Tuesday, February 1, 2011

What, Two More Cancers??

Some Other Poor Sod
I was diagnosed last week with both squamous and basal cell carcinomas. Apparently, multiple myeloma and an allogeneic transplant didn't challenge me enough. Patents with allogeneic transplants are urged to be examined by a dermatologist twice a year. I'm beginning to understand why.

Basal cell carcinoma is the most prevalent but least dangerous form of skin cancer (although, when neglected, basal cell can cause serious damage). Squamous cell carcinoma, the second most prevalent, can be more complicated and problematic. (The third most prevalent skin cancer is melanoma. ("You have, did you say, multiple melanoma?"). The shark bite on my back was the result of melanoma.)

The squamous cell cancer, which is prominent on my right cheek, may have evolved from a common keratosis, which is ironic considering that it is generally associated with sun exposure and I am a sun-avoiding, vampiric, Morlock-type creature known to inhabit the innards of computers.

The cancers will both be removed by Moh's Surgery, the least disfiguring type of surgery. Apparently, the Moh's surgery team can do both at the same time. Not that I care much about having a beautiful back, but avoiding a second date with the knife (for simple excision) sounded good to me. (I'm not even counting an upcoming kyphoplasty. Perhaps I need to make new friends.)

In Moh's, injections of a long-term anesthetic means only having to endure the nasty pinpricks once (I am told that the reason pain killers sting is that they are acidic: why can't they — and, especially, dentists — add a base to the shot to achieve a neutral pH?). A cup-shaped layer of skin is removed around the visible cancer, then frozen and sectioned in two dimensions. A pathologist then examines the margins under a microscope. If cancer cells are found, their exact location is marked on a map of the cancer. The surgeons then remove another layer of skin and cancer, but limited to the area where cancerous cells were found. The procedure is then repeated until no evidence of cancer remains. In general, Moh's results in less damage and disfigurement than does traditional excision. A plastic surgeon then "repairs" the damage.

Moh's surgery is not appropriate for every type of cancer, but when the cancer is on the nose, ears, eyelids, or other prominent features, Moh's may be an appropriate choice.

Caution! This squamous video is not for the squeamish. I mean it. You've been warned!


  1. Lon,
    I have so many basal skin cancer MoHS surgeries, I stopped counting at 10. The largest were a silver dollar sized holes(when the margins came back clear after 3 tries) in the areas between each ear and eye. The dermatologist/surgeon then stitched up the holes by pulling up and pulling back the skin. I guess I got a face lift in the process.
    I grew up in the Borrego Springs desert, then was a firefighter for 34 years and over-exposed to the sun so much, causing this skin cancer. All in my family have had MoHS surgery.

    Palm Desert, CA

  2. I was suffering from the thoughts of our snowmogedden on its way to Michigan tonight, and my brother and sister-in-law yesterday flu to Jamaica. I was looking at prices of all inclusive and dreaming of warm and sunny spots. Now the spots you are talking about, I am familiar and so was my daughter at age 13 she had one removed from her back. So now sunny places for me, bring on the snow, and more prayers for you Lon:)

  3. Lon,

    I will be praying for the you. The video is pretty squeamish, however, the scientist in me had to watch. Here's wishing you a speedy recovery. Please know that you are always in my thoughts in prayers.


  4. SCC and BCC are spreading like wild fire in USA and Australia. The main reason is due to over exposure to sun. But treatment like cyberknife and moh's surgery helps to recover your health to normal.

    Skin Cancer Treatment


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