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!