Bye Bye BCC!

About a month ago I was diagnosed with a small basal cell carcinoma, just above my right eyebrow. It looked as if someone had dipped the top of a #2 pencil eraser in pink ink and daubed it on.

Today I underwent Mohs Micrographic Surgery to remove it. As of this moment I am very happily free of the bcc!

I first noticed the pink spot sometime in the autumn. (But, thanks to the arrival of Isabella, I have been able to look back in photos and see a very tiny spot at the end of August.) It looked to me like a similar reddish spot I’ve had unchanged on my face for years, so I thought nothing of it. Sometimes this new spot was dry; sometimes raw. I kept Noxzema on it (For me Noxzema is the equivalent of what Windex was to the father in “My Big Fat Greek Wedding”!) and it seemed to calm down.

But in January, not even the Noxzema was soothing it so I headed to WebMD and viewed a skin problem slide show. After viewing the slides I was convinced it was an actinic keratosis. Being fair haired, fair skinned, blue eyed with a history of sunburns in childhood I knew that put me at risk. Because many doctors consider all actinic keratoses to be pre-cancerous, I called my primary care physician the very next day and saw him later in the week. He also thought it was an actinic keratosis but referred me to a dermatologist.

My dermatologist turned out to be great. He is smart, relaxed, kind and has a sense of humor. As soon as he took a close look at the spot he said he didn’t think it was an actinic keratosis, but a basal cell carcinoma. I said: “Well that’s not good.” to which he replied “Well, it’s not bad!”. A biopsy confirmed his eagle eyed diagnosis and I was scheduled for the Mohs surgery.

The Mohs doc who treated me today is exceptional. (Lately I have been on a roll in finding very good doctors!) Mohs surgery, named for Frederic E. Mohs, MD, was first performed back in the 1930s. A Mohs surgeon, usually a dermatologist, has an additional year of training before becoming a Mohs Fellow. If you think of the cancer as an iceberg, the specially trained doctor removes a thin slice of tissue off the top. It is marked precisely, frozen and examined under the microscope. Let’s say the left edge of the sample has a margin of healthy tissue. When the second slice is removed, more is taken from the right side. It too is marked and examined. These steps continue until all of the cancer is removed. Because of the thin layers and the level of precision, no roots of the cancer are left behind and the least possible amount of healthy tissue is taken.

To my amazement, all of my bcc was removed with the first slice! The challenge then for the doctor was how to close the wound. If he had simply pulled all the edges of the thumbnail size wound together I would have been left with a large pucker, plus it would have pulled my eyebrow up into a permanent state of skepticism and Dorothy Parker snarkiness. Happily I did not require a graft. Instead he decided on a teardrop shaped reconstructive flap which was “slid” into place and echoed the shape of my brow - quite brilliant actually.

Chuck was able to be with me for every step of the procedure, which was an enormous gift. And my doc was perfectly comfortable with Chuck snapping a couple of pics with his cell phone to document the occasion! When we were scheduling the Mohs surgery, the first proposed date was tomorrow, March 16th, but that’s Chuck’s birthday. So we chose the day before. I told Chuck that still didn’t seem fair, but he said that having a cancer free wife was an excellent birthday gift! I tell ya, the man’s a keeper!

I will return next week to have the stitches removed. Because once you have a skin cancer your odds increase for another developing, I will also be seeing my dermatologist on a regular basis for ongoing screenings.

Compared to the far more complicated and troubling skin cancers I could have been diagnosed with, I feel incredibly fortunate. I also am counting my lucky stars that fine doctors and excellent treatment are both affordable and readily available to me.