I think of myself as a healthy person. I eat good foods and avoid bad stuff like candy and soda. My day typically starts with exercise, as I hit the pool for water aerobics five or six times a week. On my “dry” days, I walk. Vaccines, yup—got all of them. And regular medical checkups as well. Yet, surprises happen.
The Annual Spot Check
One of those checkups happened last month during my dermatologist’s annual “spot check.” That involves running a UV light over your body and looking for signs of skin cancer. Usually, I get a clean bill of health, hop off the table and go home.
This year, the doctor found something of concern—just a small red dot. She took a biopsy and sent it off. The day before Thanksgiving, I got the results: basal-cell carcinoma. Hmmm. This required an adjustment from my mental state of boring good health.
The good news is that basal-cell carcinoma is a slow-growing cancer that can usually be removed before it causes a real problem. People have it excised and go on with their lives. Death from basal-cell cancer is very uncommon and usually occurs when elderly people don’t get screened or treated until it’s too late.
The bad news is that it requires surgery under local anesthetic and testing to make sure it’s all gone. This is called Moh’s Surgery and it has a cure rate of 98% to 99%. The doctor removes the minimum amount of skin required to “get” all the cancerous cells, but it may take a couple of attempts — and up to four hours.
Going On with My Life
Now, don’t get me wrong. I would rather have this procedure and go on with my life than not. Or be diagnosed with any other kind of cancer. Lots of folks have it a lot worse and I’m sure their diagnosis was more of a shock for them than this one was for me.
I was prepared. After the biopsy, it took too long for the cut to heal and I could feel what seemed to be movement there. It was probably just the healing process but it felt alive to me. My attitude was: let’s get this out and move on.
So, that’s what we did.
I was fortunate. Dr. Benjamin Solky of APDerm got it all on the first try. Then came the stitches. This creates a weird feeling, like how a quilt would feel when it’s being sewn together. And finally came the bandages — layered pressure strips that make a big white lump. As this spot was right above my top lip, the bandage presents some difficulty eating and brushing my teeth. I will cope until the bandage comes off tomorrow.
Mind you, this spot didn’t look like it was a problem. As we grow older, our skin develops tags, age spots, mottled areas, sebaceous cysts, and other ugly markings. Some of them can be really ugly. Usually those distasteful spots are benign, offending only our sensibilities and reminding us that we aren’t spring chickens anymore.
The carcinomas are insidious, though. I looked at this thing in the mirror every day and it gave me no concern whatsoever. It was little bigger than a pinhead. I had no Aha! Moment or “What the heck is that?” query. Without the spot check, I would not have been motivated to go to the dermatologist. That means it would have continued to grow—albeit slowly—until it was bigger, more difficult to excise, and more dangerous.
In Good Company
Sitting here with my stitches, bandage, and stiff upper lip I find myself in good company. It’s estimated that about 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US. These occur in about 3.3 million Americans, as some people have more than one. About eight out of 10 of these are basal-cell cancers.
And the number has been increasing every year—probably because of better skin cancer detection, increased life spans, and people getting more sun exposure. I’m blaming mine on many lovely days at Horseneck Beach when I was a teenager, wearing a bikini and no sunscreen. I’m not even sure that sunscreen existed back then. We thought sunlight was good for us.
Now we know better. During the summer, I wear a hat and sunscreen in the pool, go to early morning classes, and wear a daily moisturizer with a rating of SPF 30.
Once the bandage comes off, my face will be bruised and swollen for a week or two. But I promised not to talk about Fight Club. Also, I must forego exercise for a week and I will find that difficult. As anyone who exercises regularly can tell you, going without leaves you feeling jittery and feeling like you forgot something important.
Get Yourself Checked
What I want to emphasize here is that you need to get your skin checked once a year. Whether your GP does it or you go to a dermatologist, make sure that spot check happens. You will probably get a clean bill of health and think that you just wasted a few hours of your time. But no. You can now go for a year without worrying, as I did before.
That peace of mind is important—but making sure you achieve it is imperative.