Skin cancer whack-a-mole (I)

The one and only doctor I see about once a year is my dermatologist, darn it. In fact, I have both a dermatologist and a dermatological surgeon! I’ve gotten quite good a diagnosing the various types of cancers—some, even, that are barely visible. So far, I’ve only been wrong once in my diagnoses.

My skin is awful and it’s entirely because of sun damage, probably because, as a teenager, I was intent on having a fabulous tan. I still tan easily and rather like being tan, but it’s a dumb thing to do. I get the cancers in places where my skin has been exposed to the sun—face, legs, ears, etc.

Me, getting started.

 The “whack-a-mole” reference has to do with my own skin cancer situation. I’ve got tons of those crusty pre-cancerous actinic keratosis all over the place, plus recurring eruptions of basal cell and squamous cell cancers (never melanoma, thank goodness). The cancers keep popping up and the docs keep whacking them. (This week I’ve posted two entries, I and II. The second one explains the difference among the cancerous conditions.)

The treatments I’ve received have been various. My first surgery was on my nose. After determining that the spot was basal cell carcinoma, the dermatologist (not my current one) sent me off to a plastic surgeon to have it removed. After removal, however, an examination of the tissue showed that the edges were not clean. In other words, they had not gotten it all. So I had radiation on my nose—two weeks of daily treatments, as I recall. Incidentally, this dermatologist mentioned a treatment called Mohs surgery but said he didn’t know how to do this. Then he warned me that, should I find someone who would use the Mohs procedure, I might end up with a big nostril. That was the last time I went to that dermatologist (who now regularly performs Mohs surgeries).

Mohs surgery is one in which the doctor removes little bits at a time, checking the bits under a microscope between each removal while you wait. This process continues until the edges are clean. In this way, the surgeon removes just what’s necessary. I now have an excellent dermatological surgeon. He has performed four Mohs surgeries on my face, but doesn’t use this method on other parts of my body. For cancers not on my face he just performs simple incisions. 

Because I have so many incipient cancers, I have also used topical creams, which are quite effective in getting rid of pre-cancerous lesions (which may or may not turn into cancer). Two products work for this: Efudex and Aldara (these are trade names, not generic, which are really hard to spell). Efudex attacks problematic cells and prevents them from producing daughter cells. Aldara stimulates your immune system within the skin to attack the offending cells. After a few days, I start getting sores then scabs, after which the spots disappear.

Next week: dermatological surgery ripoffs

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