Q. Can I undergo surgery for Basal Cell Carcinoma under local anesthesia?

Answered by
Dr. Atishay Bukharia
and medically reviewed by iCliniq medical review team.
Published on Aug 19, 2014 and last reviewed on: Oct 09, 2018

Hello Doctor,

  • I am 60 year old healthy female with medically controlled hypertension.
  • I have Behcet’s disease, though mostly under control.
  • I have had various tropical diseases.
  • I also had hepatitis A at childhood, and TB meningitis.
  • I also have scoliosis
  • I have been diagnosed BCC (Basal Cell Carcinoma) half way down and in the middle of my back.
  • It is about 2cm in diameter and raised about 1cm high.
  • Having had many skin cancers removed previously I expected the same procedure i.e, administration of local anesthesia and excision.
  • However, the general surgeon at the local hospital wants me to have general anesthesia for the surgical removal of BCC.
  • I cannot understand the necessity for a general anesthesia for removal of a BCC (I have had many removed previously without any problem).
  • As I have had adverse reactions to anesthesia before,I am very nervous about this.  
  • Once I had respiratory depression during moderate sedation.
  • Of five previous surgeries, I have had blood transfusions with two.
  • My recent blood work showed low PTT. 
  • Is it necessary that I should undergo surgery under general anesthesia?

Dr. Atishay Bukharia

Cosmetology Dermatology HIV/AIDS Specialist Plastic Surgery – Reconstructive And Cosmetic Venereology
#

Hi,

Welcome to icliniq.com.

You should ask your surgeon the reason behind giving general anaesthesia in your case.

Basal cell carcinoma is a locally invasive tumour with very rare chances of malignancy.

The need for general anesthesia can arise when on clinical examination it was found that the tumour also involves underlying subcutaneous tissue, nerves and surrounding structures.

In such cases we cannot rely upon the local anesthesia as we may have to extend the surgery.

During surgery we have to remove one extra centimetre of the healthy margin to prevent recurrence of the tumour.

This margin will be sent for histopathological examination later, to determine whether margins are free from tumour.

If margins are involved resurgery has to be done.

The size of your tumour is 2cm and may be your surgeon on examination found it to be a deep tumour.

Hence to prevent resurgery, he might have advised surgery under general anesthesia.

As in case of local anesthesia, sometimes it is difficult to extend the surgery especially when underlying nerves are involved.

Do not worry about the general anesthesia as there are few anesthetic compounds which do not cause respiratory depression.

So, inform your surgeon regarding the previous respiratory depression and get treated accordingly.

  • Regarding PTT (Partial thromboplastin time), low value means prolonged clotting time.
  • This can be due to drugs like heparin, nephrotic syndrome and in many cases Behcet's disease can also alter the PTT.

For further follow up, consult a surgical oncologist online --> https://www.icliniq.com/ask-a-doctor-online/surgical-oncologist

Also Read Answers From:

Related Questions & Answers


Sunprotection and Sunscreens : All you need to know about this!

Article Overview: Sun protection is the single most important measure of preventing or delaying problems like ageing of skin, wrinkles, pigmentation disorders like melasma, age spots etc. Thus protection from sun-exposure by physical methods and proper use of sunscreens is central to prevention and treatment of these problems. Unfortunately not many people know how exactly a sunscreen should be used to optimize its beneficial effects. This article will educate everybody about concepts of ideal sun protection and use of sunscreens. Read Article


Dr. Sidharth Sonthalia
Dermatologist

What is Sun Protection and Why is it Needed Sun protection is simply guarding a body from the adverse effects of sunlight. Sun light consists of visible light and Ultra Violet (UV) radiation which are of three types – A,B,C of which UVA and UVB have detrimental effects on the skin on chronic ...  Read Article

Popular

Popular

Ask your health query to a doctor online?

Ask a Surgical Oncologist Now

* guaranteed answer within 4 hours.
Enter Your Health Query
You can upload files and images in the next step.

Fee:  

 


Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.