question: 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?