Concerns Over Possible Bone Invasion in Basal Cell Carcinoma
My father is a 63-year-old man, standing at 6 feet and weighing around 220 pounds. He is a white male with a history of sleep apnea and occasionally consumes alcohol and marijuana, about once a month for each. Approximately five years ago, he had basal cell carcinoma excised from the crown of his bald head. Regrettably, recent developments suggest that the cancerous area has returned and has significantly enlarged. He mentioned that the dermatologist removed a sizable part, measuring about 2 inches by 2.5 inches. He visited the dermatologist on March 19, 2025, where the doctor performed Mohs micrographic surgery. During this procedure, they excised a portion of the affected area, conducted tests within the hour, and decided more tissue needed to be removed. Following this initial excision, further testing resulted in a recommendation for my father to consult with a plastic surgeon for an inpatient operation. The surgeon will be tasked with scraping any remaining cancerous cells from his skull. A pharmaceutical representative was also present, providing a special type of bandage that the dermatologist used to close up the surgical site before sending my father home. After requesting updates, my dad shared pictures of the surgical site, revealing that they had removed all layers of the dermis down to the galea. I should mention, for those who might be sensitive to graphic images, that these photos may be disturbing. On March 21, 2025, he attended a follow-up appointment with the plastic surgeon, who assessed the surgical site. The doctor indicated that there was a potential need to remove a section of my father's skull and replace it with a metal plate. Consequently, my father might spend at least 4 to 5 days in the hospital recovering. This raises a pressing question: does the surgeon’s assessment imply that my dad may have "bone invasion"? After doing some research, I’ve learned that basal cell carcinoma is very prevalent among white individuals and is generally excised with a low chance of recurrence. It is commonly localized and rarely metastasizes. Does the surgeon’s examination indicate a serious concern regarding possible metastasis? My father mentioned that during his initial visit for the Mohs surgery, a comprehensive body examination was performed, revealing no further issues, leading to the conclusion that the cancer was localized. Having familiarized myself with the implications of metastatic basal cell carcinoma, I am understandably concerned. Living on the opposite side of the country, I have resolved to return home to support my dad during his hospitalization. I am curious if there is a legitimate cause for concern regarding the likelihood of metastasis, based on the details I've shared. Any insights you could offer regarding the situation would greatly assist me in determining how to proceed with my plans.
Answers (1)
3/21/2025, 6:20:45 PM
OpenHealth AI
It's understandable to be concerned about your father's health, especially given the complexity of his situation. Based on the information you've provided, it seems that your father is undergoing significant treatment for recurrent basal cell carcinoma (BCC), which may have affected deeper tissues, possibly involving the bone.
Main Points:
- Basal cell carcinoma rarely metastasizes but can invade local structures.
- The need for further surgical intervention suggests thorough assessment is necessary.
- Monitoring recovery and discussing concerns with his medical team is crucial.
Explanation:
Basal cell carcinoma (BCC) is typically slow-growing and rarely spreads (metastasizes) to distant parts of the body. However, it can invade local tissues and, in some cases, may affect the bone if left untreated or if it's recurrent, as appears to be the situation with your father. The surgeon's concerns about potentially removing a part of the skull and using a metal plate indicate that they are taking precautionary measures and ensuring no cancerous cells are left behind.
The examination your father had prior to the Mohs surgery, which showed no further issues, suggests that the BCC was mainly localized. The focus on removing surrounding normal tissue during surgery is a common and important step to ensure complete excision of the cancer.
Next Steps:
- Stay Informed: Ensure you stay updated during his medical appointments. Ask the healthcare team any questions about the surgery and potential for bone involvement, as they can provide insights specific to your father’s case.
- Communicate Concerns: Share your concerns and questions with his doctors directly, especially regarding the risk of metastasis and the necessity for bone intervention.
- Support Recovery: Plan to support your father post-surgery. This may include help during his hospital stay and recovery at home, focusing on his comfort and emotional well-being.
Taking these steps can help provide clarity and support for your father during this challenging time. It's perfectly normal to feel concerned, but being involved and proactive can make a significant difference in helping him navigate through recovery. If you have any more questions or need further assistance, please don't hesitate to reach out.
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