You may wonder why Basal Cell Carcinoma (BCC) is mentioned on a website for rarer cancers when it is the commonest cancer there is.

BCC is regarded as a minor nuisance that is easily dealt with, it is even given a non-cancer name - rodent ulcer - to distinguish it from those real cancers that eat away at you and might kill you.

The rodent ulcer I had on the side of my nose was cut out under local anaesthetic sometime in 1988.  During the next 15 years I has repeated surgery on my nose and on a second BCC that appeared on my forehead. 

In the early days there was no internet widely available but as this changed over time I tried to find out what I could about BCC.  All that I could discover was that BCC was treated surgically by Plastic Surgeons, sometimes more than one operation was necessary, it could be locally destructive if it was neglected, it did not spread to other parts of the body and fatalities were extremely rare.  So I was alright then.  My BCC was hardly being neglected - I was seeing a Consultant Plastic Surgeon very regularly and kept having operations to remove the next bit of affected skin.  I was told that as I was fair, and had spent my first years in a hot country the DNA in areas of my skin had been damaged and I was now seeing the result, some 30 years later.  I was told that there was no way of knowing where the margins of the DNA damage ended but that every time the BCC became evident, it would be removed.  I was concerned at this slow removal of my face but no-one else seemed at all bothered about it and I couldn’t find any information that said anything different should be done.

After a few years I moved areas and was referred on to another Plastic Surgeon who advised more of the same treatment.  I asked to see an oncologist as I was getting fed-up of repeated surgery.  This was done.  I was told by the oncologist that I could not have radiotherapy as there was no way of knowing where the margins of the BCC might be.  A further referral was made and eventually I saw a surgeon who specialised in Moh’s micrographic surgery.

During the consultation I was told that the referral was much too late and that there was nothing he could now do for me.  I was told that my problems were very serious and I urgently needed scans, multiple biopsies, a team of specialists including a Plastic surgeon, Eye surgeon, possibly Head & Neck surgeon and probably a Neurosurgeon.  I was devastated.  I had gone to the appointment by myself as I was still believing that this BCC was simply an inconvenience.

I got myself referred to another hospital’s Plastic Surgery Dept and had X rays, scans, biopsies, consultations with other surgeons including the Eye surgeon who said he thought he could save my eye, and from this a treatment plan was agreed.  I asked what would happen if I did not have the very extensive surgery that was proposed and I was told that the BCC would travel through my skull onto my brain.  It would then be inoperable.

I went down to theatre at 8.30am and returned to the High Dependency Unit at 6.30pm, so my husband tells me.

The top quarter of my face including part of my scalp had been removed.  There was nothing left of my face to hold the eye in place so that had had to go as well.  A good part of my inner arm was missing, this had gone, along with 14 inches of vein, to form my new forehead and its plumbing.  A large strip of skin had been taken from my thigh to graft onto my arm and to line the eye socket.  3 months later when I had recovered a little, I started 6 weeks of radiotherapy.

18 months later.  The eye socket refuses to heal and until it does I cannot be assessed for a prosthetic.  So I have to wear an absorbent eye pad, at least most people think I have an eye injury and do not suspect that there is a gaping hole behind the pad.

Time alone will tell if all the BCC has been removed.  As I understand things if it reappears on my forehead if it is not too big an area then the bone will be removed and a titanium plate put in place, if it reappears in the eye socket nothing else can be done.

If you think that your BCC might be the very rarer type that I have had, the website of the British Association of Dermatologists is now available.  Do read it, it could save your life.