basal cell carcinoma, BCC, dermatology, melanoma, MOHS microsurgery, ocular plastic surgery, squamous cell
WARNING!!! GRAPHIC PHOTOS
IF YOU HAVE A WEAK STOMACH THEN YOU MIGHT BE OFFENDED AT THESE PHOTOS OF MY EXPERIENCE WITH SKIN CANCER
THESE PICTURES WILL BE AT THE BOTTOM OF THIS POST
What do the letters BCC mean you might ask? Well, they stand for basal cell carcinoma, a type of skin cancer. This type is rather harmless compared to melanoma, which can metastasize or spread to the organs. I am sharing my story in hopes that it keeps you out of tanning beds and direct sunlight for extended periods of time if not fully protected.
It all started 20 years ago when I worked part time at the dermatologist’s office. Right away, the doctors saw things on me that needed to be removed and biopsied so every year since then, I have been having full skin exams and for about 15 of those years, I’ve either had something removed to be biopsied or frozen on the spot. I was told I was very young to be having these problems. So by now, I’m a pro at this right? Let me set the stage:
When I was in my teen years, I worshipped the sun and thought that being bronzed and suntanned was the ultimate in beauty. I suffered scores of sunburns too numerous to count as I was in the marching band and practicing outside in the summer was de rigueur. After high school for the next 4 years I marched in drum and bugle corps, again, out every weekend being exposed to the sunlight. And of course, at the beach and the yard every summer thereafter. I did use sunscreen, it was Bain de Soleil # 2 or baby oil! For that deep and accelerated tan, you know. I remember being told that I would look like an old lady before my time….yeah…yeah….yeah.
You know, when you’re young, you don’t think it will happen to you. I dug through some old pictures and found these as proof of my naïveté and I have to admit, I do have an awesome tan! But, in these photos, you can see that my nose and chin are sunburned because that weekend, I was in the sun. I am very fair skinned and usually felt that I had to get a good burn to set the stage for tanning the rest of the summer. Problem was, I always got that burn and remember peeling and crusted skin on my nose, shoulders, back, legs and arms. Even my fingers peeled!
I have had experience with basal cell carcinoma before, on my nose at two different places and they were easily treatable, as well as too many pre cancers. Just recently one being a pre squamous cell and 2 pre melanomas. So when this new spot showed up about 11 months ago, I watched it to see how it would progress and to see if I needed to sound the alarm or if it was just a sore that would heal up and go away. As a disclaimer: I had severe cystic acne when I was younger and it seems some things are never outgrown so I knew the difference between a regular zit or this shiny pink pearlescent papule which indeed did not heal up. My test is that if it comes back again the second time with the same markers as the first, then I got a real one on the other end of the fishing line and not something to be messed with.
So at the end of this past July, I called to be worked into my doctor’s schedule as he is THE dermatologist to go to and voted number one in the area. That’s a good thing and a bad thing, bad because he is booked many months in advance. But because of my history, I am worked in. Having called the end of July, my appt was for Sept 6. All went as usual and a biopsy was taken although he reassured me this was probably nothing, but come back in a week for the results and suture removal. No problem, I’ve done this before and know what the protocol is. I didn’t need to bother calling in for the results because he was going to put a rush on them and I would be in next week. So the next day, I headed to Louisville KY for the first WCAA Inspire and wore my bandaid to hide the sutures and mild bruising that occured.
I went back a week later and the tone was much different than the prior two cancers. It turns out this was indeed a superficial basal cell carcinoma, however because of the proximity to the eye, this changed the treatment methods drastically. There is a cream that can be applied, but it was too close to the eye and he didn’t want my vision to be affected, i.e. seriously reduced vision or blindness! Wait, blindness? Yes, blindness. As you know, what I do is all about the VISUAL so this wasn’t even a remote possibility for treatment. He did not want to take care of this in the usual manner of cutting it out and said because of my age, being young, it was felt that I should have MOHS microsurgery in which they take a layer at a time and put it under the microscope to make sure the cancer is not in the margins. They keep on cutting until the margins are clear and the skin is good. Uh oh, this is serious!
So my surgery was set up for Dec 7 because I am a busy girl and needed to get all my customer’s jobs out the door before needing downtime and not knowing how much would be needed. I had out of state installations in October as well as a WCAA show in Chicago I was presenting at as a vendor, in addition to speaking at my own WCAA chapter in Nov. In the meantime, I had to meet with an ocular plastic surgeon because he specializes in this type of plastic surgery due to the proximity of the cancer to my eye. This happened Oct 12 and he felt certain that this would not be a big deal and maybe a couple sutures is all. BUT…he did forewarn me that he can’t know what’s on the inside until the MOHS surgeon does her part so there could be a possibility of needing skin grafting. I placed my hopes on a couple sutures and lost. He also told me I was young to be having this done and that usually people in their 70’s and 80’s are dealing with this. Hmmm….I’m beginning to get a sense of how much damage I have done. 3 doctors have now told me the exact same thing. Does this emphasize the amount of sun exposure I really had? Wow! If I were in my 70’s, there would be no need for a graft because my skin would be so loose we could stretch it. As it is, too young, skin too taut, too bad honey. It is what it is.
NOW WE GET GRAPHIC WITH 2 PICTURES
This is what your face looks like after the first cutting. Not pretty at all. First off, all this is done with local anesthetic, and I HATE needles so I had to do a lot of talking to myself. Putting a tiny needle, even though it was tiny and this gal was good, when she went right under my eyelid, I thought I was going to pass out. I understood at this point the severity of what I was experiencing and this was NOTHING like I had experienced before. I also was hoping really hard that it would only be this one cut and they would come and tell me we were done and I could make my way to the ocular surgeon. It didn’t happen that way.
This is me after the second cutting because there was cancer still in the margins. You can see that I am starting to bruise and turn yellow already. Not pretty at all, huh? So much for my couple sutures, right? It turns out that the cancer was deeper and wider under the skin so while there was only a small papule on the surface, much more was lurking underneath. Basal cell is a slow growing cancer, supposed to be at least, so when my ocular plastic surgeon told me he was surprised at how invasive it became in such a short period of time, I was thankful I didn’t procrastinate on this and thought that maybe I should’ve done it sooner than I did. Lesson learned!
I will continue with part Two and plastic surgery as I journaled that day and I want to share those thoughts with you. It’s interesting what goes through the mind when undergoing a procedure such as this, or more like, what went through MY mind. Silly girl! I also have post op photos and weekly update photos that I will be sharing.
ARE YOU THINKING TWICE NOW ABOUT GETTING THAT MUCH NEEDED SUNTAN?
Dick Gentry said:
I wish you a fast & beautiful recovery!!! I need to set up my appointment!
thanks Dick and yes, set up that appointment today! I am having things carved out of me that do not even look suspicious yet those are the ones coming back pre melanomas! Yikes!
Brandon @ Southgate said:
Tammy, thank you for sharing this journey with us! I fear that I may one day have similar issues (am a bit surprised I haven’t already) because as a child my mother was a sun worshipper who had us outside from May 1 thru October. I can remember getting burned so badly once that I hallucinated (bad bad sun poisoning). Wishing you a less invasive 2012! 🙂
hallucinations? Oh my Brandon, I’ve had the poison on my feet, but never the hallucinations. The swelling and pain was bad enough and that was about 10 yrs ago and I’ve never let my feet get sunburned again like that.
I’m wishing for no more invasions of a cutting kind, but alas, I’ve had another tiny one show up at the same spot on my nose where a previous cancer was. I’m giving it the twice-over rule and if it comes back, you know where I will be in about 6 months! 😦
Kim Bonk said:
WOW! Thank you for sharing the photos and your story. It is true….pictures are worth a thousand words. No wonder the skin graft is painful and sensitive to the cold. You are brave and I am proud of you for being proactive and meeting it head on. Love you dear cousin!
I’m glad you could stomach the pictures. My sister and brother refused to look at them. Now you can get a sense of where I’m coming from when I say how much pain I am having. Too bad I’m not with you, cold would not be a problem 🙂
Rebecca Grace said:
Wow… Don’t beat yourself up about bad sun choices you made when you were younger. You sure weren’t the only one, and there were plenty of other bad choices you COULD have made that might have turned out worse. We all think we’re invincible when we’re young.
This is wonderful that you’re sharing the pictures — I wish you had one of what the little red bump looked like before they cut it out, to give people an idea of what to call the doctor about.
Hang in there — this is just something you need to get through to get to all the good stuff waiting for you on the other side.
Funny you should want a picture of what the BCC looked like. As I was sitting in the chair after they excised the first time, it dawned on me that I didn’t get a closeup of what they were removing! AAGH!
But I will tell you this, it was no bigger than the point of a ball point pen, and slightly raised. The first time it showed up, I thought I had scratched myself during my sleep because I awoke to a tiny lump that was bleeding. It remained that way for several days then healed up but left that pearlescent papule. My first clue. I waited till it happened again then I knew it was something to be taken care of.
Next time I will be more vigilant about that “before’ pic because the doctor did say there will be more of these in my future 🙂
Tammi, I had a Basal Cell Carcinoma (my first) removed from my nose by Mohs last year so I can totally emphathise with you. I didn’t take photos at the time of surgery, but my dermatologist did, and showed me what my dressing was covering immediately afterwards. I almost fainted and burst into tears when I saw quite how big and deep my wound was – apparently, he’d had to cut right through my nostril in one part to remove all the cancerous cells! Whilst the Mohs procedure wasn’t pleasant, luckily mine wasn’t close to my eye so not as unpleasant as yours – I can’t begin to imagine what it must have been like seeing what was happening to you up so close and personal!
Because of the position of my wound, my dermatologist recommended simply cauterising it and letting it heal naturally rather than stitching it. As a result, I was left with a deep and ugly crater on my nose which I found incredibly difficult to look and and clean (there’s just something deeply disturbing about seeing a wound on your face staring back at you, which I’m sure you can relate to). Consequently, the early stages of healing were incredibly traumatic for me. However, I’m pleased to say, I managed to endure it and my wound finally healed. And, I have to say, I’m lucky that it produced a pretty good result. I’ve been amazed how well the body heals itself and I do hope you get an equally acceptable result when you’re fully healed.
I’ve recently gone through a period of follow-up treatment to treat the rest of my nose with Efudix (maybe the ointment your dermatolgist suggested you would likely use if your wound hadn’t been so close to your eye?), with the aim of killing off any pre-cancerous cells. Again, not a pleasant treatment – as you’ll see from the rather unappealing photos on my blog – but certainly worthwile and, apart from a little ‘pinkshness’, I’m all but back to normal now.
Whist I did suffer the odd sunburn in my younger days, it was never extreme (though my nose would certainly tend to burn easily which is clearly why I’ve had my recent problem). Yet, despite this – and me not really being a great sun worshipper – I had a malignant melanoma removed from my arm some years back so my BCC is my second experience of the damage sun can do. My message to others therefore is that any sun burn is bad so you need to protect yourself. Get out in the sun by all means – you need sunlight to produce vitamin D and there’s no denying that a bit of sunshine makes you feel better – but do it in moderation and make sure you don’t burn (use a high factor sun screen and cover up before you burn!).
I hope your plastic surgery went well and wish you a speedy recovery. I will check back for updates. Take care.
Thank you so much for your comment. Yes, when I first saw that hole under my eye I felt like I was punched in the stomach. My passing out moment came after the two days of wearing the patch were up and I saw it up close and personal. I got so sick to my stomach that I had to lay down and have my mother clean it and tend to it. I took pics right away and kept going back to the camera to see if it really was so.
Yes, the fluorouracil creme, or Efudex was the creme my doctor shied away from. I however, couldn’t cry right away because the tears hurt my graft, the saltiness you know, so I had to be a brave little girl but I got in a good cry last weekend and am still working on it. 🙂 I have my moments as I’m sure you know.
Yes, keep in touch, I will link to your blog for others to see in my final post. I will have 3 probably and will be posting again next weekend to talk about the plastic surgery end of it and my journal.
I enjoy my 20 minutes of morning sun with my walk everyday but haven’t been able to walk since the surgery as the cold is really affecting the left side of my face. I need my sun!
Oh Tammi: what can I say? I am SO sorry you have had to go through all this. But I DO know all about it: have had Mohs twice. I’ve been very fortunate with it: the first one was on the side of my nose, just under the eye. But he got it all the first time, and what little scar tissue was there months later they were able to laser..so now you really would never know. And my second spot was way on the side of my face at the hairline. Do you know that your left side is much more susceptible to all this, because (so I have heard) it is the side exposed when you are driving! For me, that has been true!
I too was a total sun worshipper for years. Ah yes, the burning and redness. Loved it all!
Now, of course, I wear #45 every day of the year, have four hats and am a bit paranoid.
So, all this to say, I am with you on this. Best wishes for a very speedy, and total, recovery, my dear!
thanks so much for your commenting and having the stomach to look at my ugliness! So you know all the emotions that are raging inside me at the moment.
Lightbulb moment! : it makes perfect sense about the left side being the side most affected because of the driving exposure. I am on the road a lot with my biz and my left arm has much more things being carved out of it than the right.
I had a setback at the doctors yesterday and will be going into more detail in a future blog about it but I am glad your recovery was splendid! To say that I am a little paranoid now is an understatement too.
Thank you for sharing your story. I’m looking forward to reading your future posts. I’m the person whose blog you commented on recently (Things Happen) about my graft. My dermatologist (who is a MOHS surgeon) did not offer me the option of MOHS due to the proximity to my eye, but I see that yours was even closer to your eye than mine, wow. Wishing you well as you heal. I relate to the comment of someone else wishing you “less invasive 2012.”
thank you so much for popping over to my blog and taking the time to comment. We can commiserate although I would rather it be over something pleasant, right? I find it interesting that your surgeon opted not to do MOHS, whereas mine said that was the only solution. When reading your blog, I was wondering why you didn’t have the MOHS. I’m sure there were good reasons as I trust my dermatologist implicitly but yours was melanoma and mine just a BCC too. So maybe that was the difference in the treatment modality.
I have now found you and Lisa, who commented above, who are blogging about the experience and like I commented on your blog, am so glad I found yours as I had no idea what to expect concerning grafts. In my last post, part 3, I will be inserting a link to your blog so others can see what really is the result of something we knew little about when we were younger. I look forward to seeing my graft heal up the way yours did.
Here’s hoping for the both of us that this year is less invasive! 🙂
P.S. I really like your prom dress! Beautiful.
you know, it really was avant-garde in its day because I was the only one with my shoulders bare! I come from a very conservative area and never really cared what people thought about my style, and this photo shows it.
I still have the dress too!
Pingback: BCC and Me – Part II, The Journal « COUTURE WINDOW FASHIONS -All The Details
Pingback: BCC and Me – Part III, Let the Plastic Surgery Begin « COUTURE WINDOW FASHIONS -All The Details
I had almost the identical “hole” in my face Oct 2010! I had MOHS and a graft and a revision. It looks pretty (ok) now. I am lucky/unlucky because my lesion was in the corner of my eye and nose. The graft webbed so I “got to have” a cosmetic second surgery. I am proceeding to the rest of your story. Hoping for the best for you!
Thanks so much for sharing your experience and I look forward to hearing more from you. I’m wondering if revisions are part of the process when these things are close to the eye. I’m hoping I won’t need a re-do.
Thanks for taking the time to comment and making me feel lIke I am not alone in my trials and tribulations 🙂
Hi Joyce, I don’t know if you’ll see this reply but I’d like to hear about your experience with the 2nd surgery. It sounds like you and I have similar paths but I’m not sure I’m going to let them do the revision to correct webbing which seems very minor to me.