Basal Cell Carcinoma on the Scalp
A 39-year-old woman, weighing 175 lbs and standing at 5'8", has a medical history that includes a craniotomy for a brain sarcoma, which was followed by six weeks of intense radiation treatment. This history has resulted in a significant bald area on her scalp that has persisted for over two decades, accompanied by thin and tight skin in that region. Furthermore, she has developed hypopituitarism as a consequence of her treatment. Her current medications involve levothyroxine, growth hormone, progesterone, along with metformin and venlafaxine. For around ten years, she has dealt with multiple actinic keratosis lesions on her scalp, managing them through cryotherapy. However, one particularly resistant lesion has remained unchanged despite several freezing sessions. Recently, she received biopsy results indicating the presence of Basal Cell Carcinoma (BCC), characterized by an infiltrative growth pattern. The lesion measured approximately 0.6 mm in diameter, classified as relatively small. Her concern revolves around the duration the carcinoma has existed without being eradicated effectively. She is worried whether this prolonged presence increases the risk of metastasis to bone or bloodstream, even though BCC typically has a low rate of spreading. She is anxiously awaiting her doctor's appointment, scheduled for next week, as she navigates her worries regarding her condition.
Answers (1)
6/20/2025, 4:40:51 PM
OpenHealth AI
It's understandable to feel anxious about a diagnosis of Basal Cell Carcinoma (BCC), especially given your medical history. Here’s what you need to know and what steps to take while you await your doctor's appointment.
Overview of Your Situation
You have a small, infiltrative BCC on your scalp, which is a type of skin cancer that typically does not spread to other parts of the body. BCCs are slow-growing and most often remain localized, particularly when treated early. Your history of multiple actinic keratosis lesions indicates that your skin may be more susceptible to skin cancers due to prior sun damage, especially in bald areas.
Addressing Your Concerns
- Duration of Presence: Although your BCC has been present for a while without effective treatment, it is reassuring to know BCCs usually do not have a high risk of metastasis. Infiltrative growth patterns may require more careful monitoring and potentially more aggressive treatment.
- Metastasis Risk: The likelihood of BCC spreading to bones or the bloodstream is quite low, particularly given its small size. Most BCCs remain confined to the skin unless left untreated for a very long time.
Next Steps to Consider
-
Stay Calm and Informed: While waiting for your appointment, educate yourself about BCC and its treatments. Knowing what to expect can help reduce anxiety.
-
Plan for Your Appointment:
- List Questions: Make a list of questions to ask during your appointment, such as treatment options, potential side effects, and what to expect during recovery.
- Discuss Treatment Options: Treatments may include Mohs surgery, topical medications, or other forms of localized therapy, especially given the infiltrative nature of your BCC.
-
Follow Up on Skin Health:
- Continue monitoring your scalp for any new lesions or changes in existing ones and keep your dermatologist informed.
- Discuss with your doctor about employing regular skin checks, especially if you have a history of multiple skin conditions.
-
Skin Protection: In the meantime, protect your scalp from sun exposure by wearing hats or using sunscreen designed for the scalp, especially since you deal with thin skin in that area.
-
Manage Stress: Consider mindfulness techniques or support groups to help manage your anxiety as you prepare for your appointment.
Conclusion
You are taking a proactive step by seeking information and support about your BCC diagnosis. Remember, BCCs are typically treatable, especially when addressed early. Stay engaged in your healthcare and share any concerns with your doctors—they are there to support you through this process.
Related Questions
Struggling to Communicate My Condition
I'm a 25-year-old female, standing 5 feet 7 inches tall and weighing 112 pounds, and I have been diagnosed with celiac disease. Monthly B12 injections are part of my routine due to neurological and gastrointestinal complications. I also experience neuropathy, which is somewhat managed with Carbamazepine, and I have Raynaud’s phenomenon along with hypothyroidism, for which I take levothyroxine. Additionally, I have an unspecified autoimmune disorder that my rheumatologist is still trying to pinpoint, with an ANA indicating a 1:5120 titer and various positive antibodies detected on AVISE testing. Lately, I find myself exhausted and frustrated. There have been enough irregularities in my tests that indicate something is amiss, but no concrete diagnosis has emerged, leaving us unable to initiate treatment. I fully recognize the challenges my rheumatologist faces in unraveling such complex health issues; this is definitely not straightforward work. I make an effort to relish the moments when I feel well, eager to maximize those good days, yet they invariably lead to a crash. Understandably, I know that these cycles are typical, but the latest episode has been particularly harsh. I’ve been contending with fevers, night sweats, swollen lymph nodes, unintentional weight loss (usually around 120 pounds), fungal infections, headaches, and seeing spots. Notably, my white blood cell counts had been declining over several months (ANC dropping from 3.1 to 0.76). During a routine check, my nephrologist suggested considering a hematologist, hinting that my issues may not stem from an autoimmune source. Curious, I prompted my rheumatologist for earlier lab results to gauge my situation before referring me to yet another specialist, but my request was declined. Out of interest, I questioned a colleague who specializes in hematology about the ANC levels that typically raise concern in an average individual, and they promptly arranged an appointment for me to assess my blood work the following day. For a fleeting moment, I entertained the notion that perhaps my condition wasn’t autoimmune after all, thinking maybe there was an easily fixed hematological issue at play, which would lead to immediate improvement and resolution. Aside from minor ovalocytes (which I’m not very informed about, rated 2+), all other results were either slightly low or within normal limits. Everything from protein to hemoglobin levels appeared satisfactory, even though I was surprised when my ANC rebounded rather quickly. It seems the interactions from Carbamazepine and potentially the autoimmune factors might have skewed the figures more than they would normally. This is a relief—there's no current risk of infection, which is good news. They also proposed testing for a few more issues due to my weight loss, lymphocyte levels, and fevers, which seems prudent. In the conclusion of our discussions, the focus returned to the likelihood of an autoimmune condition. They reaffirmed the problem, acknowledging it through their physical examination and lab reviews, and I really appreciated their kindness. Yet, I still felt a bit foolish for needing to seek help. They managed to fit me in for a quick evaluation, and while the final outcome was deemed satisfactory, their compassionate approach indicated that they truly valued my concerns, which I found reassuring despite my doubts about burdening them. I often find myself wrestling with the reality of my symptoms—questioning whether I’m exaggerating discomfort by overthinking it. Ignoring the situation hasn’t worked either, but my weariness is overwhelming. I empathize with the complexities of diagnosing a condition without a definite name; I truly understand the impediments in this process and comprehend that everyone is trying their utmost, despite the frustratingly cloudy outcomes. But, honestly, I just want to stop caring for a while. When I cycle back into feeling utterly unwell, it all feels pointless. Regardless of my physical state, progress seems stagnant. I don’t assign blame to anyone, yet I can’t shake the feeling of wasting their valuable time, spiraling into concerns that might not warrant such attention when we still lack actionable solutions. I realize that simply dismissing my situation or postponing appointments won’t lead to any answers or healing, but I feel uncertain about whether I will ever discern the underlying cause of my afflictions. I can't say for sure if any treatment would actually improve my condition beyond what I currently experience. The medical team I work with is truly exceptional; I've been fortunate to have such understanding professionals. Yet, I can’t help but wonder if sometimes they might feel the same doubts. When I am feeling good, I connect with my true self, and my enthusiasm returns, making everyday activities joyful. I approach appointments with positivity, unaware if they can sense the shadows of my frustration. It’s difficult for me to express these feelings to them. They haven’t faltered in their efforts, and perhaps neither have I—but it’s undeniably a tough situation to navigate.
Three Years of Sinus Distress: A Call for Assistance
I am a 36-year-old woman with a history of cancer, having undergone chemotherapy, radiation, and immunotherapy (Keytruda), which I stopped around 2021. Approximately a year later, I began to experience troubling symptoms after spending some time in Egypt, where I encountered polluted air, smoke, and engaged in occasional smoking myself. My main concerns include: - Constant nasal swelling and a sensation of tightness as if the tissue inside my nose is "stuck together." - Development of thick crusting within my nasal passages that sometimes obstructs airflow by sealing the tissue shut. - Although my ENT examinations reveal no active infections, doctors consistently note that my nasal tissue appears "inflamed." - Additionally, I endure swelling and discomfort in the lymph nodes throughout my body. - While a few antibiotics have offered temporary relief, the symptoms return once the medication is stopped. I noticed improvements when taking Bactrim, cefadroxil, and doxycycline, but Cipro did not provide any benefits. This ongoing sinus issue has plagued me for around three years, with sensations of rawness and extreme crusting reported—one ENT even rated my condition as 9 out of 10 for crusting severity. After living in Egypt for over a year dealing with this discomfort, I returned home in hopes of better healthcare support. Throughout this period, I've undergone MRIs and CT scans, visited three different ENTs, and even had a surgical procedure intended to remove the crusting. Despite the procedure, my symptoms recurred. Recently, another ENT agreed to culture my sinuses for the first time, despite my ongoing antibiotic treatment during the swab. The result was a "scant" presence of Serratia, with sensitivity testing indicating that while Cipro could potentially work, it was among the least effective treatments I have tried. Based on the sensitivity results, I switched from cefadroxil to Bactrim, which unfortunately coincided with a resurgence of pain in my lymph nodes. My doctor advised me to rely solely on Bactrim, but I find this troubling. The situation is overwhelmingly distressing. The discomfort is localized to my left sinus and seems to radiate into my ear, enveloping much of my head—a complication rooted from a previous fungal infection in my ear. I am currently under the care of an infectious disease specialist who has conducted over 20 tests, especially considering my history of travel and potential autoimmune disorders. I have expressed my concern that the lymph node issues are linked to my nasal condition, yet he appears skeptical. When I first returned to the States, I was suffering from open sores within my nose, which improved significantly with the application of mupirocin. Today, my ENT prescribed a nasal rinse containing xylitol, mupirocin, and gentamicin, which provides some relief, although it feels like a minor effort against a larger problem. I am feeling incredibly desperate at this stage. There is an unsettling thought of returning to Egypt, as I might have easier access to necessary testing and treatments. I spent three years largely confined to bed due to cancer, and now this sinus issue has me nearly bedridden again. Any guidance or assistance would be immensely appreciated.
Concerned About Unidentified Tissue During Bowel Movement
I’m a 20-year-old female with a BMI of 21. Although I have an eating disorder, I’m not sure if it directly relates to my current issue, but I believe it’s important to mention for context. I have used laxatives occasionally, although significantly less than in the past. I understand the dangers associated with them and have experienced withdrawal symptoms, including constipation, so I’m aware of the potential consequences. In 2023, I would typically take around 10 laxatives nightly for months, occasionally increasing to 20, but I ceased this habit in late 2024. Since then, I have relapsed and now only take them two to three times each month over the last six months. On Wednesday night, I consumed 16 laxatives and completely evacuated my bowels. Subsequently, on Thursday night, I took 4 more to clear the remnants of my meal from Wednesday. Today, however, my stools have been completely liquid and devoid of solid matter for the past two or three bowel movements, until just now. When I wiped, I discovered something unusual. I initially searched online to identify what it could be, thinking perhaps it might be a pill casing from a probiotic I had taken earlier; however, the texture does not resemble that at all. It feels like some kind of tissue, similar to the consistency of period blood clots—stringy, fibrous, rubbery, and surprisingly tough. This has raised an additional concern: I’m uncertain whether this substance exited from my anus or vagina, as it was positioned near the exterior of the anal area. Today, I’ve experienced significant abdominal cramps, which is puzzling since having a hormonal IUD has usually alleviated my menstrual symptoms. I haven’t consumed any food today except for a spicy salad with peppers, cucumber, tuna, and dressing, and nothing from that meal has come out, so I doubt it could be food-related. In my concern, I flushed the tissue, thinking that by the time I would be able to see a doctor, it’d be too late for examination. Now I’m regretting that decision and questioning whether I should have stored it in some way. Additionally, I’m unsure if it’s reasonable to make an appointment with my GP over this, so any guidance on how to proceed would be greatly appreciated. I’m feeling anxious because I can’t seem to reconcile this incident with any normal explanation. If anyone has any insight, I’d be immensely grateful. EDIT: I’ve been contemplating the possibility of this tissue originating from my vagina instead of my anus, as that makes more sense to me. Could this be indicative of a fibroid? While spontaneous discharge appears to be uncommon according to medical sources, the descriptions and some images I’ve seen seem somewhat similar.
Testicular Pain and Bump: What’s Going On?
Summary: I’m a 16-year-old male, and I’ve been experiencing discomfort in my right testicle when it’s touched or pressure is applied, particularly in the upper section (possibly near the epididymis). The issue began two weeks ago after my first visit to the gym, specifically after performing leg presses. While the discomfort subsided with rest, it reoccurred briefly after swimming, and now there’s a small, hard, tender bump on the upper part of the testicle (likely where the epididymis is). There's no swelling and no history of STDs, but I did have a scrotal hernia when I was 10. Detailed Account: I’m 16 years old and have noticed pain in my right testicle whenever it’s touched, located mainly at the top (possibly the epididymis) and previously in the back. Here's a timeline of what transpired: About two weeks ago, I began my first gym session, trying out all the different machines. I might have overexerted myself with weights that were too heavy, particularly during leg presses, which I later learned could potentially lead to injury, like a hernia. Later that same day, I experienced pain in the upper and rear sections of my right testicle. I realized the pain seemed to intensify upon contact or pressure in that area. After a few days of rest, the discomfort subsided significantly, but I still felt mild tenderness if I touched the area. Approximately a week later, after going swimming, the pain returned for a short period. I also noticed that the right side of my scrotum sat slightly lower than the left, although my left testicle usually hangs lower anyway. This condition persists, but the difference is minimal. By the start of this week, the pain had nearly vanished, except for a small bump on the upper section of my testicle (what I suspect is the epididymis), which was tender to the touch. I no longer feel discomfort in the back portion of the testicle. Earlier today, the pain flared up again briefly, but it has since calmed down, only hurting when I specifically touch that area. About me: I am a 16-year-old male, generally underweight or at a normal BMI. I had a scrotal hernia at the age of 10 (before puberty) that caused swelling, but I used ice and it has been alright since. I do not have any STIs or STDs and am a virgin.
Recommendations for Binding Agents?
Greetings everyone, I’m a 27-year-old male living in the USA, and I was diagnosed with end-stage renal disease last November. This condition stems from a combination of genetic factors and elevated blood pressure. Aside from my kidney issues, I lead an active and generally healthy lifestyle. I've made significant adjustments to my diet and consistently take my phosphate binders during meals, usually 2 to 3 with each one. At the moment, I am using sevelamer as my binder. However, I haven’t seen substantial results; the lowest my phosphorus levels have reached is in the 6s. My nurse practitioner is often concerned about my phosphorus levels, despite a slight improvement over the last few months. I’d like to hear from anyone who has experimented with various binders and can recommend a particular one. So far, my current binder has not presented any adverse effects. Thank you!