Me and Basal Cell Carcinoma
This blog is brought to you by the letter 'H' and the letter 'S'!
'H' is for hats! They can be fun or fashionable. They can be personalized and show your personality. They can also be protection!
'S' is for summer, sun and sunscreen. Can anyone guess what else 'S' is for?
That's right! If you guessed skin cancer give yourself a big hand!
I want to share my experience with you in hopes to educate someone, anyone about the risks of being casual with the sun by not taking simple precautions in reducing your risk of skin cancer.
My journey with skin cancer started back in 2008. It was a small pimple size thing that just kept scabbing in the crease of my nostril. After a couple of months I thought I should get it looked at. Calling my doctor I booked an appointment and she set me up with the dermatologist they had on site.
This doctor took a look, and did a biopsy. I left with one stitch. A week later (I think. It was a long time ago) I received my results. It was confirmed I had basal cell carcinoma. I was fortunate as that biopsy was the start and finish to ky treatment as the margines came back clear. That was it! I was cancer free! No lecture. No warnings. In fact, it was the nurse in passing as I worked in the same building that quickly told me my results.
"You're lucky. You only had Basal cell carcinoma." she said. "If you are going to get skin cancer this is the one you want!"
That was it. Conversation over.
What is Basal cell carcinoma?
Basal cell carcinoma is the most common type of skin cancer. It developes within the basal cell layer of the skin. Basal cell carcinomas usually grow slowly. They don't usually metastasize or spread to nearby lymph nodes or other parts of the body. That said early detection and treatment is important. The pimple size wound - as in my case - is the tree trunk, but what it is doing in the skin, and how far it goes, those are the roots. In other words, what you see isn't always all there is. There is the invisble.
Basal cell might be the one you want if you are to have skin cancer at all, but it can be life altering just the same; and just because it rarely metastasizes doesn't mean it won't, so it can also be life threatening if left untreated.
I was young enough back in 2008 to believe that I was still kind of untouchable when I got that one. No one else took it serious and neither did I. I mean, I did, but once I got the results it was simple... Phew! It was tiny and over. Sunscreen and hats was only briefly debated and quickly forgotten. I simply moved on. Besides, I wasn't a sunbather. I never did tanning beds. I didn't sit out in the bright sun for any length of time. I did boat and swim, and I did use sunscreen, kinda sorta. I mean I put it on and went swimming. It was a pain. You have to keep applying it and I didn't, and in time I didn't bother using it at all. Besides I was never in the sun long enough to burn. I did sit outside on the patio or at the beach, but when I was sitting out I was under an umbrella or in the shade. Why bother?
Fast forward to March 2021.
"Awe man... an ugly pimple smack dab in the middle of my face. Nice. *sigh*"
"Hmmm. Somethings up here..."
Scab gone. "Phew."
A week passed...
"I better call my doctor."
Since we were deep in Covid it was a phone appointment, but I was grateful that it was immediately taken seriously. I was told there would be a referral made for me to see a dermatologist.
In June I went to see the fabulous lady that would take even better care of me.
On that first appointment she assessed the tiny scab. She quickly booked another appointment for the biopsy at the end of the week.
Returning days later I expected from the pimple size of it, it would be another teeny tiny mellon scoup kind of thing. Nope.
Shave biopsy image. It doesn't look like much in the picture but it was big enough considering what I had prepped myself for.
After she froze me - which was so NOT pleasant I might add, she did what is called a shave biopsy. That is what you see in the image above. When she showed me in the mirror I was shocked!
"It was tiny." I stated.
She shook her head "No it wasn't."
I asked "Did you take it all out?" I assumed from the size of what she took she must have felt pretty confident that she got it all. I mean why else take such a big amount?
"Highly unlikely." she said. "This will need surgery. I will send you to a doctore that does remarkable work. You won't have to give up your modeling career."
To this I laughed as she was just being cheeky. I was however stressed but at the same time relieved to know that in the end it would be fast, simple and over.
October 2021 I had my appointment with the surgeon who looked at it ready to get to work.
"Hmmm... It's red around the edges." she said.
She went on to tell me that she didn't want to cut, sew me up only to have to have me come back to do it again.
See, when skin or whatever is taken out for reasons such as this it is sent for testing to ensure the margins are clear of anymore cancer. This takes time. She could have cut the red out also but then she could be taking healthy skin unnecessarily leaving me with a bigger and unnecessary scar. If she didn't take the red edges it could have been discovered that she didn't take enough landing me back in her chair weeks later to do it all over again. In the end she concluded that Mohs was the way to go.
What is Mohs?
Mohs is where you go to the hospital. The surgeon takes what she determins from a visual of the skin along with the results of the biopsy she has to be enough. The piece - more like chunck taken is tested on site while you wait unstitched.
If it comes back showing cancer in the margines she freezes you again and cuts more. This process is repeated until all margins come back clear. Yes, it is as intense as it sounds.
Oh, and did I mention you are only frozen, not asleep? You feel EVERYTHING but the pain. Holy intense. Let. Me. Tell. You.
Once it comes back clear your reconstruction is dermined. Pending the severity of the removal it could be a simple stitch procedure or it could be a skin graph to name another option. I am sure there are more options but I am no surgeon. The aim is for the best, least scarring reconstruction possible.
I luckily only had the one cut but it was still big enough and reconstruction was very intense.
Since a simple 'stitch it closed' wasn't going to work in my case they had to cut more in order to close it properly. I now have an upside down 'T'. They needed to cut across my nose and down the sides to releast tension on the skin inorder to stitch the hole closed. They also had to cut higher up on the bridge to not leave me with a pleat.
I left with a pressure bandage and the promise that it will look ugly for a bit, but in time it will hardly be noticeable. I have to say, what I saw in the mirror prior to the badage I am having a hard time envisioning that, but apparently she is the best at what she does. It will take a long while but fingers crossed...
Hours later with so much swelling and no more freezing I was in pain from nose to head, and nose to ears. I had the worst sleep trying to sleep sitting up and dealing with the pain that every 3hrs required more Tylenol.
What was most intense about all of this?
The most intense was well, all of it. It was intense knowing something was up and waiting for the confirmation of what exactly I was dealing with. It was intense with it being smack dab in the middle of my face. It was intense getting the freezing shots in my nose for the biopsy. It was intense to see the biopsy damage and wondering how it would heal. It was intense knowing I had to do surgery and wondering since this little thing caused this much damage so far, what will the surgery leave me with? Would I lose a nostril? Will I have a nose at all? It was intense the day I went for the inital surgery only to hear it might be as big or bigger than the worries I initally had. My above mentioned worries went from telling myself "You're being silly. Of course you will have a nose." to "But will you?" It was intense to wait longer and in limbo wondering how much more it was growing. It was intense getting many shots into my nose to freeze me for the actual surgery, and to feel the cutting when she finally started. It was intense waiting with a whole in my face wondering if they would need to do more. Finally, hours later getting the 'all clear' it was intense going over the reconstruction proceedure. It was intense getting the freezing again - mutliple shots and feeling and hearing all the slicing, pulling, and smelling of coaterizing for an hour. It was intense seeing the final result in the mirror - seeing all the swelling and all the stitches and trying visualize in my mind how it will possibly heal as well as they say it will...
Currently I am wearing a pressure bandage. Once that can come off (another 24hrs) I will spend the next two weeks cleaning it once a day and keeping it covered, and another week covering whenever I go outside. After three weeks I can wear sunscreen and makeup again as my body does the rest of the work. It will be months before I finally see the end results of the healing, and what I am actually left with. The shave biopsy I had took months to be barely noticeble to me, and invisble to anyone that didn't have a clue I had one. This will certainly take longer.
My experience is by far minor in comparison to what some people experience. I was fortunate! Some lose their nose entirely. Some lose major portions of their skin. Both senerios I mean to imply that they are disfigured. There are some that have to return time and again for the proceedure and chemo as they are unable to cure them with a - I say simple procedure, but it isn't simple. Some have the skin cancer that in the end takes their life.
Basal cell is the most common but there are other types of skin cancer such as:
Developes in melanocytes, or the skin cells that make the brown pigment also called melanin. These are the cells that darken when exposed to the sun.
Squamous cell carcinoma
This type of skin cancer is second in popularity to Basal cell carcinoma. It is usually found on skin that has been exposed to the sun. It generally grows slow, and it is uncommon for it to spread, or metastasize. But it is more likely then Basal cell to dig down into fatty tissue beneath the skin and can spread even further.
Merkel cell carcinoma
This one is agressive. Usually areas exposed to the sun like the scalp, face extra. This may matastasize to the brain, or other organs.
The above is just to name a few. There are rarer kinds of skin cancer. I am sure not all types of skin cancer is caused by the sun but you can take some measure to protect yourself. A few simple ones are:
1. Wear sunscreen and hats. Wear long sleeves if possible. Reduce your time in the sun, or at least the times when the UV is highest such as been 10a.m. and 2p.m. Suncreen and hats for your children also. Reducing their UV exposure will help reduce their odds as they grow into adults of developing skin cancer. Forming the habit of suncreen and hats while they are young will hopefully have them continuing it when you no longer have the power to hold them down and lather them up.
2. Educating yourself on the different skin cancers and what to look for. This will allow you the possibily of early detection making for the highest cure rate.
Skin cancer is still a cancer. It is scary, and it can be deadly. If you take precautions and seek medical help when you first suspect it, it just might save you disfigurement or more importantly your life.
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