Life Goes On...: My Skin Cancer Story

The phone rang. I saw the number, and I knew I was about to find out whether or not I had skin cancer. I almost didn't answer; after all, I had had the flesh-colored mole checked by my doctor and 2 different dermatology physician assistants over the past three years, each one more sure than the last that it was nothing. But even as I heard the kind voice on the phone telling me that I did, indeed, have basal cell carcinoma, I told myself that it was nothing to worry about, just a quick in-and-out procedure; maybe I'd have to sport a little band-aid for a few days. They gave me the choice as to whether I wanted to receive radiation or to have the spot removed. After a few days of going back and forth, I chose the Mohs surgery because it seemed more final. I just wanted it gone, and I didn't want to commit to 20 sessions of radiation over 6 weeks for something that may not work or something I might have a bad reaction to. I spent some sleepless nights after the surgery was scheduled searching online in hopes of finding anyone with a similar story to mine (same age, same place, etc.), just for some idea of what the end result might look like.

I went in for the Mohs surgery thinking that I was pretty sure as to what to expect during the procedure. Goodness knows I had read enough about it. I knew that it could take hours for them to analyze the margins of the section they took, and that there is often a need for a second or third cut, followed by more waiting each time. I had pictured them taking off a few layers from the top of the mole, testing them, and then shaving down a bit further if needed, until I had maybe a tiny laceration above my upper lip (something like cutting thin layers off of a tree stump). The smell as the doctor cauterized my flesh literally right under my nose was something I will never forget. As far as pain, I felt nothing but pressure. I sat patiently and waited for the doctor to come back with the test results. When he came back and said that he had gotten clear margins after only one pass, I couldn't believe it. I figured it would be a very small little cut, and I wasn't worried at all until he told me that he was going to need to refer me to a plastic surgeon because he didn't feel comfortable handling the level of reconstructive surgery that I required. Apparently, in actuality, after he numbed me, he had dug a perfectly round hole out just above my top lip (think excavator). My heart started pounding, and I was not prepared for what I saw when I finally mustered up the courage to look.

When I saw the picture Erik took of the hole in my face, I started to cry. We had just seen Wonder Woman, and I envisioned myself looking like Dr. Maru when it was all said and done. Unfortunately, this image stayed in my head for quite some time.

When we met the plastic surgeon (who is younger than I am) just an hour or so later, he immediately set to work explaining how he would fix things and move things and skin flaps and asymmetry and honestly, it was over my spinning head. I just told him I trusted him and would see him soon. He covered the hole in my face back up and sent me on my way until the following day when I could see him for the surgery. I didn't know what he could possibly do that would fix something like that, but I went in bravely, ready to be sewed up. The surgery was more intense than the Mohs surgery. He let me pick the OR music, and I laid on a steel table while they numbed me up and covered my face with a paper sheet. I was awake through the whole thing, and again, that smell of burning flesh threatened to make me sick right there in the OR. I asked the doctor at one point why my lip was twitching so badly, wondering if he had struck a nerve or something. He assured me that it was just his assistant putting cotton swabs into the hole while he was stitching up the muscle. It was a weird feeling. Then they moved to the outside stitches, and I began to relax. He was calming, confident, and funny, and I knew I was in good hands.

When it was over, he told me he would see me a few times over the next two months, and then I would switch to seeing him every three months. The initial recovery was not quite as easy as I had thought it would be. The surgeon told me that I had to stay in bed for a full week, and that I could only get up for absolute necessities; that may have been the hardest part. I couldn't even give Addison a hug in case she were to accidentally hit the stitches; I felt like a terrible mom. To make matters worse, I could not even open my mouth to eat, and I was not allowed to use a straw at all. My lips were so swollen, I looked like the victim of a botched lip augmentation. We had quite a time figuring out how to get me nourishment with me not being able to move my lips. FYI, eating a smoothie with a baby spoon takes HOURS. I had to have everything I ate completely blended, and I was so thankful during that time to have some wonderful moms from the school bring me amazing soups. I went through a lot of towels too, because when you can't close your lips, things tend to dribble right back out. I really could not talk at all (it turns out that having your lips touch is important to making coherent sounds) and if I was even tempted to laugh, the pain of stretching the stitches stopped me quickly. Once the surgeon took the stitches out though, it was a fairly easy recovery. I experienced lots of stabbing pains and uncomfortable twitching as the nerves regenerated, but it was bearable. . Once I was released to the outside world, I was religious in putting on my scar cream and keeping my scar out of the sun, and that allowed me to regain mobility and heal faster than my doctor expected. In fact, at my last checkup, he asked me if I even wanted to discuss the idea of having laser resurfacing, and when I told him no, he didn't bat an eye.

I have included some pictures below to show the initial "hole" and then the recovery, as this is the thing I could not find much about (except for the worst case scenarios) on my many late nights of searching and wondering. Will it come back? Will I still look like myself? Will this scar be the very first thing people notice about me from now on? In six more months, when my scar is no longer under doctor care, I am sure I will be even happier with the results, but right now, in this moment, I can say I rarely remember that I have it or worry what people are thinking about it. In fact, I tried to take a picture of it many different times in many different lights to show my six month picture, and although it is still visible in the mirror, it hardly shows up in pictures, if at all. I am still worried about the fact that I am likely to have more skin cancer in the future, but all I can do now is stay out of the sun and be vigilant with sunscreen. The damage has already been done. I can count on both hands the number of times I have visited a tanning salon, but I did receive many bad sunburns when I was a kid/teen, and with my fair skin and family history, it seems that me getting skin cancer was just a matter of time.

A word of advice: If you have a spot that you are even the least bit suspicious of, please go get it checked BY AN ACTUAL DERMATOLOGIST. It's what they're trained in and what they do. Get a referral if necessary. Do not just blindly trust your primary care doctor or settle for a PA. If I had trusted myself and ignored their "It's nothing!" assurances over the years, chances are it would have been a quick freeze for a precancerous growth. Instead it had time to take root and grow over a long span of time. Listen to yourself and go with your gut. Demand that they test the spot if they don't offer. You are your own best advocate. I wish it hadn't taken me so long to become mine!

The hole in my face...deep and round enough to swallow a dime.
The dots around it indicate how much bigger it could have been had the margins not been clear.