May 6, 2010

Life's lessons

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.


Rachael said...

Wow, thank you so much for sharing this. Skin cancer is the most common cancer in women our age. Given my history of tanning and love of the sun I am extra careful of always checking my skin and getting a professional check every year. I've had several suspicious moles removed, but thankfully none have been cancerous. Even though just recently i have started using sunscreen, i still just love the warmth of the sun on my skin. It's so cruel that it's so bad. Ang, it's scary to hear anyone you are close to has any type of cancer...but thankfully the survival rate is very positive. My mom's father died from complications from malignant melanoma---back in the late 1960's when there really was no cure or awareness of skin cancer. Thank god your spot on your belly is something that can easily be removed and treated. I have a very close girlfriend who had moles that sometimes hurt or bleed and she is too scared to go to the dermatologist, I wish i could somehow convince her to go! Any advice would be great!

Patty Ann said...

There are some fabrics now with built in sun protection, that would give an added sense of security. We need the Vitamin D from the sun, I suppose the best advice is still to avoid the peak sun around noon. So glad you knew what to look for, and they agreed to delay treatment until after the baby comes.

patty said...

Thank you for such a terrific explanation of this disturbing skin cancer. I didn't realize you've had the spot for so long. It's rampant in my dad's relatives as well as grandma Mary's. She had so many lesions removed from her face that just a few months from her death, her care givers at Bishop Hills couldn't figure out how to keep her oxygen mask on her face due to swelling! She used to remark how grotesque she felt after any lesions were removed. Maybe this summer we can check one another's backs while we're safely wearing our swimsuits with sunscreen layered on our bodies! Years ago we used to do the "time to switch sides" alerts to each other while at the GR pool. Time to start new trends! Thank you for sharing!