Treating Basal-Cell Cancer: A Friend's Experience.

.The following account is the actual operation a dear friend of mine experienced this week and told to me in three emails which I have patched together and have her permission to publish on HP.The surgery was for removal of a basal-cell carcinoma of the temple area; the cancer had been detected approximately 4 years ago, but left until another doctor pointed out that it should be taken care of.Basal-cell skin cancers are not normally life-threatening, but most do continue to grow slowly. This means that at some stage, especially on the face, such radical surgery to remove them will be needed that plastic surgery may also follow to hide ugly scarring.The Mohs procedure (see Wikipedia, etc.) has been around for a good many years now and is recommended when several biopsies may be required to indicate to the surgeon how much cutting he needs to do to eliminate every last cancer cell. These cancers have “roots,” or, as H. says, ‘fingers, which also have to be eliminated.

Here is H’s story, told in her own vivid manner, of her not too unpleasant day in a Dallas hospital. Certain names have been disguised for obvious reasons. Note: None of the pictures added to this hub are of the author, H.

"Well I am back in one piece...but a little lighter. Quite a big piece taken out of me...bout the size of a quarter in diameter...but do not know exactly how deep he went...it is 4:30 and we just got back a little while ago.

It was as good an experience as it could be...all the nurses and the doctor were exceptionally nice and friendly and it was a pleasure being round them.

We got there early and were the second ones to be called in so was sitting in the surgery chair by 7:30am. Doc came in and introduced himself and proceeded to volunteer all kinds of information about my condition and about Basal Cell in general and the dangers and effects of not getting it treated promptly...He agreed that it is not a lethal cancer...and is very slow growing...but will definitely always keep growing...both downwards...and also OUTWARDS...and therefore if you wait to have them removed you will risk ending up with a grotesque scar...specially on the face. If you do not get them early then you risk needing such a deep cut that you would need skin grafting and sometimes even cosmetic surgery...

The nurse proceeded to prepare my face...injected the entire area...buzz-cut some of my hair off!...(I THINK it is ok...but won't know for sure how much she took off till all the bandages are off tomorrow)...and did a whole slew of other prep work that I could only feel and not see what she was doing. She took photos...and then Doc came back in to do his thing...

He examined it and started drawing on the area...and marking off different areas...which I later found out through him...that were areas he could see through his special microscope glasses… that were cancerous...then he started cutting...and cutting...and cutting...Yikes! I could see later when the nurse showed me my OWIE - (ouch) that he made a hole about the size of a quarter...

Then he did all kinds of treatment to the wound...including using some kind of what the nurse called a vacuum which had to be grounded by putting my leg onto a steel plate...to stop me from being electrocuted! Then the nurse dressed it with a temp dressing...and sent me into the waiting room for a couple of hours to wait for the results of the biopsy of what he cut out.

Finally the nurse called me back in and said all the cancer had been taken out with the one cut...and now she had to do more injections in the wound to numb it...and get it all cleaned up and prepped for the Doc to do his needlework. The prep work was extensive with all kinds of applications of who knows what...including my hair being gelled back so nothing was in the way.

Doc came in...and sewed on me for at least 20 minutes! I asked how many stitches...and neither doc nor the nurse had a clue...just LOTS! He first stitched tiny miniature stitches INSIDE the wound...and then closed up the wound all the way from my eye to the hairline...with more miniature stitches...dozens and dozens of em! Then he did all kinds of pressing and wiping...and more vacuuming...and finally said I was good to go...but not till he spent a few minutes with some friendly chatter before he left...very nice man...ideal kind of person to be a doc.

The nurses (Two of them) then gave me my walking papers and instructions...WHOLE procedure took 4 hours...and believe me they earned their money...

I am supposed to ice this every 20 minutes....gotta watch the clock cos it is important to keep the swelling down so the stitches hold and so it will not scar...

No pain besides the initial prick of the needle when the girl was numbing the site...she warned me it would not be pleasant...but I tell ya...the dentists needle is MUCH worse...so I have no complaints!

Only one cancerous lesion...and he was able to get it with the one cut, anyway...he has been trained in cosmetic surgery and assured me that my owie would heal in no time...and there would be minimal scaring if any.

He said I could wear makeup on it after one week when the stitches dissolve...I have to leave the Pressure Pak on for 24 hours...keep it dry...then after 24 I can shower and wash it all off with Dial Soap and from then on for a week I have to put Antibiotic Cream on twice a day and keep it covered with a patch. Can not BEND...LIFT more than 10 lbs...or do any form of exercise for three days.

He has all the sophisticated equipment to be 100% sure there is absolutely ZERO cancer left...I am totally confident about that...The whole process of Mohs surgery...is cutting layers...viewing on microscope what they take out...to see if there are FINGERS going deeper than the cut...and if so...then they take another slice. But he took plenty with my first cut and was able to see when he did the BIOPSY...that there were NO FINGERS penetrating through the cut flesh...and he could also see with his special microscopic glasses just how wide he had to cut... which was way wider than what the red patch indicated...then all was mapped out precisely...very intricately...this was no hash job believe me. He knows exactly and precisely where all the bits of flesh he cuts come from...and he biopsied every part of it! He said when he does the biopsy...he has to actually VIEW...EVERY SINGLE CELL...of the entire portion of flesh that he cuts out...and he KNOWS exactly where it comes from...from the mapping he does BEFORE he cuts...

This is an EXACT SCIENCE...not anything like the other quickie options...In any event...he was more than generous...When J. and I went to pay...the nurse said ...well that procedure is $2,900!!!.Well then she says without batting an eyelid...but Doctor S. said he would do it for $1,0025...and he apologizes but that is the very best he is able to do as he can not charge less than Medicaid... So...the four hours of professional attention and surgery and biopsies was only a tad over $1,000 which I thought was exceptionally cheap for the time I was given by an obviously first class doctor in a first class facility...

So...that was about the end of it I think...not an unpleasant day at all...a bit tiring waiting in the waiting room while the biopsy is being done...but other than that I was waited on head an foot! . I gotta go do my next ICING! Jeepers this is gonna be the most difficult part of the experience!!!"