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My 98 year old aunt who is in good health for her age, was just diagnosed with Superficial Basal Cell Carcinoma. It is on her cheek. She has had this on her face for a long time... longer than a year I suspect.


Her doc has given two choices…. Chemotherapy cream (which seems like a good answer, but the treatment and Aunty's anxiety may not handle). The second choice is surgery (localized numbing to get it all out and then two sutures in and maybe out). There would be a scar (a line) that could be camouflaged with makeup or will blend with wrinkles. The third option is to just do nothing. With the word superficial, it sounds like it could be ignored, but if she lives 10 more years…. What are the possible problems?


Everything I read says have it removed, but nothing related to someone that is 98 years old. (She is scared of a horrible after scar or divet in her cheek which is very thin.)


She knows I'm asking for opinions. (She goes to the grocery store once a week with my husband, her nephew. She gets in and out of the car on her own. She does her own laundry and fixes her own breakfast and lunch. Reads the newspaper and does crossword puzzles... starting to get forgetful, but who isn't.)

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Thank you everyone!! Since this is such a slow growing cancer the decision has been made to not do anything further.
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I had a squamous cell on my nose and had it removed by Mohs surgery. Boy did that turn me black and blue around my eyes. Mom had had one too, years ago. She had surgery and a resulting scar. We actually had twin scars!😁

At her age I would try the cream. Certainly no surgery, it may be quite deep and then the resulting bruising from surgery.
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Mum had a skin cancer removed from her face in 2017 at age 83. There is no scar or dimple to be seen. The doctor made sure to follow an existing wrinkle line.

Dad has had more skin cancers than I can keep track over over the last 20 years. He has had them surgically removed, frozen off and had the Chemo cream. The chemo cream has been used on places like his nose and the back of his hands where there is very little flesh.

On his nose it worked very well. On the back of his hands in 2017, age 87, it worked, but he wound up getting a staph infection as he would not scratching it and he does not trim his fingernails. The staph infection spread from the back of his right hand to his right arm, where he was also scratching.

Dad does not have dementia, but he had not been properly applying the chemo cream or it was too strong, I cannot remember which now. He had to go on antibiotics to clear up the infection, then went back on the chemo cream to clear up the cancer.
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You can google “basal cell removal in the elderly” and there is a growing opinion that dermatologists are too quick to perform surgery on the very elderly, when the chances of the slow growing basal cell cancer actually causing their demise is slim to none. My Mom is 93, and I decided not to further treat her basal cell nodule on her cheek after the biopsy. The biopsy itself did remove all the external nodule, at my request, but didn’t get the entire thing under the surface. The extent of that wouldn’t be found until the Mohs surgery was complete. It could have been small, or could have been huge. My Moms overall condition is much more fragile than yours seems to be, and I just decided not to put her through any more anxiety or pain. I never even told her it was cancer, just a “pimple”. Her NH doctor thought I was nuts for even considering further surgery. That helped me make my decision to forget about it.
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worriedinCali Jan 2019
My mom has one on her arm and her doctor said it just needs to be monitored, no need to have it removed. She’s 70. Dr Sandra lee (dr pimple popper) has shown a lot of mohs surgery on her YouTube channel and some of the patients have been quite elderly, I was kind of surprised they chose to go through that. It’s not something I would even have done on myself unless it was absolutely necessary.
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Those creams will remove skin tissue, leaving a pretty raw patch for the entire treatment and about 7-10 days after treatment is complete. If she is worried about how she looks, this will be a problem for about 4 to 6 weeks. It needs to be applied outside of the spot , so depending on the size it could be fairly large. I also found the cold to be extremely painful, I looked silly with gauze on my nose but it beat the pain.

Hind sight, I would have had it removed and been done with it.

I would make the doctor give you a timeline prognosis for doing nothing. Ask him what he would do if it was his mom.
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So, my mom had a punch biopsy for what turned out to be a basal cell carcinoma on her cheek, near her nose. The biopsy was closed with one stitch. Follow up was with the chemo cream. No problem.
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At 98 I would do nothing. The cream will make her skin very sensitive and irritated. The side effects of that cream are pain, itching and inflammation to name a few. If the spot isn’t bothering her now, I would leave it be. I can’t see causing physical discomfort to a 98 year old.
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My mom had a small spot on her chest that would crust, putrefy, slough and bleed repeatedly. We had been doing "watchful waiting" for several years when out of the blue (I'm still flabbergasted about that) her nursing home doctor left a note that we could treat the area, and he gave a list of options. I initially agreed to go ahead, but after doing a lot of on line reading, consulting with the good folks here on the forum and the nurses at her nursing home and asking mom's opinion I decided to do nothing.
At 98 how much longer can she possibly live? And if it is asymptomatic, why borrow trouble?

edit - the cream sounds like a simpler, less invasive option but from my research it is anything but!!
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I had a basal cell next to my nose removed about 10 yrs ago so I know what u are talking about. I had mine removed. If a cream is being offered, I would go that way. The elderly's skin tears very easily. Stitches will be needed. I don't think a basal cell if as serious as other skin cancers like Melanomas.
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I’ve been through several skin cancer episodes with my dad. The last one turned into far more treatment than I believe was appropriate for his age and condition and took many months to fully recover from. I’d opt for the chemo cream and avoid the surgery. I’ve seen the surgery turn more complex and recovery take longer than predicted, just not worth the torment in someone so old. If she’s not on board with the cream leave it alone, she’ll likely do fine
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