Of course my job forces me to know a lot about medicine, but I generally find I'm a jack of all trades, master of none, being in primary care. Many times it takes experiencing something yourself to be forced to learn a bit more. This month I am getting familiar with basal cell skin cancer.
About two years ago, while pregnant with Charlotte, I noticed an interesting red blotch as it stretched more and more over my growing belly. My doctor at the time told me not to worry about it. It never disappeared really. At a general glance, you would think it was an irritated spot, no bigger than a pencil eraser....I would think it was ring worm or eczema if it hadn't been there for so long. About one month ago, there were a few pinpoint dots of blood coming from it while toweling off after a shower. I hit my boss up for a free biopsy, which I finally got around to another month later. I told him, "Please don't laugh at me for being a hypochondriac, but I swear this is basal cell." Lo and behold, I was right.
Basal cell carcinoma, BCC, is cancer, yes, but only invasive to local tissues, rarely metastatic. It can be quite destructive when found in its typical location, the face. Risk for basal cell is increased with sun exposure. It is the most common form of skin cancer and approximately 30% of Caucasions will develop BCC. I was just surprised to develop it at such a "young" age.
I met with the surgeon yesterday and will be postponing surgery until after the baby comes so that my scar will not be grotesquely deformed. The most common surgery today is Mohs, a microscopically performed surgery. The doctor takes repeat biopsies over the course of one day until they are able to microscopically confirm that the cancer has been removed in all directions. Only at that time will they close the wound. This surgery is most popular as the cure rate is >98%. Because BCC is slow-growing, it is safe for me to delay the surgery.
This cancer will really be more of an inconvenience than a threat. I will now need yearly skin evaluations and an extra helping of my spf 30. Really, for the fear of melanoma, I haven't laid out in the sun for years.
Remember when checking your skin to not only look for the dark and changing lesions, but watch out for any persistent, pearly reddened areas that may bleed or become raised. We're not as young as we like to think we are anymore.