A Little C

So for the last several years, I’ve had a regular check-up with my dermatologist where every six months I give him my co-pay and he takes out the liquid nitrogen wand and zaps half a dozen or so things on my head and arms, reminds me to keep wearing hats, and use sunscreen.

Such was the case this month. We were doing the standard search-and-zap when he was scanning my head and began saying things like, “Hrrrmmm” and “Mmmmm” and “I don’t like that” then saying to his assistant, “Prep this area for a biopsy.”

There had been an area on my head that had been kind of itchy and hadn’t seamlessly healed from the last LN2 treatment like all the other ones had and so I figured that area would get a little extra scrutiny. My dermatologist said that he was going to take some samples and have them analyzed to determine “what it was” and then “what we’d need to do about it”. His normal cheerful demeanor while pew-pew-pewing me with liquid nitrogen had evaporated.

And sure enough, a couple days later he calls and says, “Yeah, it’s a basal cell carcinoma.”

I’m sorry, carci-wha? I mean that makes it sound like cancer. And I couldn’t have cancer, right? I’m still young. I just get little blemishes. Certainly not skin cancer.

But as it turns out, biology isn’t going to be held up by my denials or euphemisms. On the upside, it turns out that as skin cancers go, basal cell carcinomas are the one to get (yay me, I guess). They tend to be slow-growing and non-metastatic and readily treated by surgery. Tend to be.

Not so great Red Spot

So on Election Day, I’ll be going to a clinic for a little out-patient surgery to make a hole in my head. Hopefully, a small one. The procedure is called Mohs surgery — a procedure by which the surgeon will go in, take tissues in a grid and test them in real-time to see if they’re cancerous or not. The excise-test-repeat is done until everything comes back clean. One of the benefits of Mohs surgery is that it minimizes tissue loss — which is nice considering it’s on my head and visible and all that.

So, that news wasn’t very welcome, though I know it’s certainly not the worst news you can get from your doctor. I have been trying to throw around “I’ve got cancer” in the hopes of getting treats and stuff, but so far basal cells aren’t generating the sort of sympathy desserts I had in mind. I can always hope for recovery desserts, I suppose.


63 thoughts on “A Little C

  1. Holy crap! This is sobering stuff, and I hope that your procedure next week isn’t too painful AND that it gets all of it on one shot, not a bunch of repeats.

    Email me your address and I’ll happily bake you something wonderful! In my book, sympathy desserts are definitely in order.


  2. Tomorrow marks the one year anniversary of my mohs procedure. Tomorrow is also when I go back to my dermatologist for a regular check-up.
    The name of the surgeon that did the procedure on me ON Halloween was Dr. Chiller. I am not kidding.
    Hang in there Steve. There are worse things.

  3. Steve, I have had NINE basal cell carcinomas over the years. My first was when I was 38! That was before MOHS was being done around here. So was my second, and both of them left bigger scars than necessary. One had to be removed twice, so they took out a whole bunch more, right from my forehead. Now I wear bangs, haha. I’ve had 4 on my face, 3 on my collarbones, both sides, and two on my back. MOHS was done on the ones on each side of my nose, so the scars are nice and small. They don’t have to remove any more than necessary with the procedure, and it is really the way to go, especially on the face.

    Bottom line is, I’m still here, nearly 30 years after my first one was removed, and not one of them has slowed me down a bit. After a childhood in Florida, way back before such a thing as sunblock, I’m just very grateful none of them were melanomas. It will be over before you know it, and you can get lots of sympathy and TLC when you have a big bandage on your head. Practice moaning a little bit, with an occasional whimper thrown in for good measure, and work on looking very, very sad.
    Seriously, good luck. Hope it is quick, relatively painless, and heals up fast! Go buy yourself a 55-gallon drum of Total Eclipse Sunblock, and a do-rag to wear UNDER your hat. Keep us posted on how it goes.

    • Thanks Marcia! I have a suspicion that this is sort of the tip of the iceberg as these things go, but I know with vigilance by both me and my dermatologist, we’ll likely be able to keep things in check.

      I’ve been super-careful with the suns for years now, but like you, I’m paying the price for being in the sun so much as a youth without giving much thought to protection.

      • I’ve managed to catch all of my more recent problems early, and the removal process has been not too much more involved than a biopsy. But that first one! Oh, my. First it was removed using visual markers, then it came back. Turns out it had “arms” that went in several directions away from the main cancer. So they had to take it out again, and this time, he left me with quite a divot in my forehead that never filled in again. Hence the bangs. But that’s because he had no way to know just how far out the arms went, and there was a lot of guesswork involved. With MOHS, you won’t have that problem, and they will only remove exactly what’s necessary. I’m sending you lots of healing energy, and best wishes that it will be a small wound which heals quickly. (At least they aren’t telling you as you go in that they may have to remove half of your nose. That’s what I was faced with! Twice. But I lucked out.) You’re gonna be fine. That’s my story, an’ I’m stickin’ TO it!

  4. My aunt was a red-head living in Mississippi.
    She used to come visit us every year, and every year my dad checked her over for these.
    She had at least a dozen of the things.
    They all got gone and that was that.
    It really is the one you want to get, and they really can get it all.
    (Doesn’t make it okay, doesn’t make it not scary.)

    • lauowolf — that’s the thing, isn’t it? I know that with vigilance (and excision) these things can be taken care of — but it still doesn’t remove all of that dread-feeling when you think about it.

  5. ohhhh wow. and dang I mean it’s basically on your skull, it’s not like there’s that much flesh there to get. (well I don’t know, maybe there is on you? :-P) as soon as I saw the pic in my Reader it made me think of my dad. Bald since his 20s, always out doing stuff in the sun, didn’t wear hats hardly ever, and his pate was very freckled and burnt and he had some growths taken off too.
    Well good luck with the treatments. I hope it’s as minimally awful as possible for you.

    • cranky — did you just say I have a fat-head? :) Thanks much for the well-wishes. I’ve been careful for years, but know that I wasn’t so much in my youth (when you know you’re going to live forever, right?). I’ll have to post and after picture… :)

  6. I’m sorry to hear this. Another friend of ours had to have a similar carcinoma removed from a similar spot earlier this year. She said the procedure wasn’t too bad. I hope yours goes well.

  7. Ouch on top of the skull there! My brother has just had two cut out of his back then had to go back and they cut some more but they seem pretty happy with it at the moment. Not much good being a fair skinned ranga farmer here in Australia. (You probably don’t call them ranga’s but thats what we call red heads here). He said to the doctor that his back hadn’t seen the sun for over thirty years but she told him all it takes is one bad sunburn when you’re a kid and that can set it all in motion. Hope it all goes well.

    • Thanks Jane! I think I am going to refer to myself as a ranga now (it’s not derogatory, is it??) — I like the way that sounds. Though in reality, there’s really not much hair (red, or otherwise) left up there!

      I’m also amazed at the number of things that get LN2’d off my back, because even as a kid I was pretty careful about that — though there were some pretty bad burns there too.

      • Lol – not as long as you don’t say it in a derogatory manner. Our Prime Minister is a ranga but I’m not sure every one calls her that meaning it as a term of endearment but in general it means no harm. It comes from orangutan.

  8. Agh, Steve! Good luck with the removal. I had basal cell carcinomas removed from my back and from my left cheek. It was before the Mohs procedure was invented, however, so I had it done the old-fashioned way: the surgeon cut them out, then sent them to a lab for tests. I spent a week chewing on my nails, hoping it wasn’t cancer-cancer, the kind that spreads to your internal organs and bones. As luck would had it, it was not, but still, I had sutures on my face and back and I felt like I wanted to go home and hide. So I’m glad they have the Mohs procedure now, and hope you will recover quickly and soon.

    • Thanks HG! I’m very glad that your BCCs (and mine) were not cancer-cancer (which is exactly the term that I’ve been using for myself to describe what these are not…).

  9. Any time the C word comes up, you can’t help but be scared and serious. Even though everyone will tell you it’s not a worry. Keep breathing, buddy. Then, get ice cream.

    • Thanks Steph! Yeah, there’s something to be said for being pro-active about your own health, isn’t there. An important lesson to remember as we get older. I definitely keep up the updates.

  10. Oh man, that’s scary but from what you said & from reading the comments, hopefully all will go well and recovery will be quick & easy! (Or slightly less quick if you want to play the bake-for-me card a little longer.)

    Today you can say, “Gee, I’m glad I don’t have any hair up there or else they might not have found it.” See? Being bald is a good thing! Bet you already knew that. :)

    In all seriousness, I’ll be praying for you on Tuesday.

    • Thanks Mello — I really appreciate it. Everything points to a routine surgery and recovery, with little chance of recurrence. So I’ll take that, yes. My guess is that others will pop up from time to time, but now that I know what the symptoms of this one were (the lack of quick healing, the itchiness) I think I’ll be able to be on top of it even better.

      You know, I haven’t had hair for so long, that I don’t ever really lament its loss. I’m pretty happy with “me”, so yes — one more added benefit for the clean-pate club! =P

  11. Being natural gingers, we are hit early, aren’t we? Even my father (who tans easily) has had it. My godfather REALLY had a large area…something like 10cm (maybe more). It was large enough that they had to get skin from elsewhere to patch his head up.

    Now that you’re a member of the society, you’ll be going in more than yearly, I hope! I think my parents go quarterly. Mum hasn’t come back positive yet but she’s a natural (well, was) ginger, too. I think dad (being darker) got screwed BECAUSE he tanned so easily that he didn’t ever cover up. It’s a theory and no matter what, it’s scary to hear.

    You’re in my thoughts. You will be grand but it’s a gut punch hearing it!

    • MT — yes, I’ve been going in every six months for the past several years for check-ups, and I think that frequency just got increased to every 3-4 months. That’s okay — I don’t mind that one bit!

      My brother is much darker toned than me and tans readily, but our conversations about this has had him make an appointment for himself, so that’s a really good thing to come out of it, too.

  12. Hopefully you are not too much worried about it, Steve…..I wish you fast recovery.

    Within this comment thread I was reading about Sunblock. Don’t buy into that myth. Either one has the genes to aquire Melanoma easily or one has not – and there is the Immune System factor, either that is very strong or it is compromised. The most melanomas occur on areas on the body NOT exposed to the sun. Humans need the sun exposure to keep the Immune System strong and take up enough Vit.D. When I was young, I practically baked in the sun an entire day for 3 weeks at once and 4 years in a row at the beaches in Zuid-Holland, I was using different dark oils, like haselnut, walnut etc. I was so tanned, that my teeth looked foreign on me when I opened my mouth, I should have gotten Melanoma, right?? I never had a blemish and I am 77 years old now. Taking care of the Immune System is the most important health concern. If that is strong, it will also fight cancer effectively. I am not a doctor but I am interested in everything concerning human health.

    • Karin — thanks for your well-wishes. Like so many human conditions, we are dealt our genetic basis and then add on environmental effects (both positive and negative) from there. There’s also so much data coming forward about how interconnected our systems are — cardiovascular, body mass, stress, reproduction, immunity — they all influence another. One of the best things we can do is keep our body and our mind sharp with good diets, and both physical and mental exercise. Tip the odds into your favor as much as you can.

  13. Yikes. If you had to look through the cancer catalog, you did pick the right one to get. As long as I can remember, my dad has gone to the dermatologist every six months, and every six months he comes home biopsied, LN2’d, etc. Most of his have been basal cell, but he has had a couple of the M-words, too. You are very wise to hand over your copay a couple times a year.

    Because the Moh’s Surgery is on your head (and because it’s Halloween, and I’m a smartass), I must point out that Moh’s Scale classifies the hardness of rocks. Coincidence??????

    Um. Yes. Different Mohs.

    Good luck, sir. It sounds like you’re in good hands, and perhaps Penny will provide tasty pastry for your recovery.

    • Yes — you never want the Cancer Catalog to show up in your mailbox — especially around the holidays, but yep, it’s probably the best one to get.

      I’m a little bit disappointed that I didn’t have a giant bandage and/or suppurating scar on my head for Halloween, but you can’t have everything.

      A Mho is also a unit of electrical conductance, essentially ohm(-1). That made me think it might be some sort of electro-shock therapy, but again, no such luck.

    • I thought Mohs = rocks too, so thanks, Tom, for mentioning it.

      A friend of my parents’ had to have an entire EAR rebuilt from this, so you are getting off pretty easily. Of course he didn’t have the frequent checks, so there ya go.

  14. Yikes! Yeah, the “c-word” is never good to hear. It’s good that you get regularly tested.

    Now, I’m off to have my wife carefully examine every itchy spot I have. She thanks you, I’m sure.

  15. good luck! I’ll be sending good jujus for 1 cut & it’s done.
    i’m having a spot checked on Monday. but I’ve now realized I have 3 of said spots across my body, so I’m really hoping it’s not “the big c”. Though, frankly, with my history of 2nd degree sunburns I’m sure they’ll find *something* bad on me.

  16. I’m sending prayers your way. My dad had this surgery a few years ago. Thankfully he was fine, but it was scary for him for a little bit.

  17. Yikes! I’m glad we live in an age with the medical technology we have…not just to identify these things correctly, but to treat them the right way. Hope your noggin is doing fine!

  18. Pingback: A Week Later | Stevil

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