My Story – Basal Cell Carcinoma of the Scalp: Yet Another Cancer!

 Trying to keep VERY calm and love autumn. . . .

Yes, it’s true. After my reprieve yesterday, when I received a benign mammography report by fax, today I got another one of those calls telling me I had cancer. This one’s not so bad, though–nothing like the uterine cancer that’s still inside of me. (I’ve never looked forward to a Friday the 13th so much. See the My Current Story entries for background information.)

So, why will I soon start parting my hair in the middle? As I mentioned in the November 19 blog post, one of my triple-header medical visits the other day was to a dermatologist to check a pink spot on my scalp that I’ve had for a couple of years or so. Over the past few months, it has became pinker and itchier. It’s right in the part of my hair, just left of center, and thus has been exposed to ultraviolet (UV) rays–although I hardly ever go out in the sun. I happened to mention it to my family doctor during my pre-D&C medical visit a month ago today. She took a quick look said I should see a dermatologist to have what might be a “precancerous lesion” checked. I all but forgot about it, but then I caught my image in the mirror, and the spot was more noticeably pink. So I called.

The dermatologist did a biopsy in her office two days ago and said it would take up to two weeks to get the results. However, it took only two days, and 48 hours after the biopsy I had the faxed pathology report in my hands that says the little pink spot is a basal cell carcinoma. This is the most common form of skin cancer and is fairly easy to treat–and highly curable. It is not a melanoma* so is not much to worry about (especially with everything else I have going on–apparently this is unrelated to the uterine cancer . . . hmmm).

As the dermatologist explained, this common, mild form of skin cancer doesn’t get bigger in area, but it might change and become disfiguring if it isn’t removed. So she referred me to a dermatologic surgeon for Mohs micrographic surgery—another new medical term for me. (I will be adding a glossary to this blog.) I thought this might be an acronym, but the dermatologist said it was named after the man who invented it at the University of Wisconsin, Dr. Frederic Mohs, back in the 1930s.

The procedure has obviously evolved since that time and is often used to remove basal cell and squamous cell carcinomas, the latter being the second most common form of skin cancer. In Mohs, the surgeon doesn’t dig a big trough around the lesion as with a regular excision, which is especially important when the site is the face or head. Instead, this staged procedure involves removing a thin layer of the lesion, viewing the tissue under a microscope to check for cancer cells, and slicing off successive thin layers of the lesion until the slides show no more cancer. This leaves as much healthy skin intact as possible.

The Mohs procedure is done in the doctor’s office and can take one to four or more hours, depending on how deep the lesion is and how many layers need to be sliced off (ooh; and that local anesthetic burns). Fortunately, I don’t have New Year’s Eve plans because my head will be partially shaved and I’ll be wearing a bulky bandage. (Halloween might have been better timing.) The stitches are removed in a week or so.

I did ask the dermatologist whether the procedure could be done following my hysterectomy while I was still under anesthesia, as discussed with my oncologist, but the nature of Mohs prohibits this. It also requires special training, and not all general or plastic surgeons do it. So, my procedure in the surgical dermatologist’s is scheduled for Monday, December 30, 2013, giving me precious little time to recover from the hysterectomy. But like everything else in my life right now, it’s gotta be done.

The American College of Mohs Surgery provides clear, understandable explanations and is worth a visit if you have, or think you might have, a skin cancer that needs to be removed. For general information on skin cancer, see the Skin Cancer Foundation.

The original dermatologist said I should return to see her in three to five months so she can check me head to toe for any other skin cancers.

“The Patient Path″ seems to have been named wisely. . . .

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* Maureen Reagan, daughter of President Ronald Reagan and actress Jane Wyman, died at age 60 from melanoma. Read her obituary.

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NOTE: If you haven’t done so already, PLEASE read yesterday’s post on uterine cancer risk factors—it could save your life or the life of someone you care about. And don’t forget your SPF moisturizer or lotion, hat, and shades whenever you go out in the sun.