Thursday, March 02, 2006

Too much sun

Well, time and too much sun from my childhood and career as a field botanist have caught up with me. I have basal cell carcinoma on my nose next to my eye. I'll have it removed via Mohs surgery on March 28th. I've been doing too much background research and I'm kind of freaked out by the amount of tissue that's removed in this surgery. Given the location of this cancer, I can expect to have some reconstructive surgery after the tumor is removed. However, the good news is that Mohs surgery (named after the surgeon who developed the technique) works with a 99% cure rate. The reason it works so well is that each slice of tissue is examined by a pathologist at the time of the surgery to produce a map of the tumor. This enables the surgeon to remove every cancerous cell during the procedure. I'll post a follow-up after I have the surgery. In the meantime I'm trying to not think about it.


Anonymous said...

so sorry to hear about your damaged skin cells -- looks like you caught it early on.

being freaked out is 'good', if you get through that stage quickly...then you just do what you have to do...getting rid of the damaged cells, and trusting in reconstruction.

after surgery, you might not be able to wear framed glasses for a while ... depending on your vision, this could be more of a problem than the procedures...

my thoughts are with you.

Andi Wolfe said...

Hi -e-

Thanks for your good wishes. I'm starting to feel a little less worried about it, or, at least,
I slept all night last night for the first time in over a week. The more research I did on basal
cell carcinoma, the more I realized that what you see on the surface is like the tip of an iceberg
and the tumor usually branches out in several directions. That's what got me freaked out in
conjunction with looking at images of the Mohs procedure itself.

I'll be ok. I'm in good hands and I'm sure my surgeon deals with this all the time.

I'll post updates after the surgery.

Cheers - Andi

Anonymous said...

Hey Mom!

You should be fine, as long as it doesn't leave a big ol' mark... ;D

Anonymous said...

In 15 years experience as an O.R. nurse, I have been involved in the procedure countless times. I've noticed that you have mentioned a dermatologist and a surgeon. I dealt with surgeons only in an Out Patient Surgery setting. The situations involved placing the patient under heavy sedation. Tissue excised and sent to a standby pathologist in his / her lab (which was at the hospital). As you have mentioned, the pathologist then do their thing. Next the pathologist calls back to the operating room. The surgeon is notified if all the cancer has been removed of if more tissue is required to be removed. The original specimen(s) get tagged for orientation (before being sent to the pathologist) and the surgeon is able to cut in the direction that requires additional removal. Once all the margins are clear, the wound is closed in whatever method is appropriate. The patient awakens quickly and is home in no time.
One of your main concerns seems to be the big ol' hole that will be left in your face! The surgeons I dealt with would always fill the void with the patient's own tissue, usually removed from behind an ear. Another option is to create a flap of tissue adjacent to the "hole" and pull it across. I hope someone has already explained all this to you by now.
A member of our turning club recently had a basal cell removed from his nose. He elected not to have the void filled. Stated he did not want to have another site of injury to have to worry about. I think he may regret that decision.
The threat of cancer is definitely something we don't think about until it slaps us in the face (in you case, literally). But as you have researched and discovered, this is one of the kinder cancers one could deal with if given a choice.
I noticed on WOW that a retired plastic surgeon has asked you to contact him. Hopefully he can help you understand things and help to calm you.
If you have any questions I could answer, feel free to contact me. I'm in Florida in the AAW resource book.

Bob Elliott, RN (aka bobzwood)

Andi Wolfe said...

Bob, Thanks for your note.

My understanding of the procedure from the literature the clinic sent to me is that I will be under local anaesthetic. During the pathology work-up I'll be in the waiting room, cooling my heels.

The surgeon is certified from the Mohs College, which means he's a specialist in this technique. He's also a certified plastic surgeon, so he'll take care of whatever reconstruction needs to be done after the tumor is removed.

I did send an email to Mirek to get his opinion. I'm to the point now where I just will have to deal with whatever happens. It could be much, much worse, of course.