudix cream I've been told to start using it on a previously biopsied BCC but how do you know of it has worked? As presently mine is just scar tissue. Thanks

That's terrible that the GP hasn't even seen him in person. My husband had this in the same place and it took several appointments between the referral being made and removal. He definitely needs to get it looked at ASAP.
My husband's was the same, it would bleed randomly for a few months and then usually dry up and look more healed for a while. That doesn't mean anything, it'll need removing.

I had one recently. Gp refused to see me and tried to diagnose over the phone. Ridiculous.
They warned referral on NHS was 2 years. I went private as had insurance. I was worried as the area bled and itched and was in a sun exposed region. Got it out, biopsies and was a bcc. Gone now. Definitely don't leave it x

If it's bcc it will be okay to leave it, based on it's location. My dad had one on his ear and was actually encouraged to leave his by the dermatologist as its removal is disfiguring, although he had it done eventually because of the bleeding (looks like something has taken a bite out of his ear). Bcc isn't dangerous and won't morph into a malignant cancer.

BUT I would want to be 100% sure it's bcc first and he should be referred for that.

If it's near his eye then he needs to get it looked at before the risk of if growing larger and needing skin grafts and possibly into the structure of his eye.

I had a BCC near inside if eye that I left far too long because I had other more serious medical issues at the time and it almost caused a major issue. I saw the specialist plastic surgeon on a Friday and he operated the following Tuesday - in the end the incision was only 1 millimetre from the corner of my eye and involved 8 stitches. The surgery was straight forward and took about 30 minutes.

I'm so sorry to hear about your dad

I would be very wary of a BCC close to the eye. It's one of the few locations where it can kill you. It can invade the eye socket and ultimately the brain. They're pretty slow growing so it's not going to happen overnight but personally I would want to get it out ASAP.

I had one just below my eye removed recently. It was all removed but the consultant wasn't happy as the smallest margin was only 0.5mm so he wanted to go in and excise a bigger margin as it is much more aggressive if it comes back.

If it was my dh, I would be seriously trying to persuade him to get referred.

BCC is most definitely malignant.

Based on its location (close to the eye) it is really not a good idea to leave it. The removal of your eye is likely to be a lot more disfiguring than a scar. The second excision on mine was done in December and the scar is barely noticeable.

Also, the only way to know if it's a BCC is to do a abioposy, which involves removing it.

The non urgent ones are generally in places like mine on my leg, I was told mine was non urgent so I will give it a bit longer after using the Efodex and see what happens, it seems to have helped some of it but one on the face especially near the eye I would go and get sorted asap.

Hi in DH's case, when he used it the area initially became a lot worse, the course of treatment was 3 weeks. After that it took about 6 weeks for the area to heal over, so it seemed to have worked, but the skin now seems to have broken again and he's reported that the underlying lump, never went.
I guess you only know the cream has worked if you don't get a new breakout!

My BCC which was biopsied and I was prescribed Efudex as it was a flat dry skin patch which occasionally itched and scabbed a bit, consultants letter said to use twice a day for 4 weeks and wouldn't know if it was healed for up to 3 months after that. Some of the lesion seems healed but it's breaking out a bit at the bottom, it's on my shin so not an easy place to excise but I shall see what happens with it and then maybe I will need another doing with Efudex. Consultant didn't seem concerned about it, there was no lump just a flat patch.

BCC rarely spreads (as in metastasises), but that doesn't mean it's not malignant. It's a carcinoma, which is malignant by definition. And it can grow and cause problems as per PPs. Also, it can be difficult for a layperson (or indeed a dermatologist) to tell a BCC from an SCC, and they do spread somewhat more often. It needs seeing (in person).

The biggest issue is that you don't actually know whether it's a basal cell or something worse and you aren't going to be able to know until he sees a specialist.