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jktbre
03-04-2009, 01:32 PM
Hi,

I went to the Dermatologist two days ago about a spot on the side of my nose that has been there for a few years. It bleeds on occasion and my hubby said that it was getting bigger and changing colors. The dr took one look at it and said that it was a Basal Cell Carcinoma. He wanted to set up surgery for the following week but I could not make that date. He did a scraping of it and said that he would like to do the surgery at the end of the month. (I am going away next week for a short family visit). The results of the biopsy are not in and already he is planning surgery?

Also, I have been having trouble with my vision in the eye above the bump. I did not think to ask the Dr about it. My vision goes blurry in that eye and then returns to normal. Does anyone know if the two could be related?

What are your opinions on surgery. I know that it should not be a factor but I am pretty vain and the thought of an ugly scar really bothers me. One of my residents has had her entire nose removed as a result of skin cancer and it looks like they just slapped putty on her face and called it a nose. Yikes. I keep joking that I am following her footsteps but seriously, I don't want that nose.

Thank you.

Thanks.

Chele60
03-04-2009, 02:22 PM
Don't feel badly for not wanting a scar or other disfiguring mark on your face. Regardless of our health situation, nobody wants a scar on their face. I feel badly for your co-worker, yet I'm not sure of her exact situation and it may not duplicate yours.

Basal Cell Carcinoma is something a dermatologist can spot fairly easily. A biopsy can confirm it, but it's common enough so a doctor knows what it is. Facial surgery for BCC is really amazing right now. I'm not sure when your co-worker had her surgery, or the extent, but there is some reconstructive surgery that is really amazing. I really believe it comes down to researching your plastic surgeon and getting the best you possibly can. This is not an area to scrimp on!

I can't speak to the possible relationship between your BCC and your eye. My knowledge just doesn't go there. You might want to check with your dermatologist and see what s/he thinks. Or maybe somebody else on these boards might be able to address that.

jktbre
03-09-2009, 08:14 AM
Thank you for responding, Chele.

The lady that I work with is a 94 year old resident at an assisted living center, not a co-worker. She spent many years on fishing boats and has numerous suspicious skin areas but because of her other health issues, they are not pursuing them. They did remove a spot on her face as it bled easily and interfered with her day to day activities.

I do not know when they did her nose. It really looks terrible but it was many years ago and medical care has improved tremendously since then.

My concern is partly the healing process and how frightening I will look to my residents. Because we are a small facility and only one CNA is on shift at a time, our residents become very close to us. I am wondering if my being there and lookingmonsterous will frighten them. I really wont know until after they dig away as to how deep of a hole in my face I will have. Being that it is the side of my nose, I imagine that it will not be an easy process.

I have been reading through the board and feel pretty encouraged by many of your posts, however and I wanted to thank all of the members here. Thank you.

Chele60
03-09-2009, 03:01 PM
My apologies regarding the resident = co-worker! For some reason I had thought resident = nurse or intern. My bad!

There have been great inroads with facial surgery and melanoma in the past few years - it is really amazing! You should be able to have a consult with a plastic surgeon performing your surgery, and when you do ask for references/pictures of his/her work. Be exacting in your concerns. A plastic surgeon wil certainly understand!

You will definitely want to look for posts by teapotlady, too. She was just recently diagnosed with Basal Cell on her face. (Temple area, I believe?) She was very concerned about scarring, and rightly so. She has just recently had her surgery, and her post-surgery posts are on this site. She has some very positive things to say.

If you get a chance, you might want to do some investigating online regarding MOHS surgery. It is primarily used for Basal and Squamous Cell cancers, and it used when the maximum amount of skin is to be preserved for cosmetic reasons. It is fairly new technology and is only performed by certain surgeons, but it is definitely worth looking into!

jktbre
03-18-2009, 10:46 AM
Hi,

I made an appointment with a MOHs surgeon. There really seems to be no convenient time to have this surgery. I work in the health field myself and am wondering how much recovery time I will need before returning to work. Any ideas? How much time did you guys take off or were you able to return to work immediately?

Chele60
03-18-2009, 12:43 PM
Sorry, I can't answer your questions. I had a WLE on my left knee for melanoma.

I just wanted to pop in and say thank you for the update. I think you will be happy with the MOHs surgery. And I hope some one comes along who can answer the questions you have!

jktbre
04-02-2009, 10:31 PM
Finally picked up my pathology report. Those things are not easy to read:) What it does say is that it is a basal cell carcinoma, ulcerated and incompletely excised, level 4 surg path gross and micro. Any one understand what any of that means?

LemonBar
04-07-2009, 10:32 AM
Hi There,
I came across your post and wanted to reply because your situation seems nearly identical to mine.
I went to the dermatologist several weeks ago and he knew, on sight, that the bump on the side of my nose was most likely a basal cell cancer and saw no need to do a biopsy. It was 4mm and had been there for a few years (I thought it was a new mole, or a cyst...).
I had a simple surgical excision a week ago. It took just an hour in the office and I left with four stitches (plus one "inside"?!) and was told to "take it easy" for the rest of the day. I returned to work the next day and it was fine, but I felt silly with a big bandage on my nose for a few days. It healed well and I had the sutures removed yesterday. The doctor thinks the scar will fade to nearly invisible within months. Honestly, the techniques they use these days are amazing. I wasn't terribly concerned about scarring, but I think a good doctor cares about doing good work. The pathology report showed that it was indeed a basal cell cancer and that it was completely removed.
Anyway, I wanted you to know that you were not alone and to wish you well in the coming weeks. The waiting for the procedure is worse than the actual surgery, and the recovery is easy, so try not to worry.:cool:

jktbre
04-08-2009, 06:00 AM
Thanks for the encouragement, Lemonbar. I hope it goes as well as your did and am glad that yours went so well. I just keep picturing this horrendous hole in my face.

LemonBar
04-08-2009, 09:55 AM
Quit looking at pictures on line!! There are some very frightening images out there! I'm pretty sure your doctor would have told you if you needed extensive surgery or repair.... did they not give you an idea of what to expect? When are you scheduled for? I really think you'll be just fine.:)

Chele60
04-08-2009, 01:38 PM
Finally picked up my pathology report. Those things are not easy to read:) What it does say is that it is a basal cell carcinoma, ulcerated and incompletely excised, level 4 surg path gross and micro. Any one understand what any of that means?


What your pathology report is basically stating is that you have Basal Cell cancer (basal cell carcinoma), it is/has been bleeding (ulcerated), and there is still a residual amount of the tumor in the tissue (incompletely excised). "...level 4 surg path gross and micro" are terms that I think are for the surgeon, as I'm not familar with those.

The item that would grab my attention is "incompleted excised." For basal cell and squamous cell, the percentage of individuals who are incompletly excised is roughly 16%. Of those individuals, if they and their doctors decide not to excise further, there is between a 30%-60% chance of recurrance within 1.5 - 55 months. Overall results are that 1/3 of patients incompletely excised have a recurrence that will need to be treated within the first 3 years that, if caught early, will require minimal treatment.

If it were me? And with today's surgical techniques? I'd be in the surgeon's office just as soon as I could get in demanding he/she get ALL of that cancer out of my body NOW! I know that's how I felt about my melanoma. Granted, it was on my knee, but I worried about the scar later. (I still have the scar, BTW) Even though basal cell is more common and doesn't always result in death, this form of skin cancer can metastasize and become lethal. People have died of basal cell cancer. I realize it must be scary to think this is on your face (YIKES!), but with surgical techniques what they are today, and how common basal cell cancer on the nose is, it truly is amazing what is done!

And remember, cancer doesn't simply "go away" or stay in one place until you want to deal with it. Hopefully, you and your doctor can chat and you can get a clearer picture of where you need to go at this time.

LemonBar
04-08-2009, 01:49 PM
Chele60, I'm pretty sure the pathology report was just from her biopsy that was done, so it would naturally come back as "incompletely excised". I don't believe she's had surgery yet.

Chele60
04-08-2009, 02:55 PM
Chele60, I'm pretty sure the pathology report was just from her biopsy that was done, so it would naturally come back as "incompletely excised". I don't believe she's had surgery yet.


I'm fairly certain it is a pathology report from a biopsy. However, when my doctor reviewed my biopsy findings with me she also stated the melanoma was extremely small and was probably fully removed with the biopsy. What I'm trying to impress jktbre is that there is a residual amount of tumor stil present. What she chooses to do with that information is up to her.

jktbre
04-09-2009, 06:11 AM
Hi guys,

I do intend to have it removed. I am meeting with the MOHS surgeon on the 13th of this month. My initial thiughts were that I would just take off a couple of days from work but with it being a level 4, I think that means that it goes in pretty deep. I am thinking that maybe I need to plan to take off a good week as I do not wish to frighten my residents or to risk infection considreing my work environment.

I am concerned that it is on my face. I let this thing sit there for four years but you are right, they just do not go away on their own. I also have other spots on my arms and back that now are worrying me. See, once diagnosed, you start to notice spots that otherwise you would have just dismissed in the past and then they suddenly start getting that evil look to them, lol.

Thank you all for your input though. I will let you know what the surgeon says. I do believe that a MOHS surgeon is the best bet for a BC on the nasal bridge.

LemonBar
04-09-2009, 08:39 AM
Good luck on Monday and keep us posted. I hope the meeting with the surgeon goes well, all your questions are answered, and that you are reassured about the procedure and outcome. The surgeon can definitely let you know what to expect in terms of recovery, time off from work, and so on.

Do ask your doctor about the "level 4" from the pathology report. I'm not sure, but I think that refers to the type and extent of exam the pathologist performed, rather than anything about the lesion.

Don't worry too much... I also let mine "sit" for three or four years. Yes, they grow very slowly, but I know it's hard not to wish you'd done something sooner. And I showed every odd bump and spot to the dermatologist, too, after he found the basal cell cancer even though another doctor had already done a complete skin check. I now have to go back once a year for a complete look-over (which I'm very glad for), and was told to call sooner if I had questions about any other spots. I also got a firm lecture about sunscreen and wide-brimmed hats.:p

Let us know how things go Monday!

jktbre
04-15-2009, 02:23 PM
Hi guys,

Surgery is scheduled for May 14th. the doc says that he does not think it is very deep, so you were right, Lemonbar. I get to keep my nose, lol. He says that I should be able to return to work in two days so I feel good about that as well. Thanks ladies.

Chele60
04-16-2009, 08:11 AM
Fabulous news! I'm happy for you in that it doesn't seem very deep, and you should be able to return to work fairly soon. Good thoughts being sent your way!

LemonBar
04-16-2009, 08:41 AM
Oh good! I'm so happy to hear that! :)
And you'll see, doctors are so careful with faces. They will do very careful work, tiny stitches, and you'll be happy once it's done. A little scar is much nicer than a skin cancer, right?? (Yes, you can keep your nose!) Good that you'll take a couple days off work, too. Even though it's a small surgery, it can really take some energy out of you, so it's good to rest.
Let us know how it goes! Ask any questions you have in the meanwhile, too.

jktbre
04-16-2009, 08:44 PM
Thanks ladies. Turns out that my brother has a basal cell on his cheek and our youngest brother just had one removed from his ear.

LemonBar
04-22-2009, 08:50 AM
Oh, how interesting! Our siblings would have had similar early sun exposure, and also similar complexions and risk of skin cancer, I assume. I've got three brothers and will lecture them next time we get together.

If you don't mind, I'm curious if you, too, had lots of sun in your early years.

jktbre
04-22-2009, 10:48 AM
We spent a lot of time outdoors. Were toddlers on Florida beaches. My youngest brother was just told by his general Dr that he needs to see his derm about a rash on the back of his neck..lol. Guess when it rains, it pours.

LemonBar
04-22-2009, 02:55 PM
Hmmm, yeah, we grew up in California and spent so much time outdoors and on the beach. My doctor said that what we're seeing now is the effect of that sun from many years ago. Did sunscreen even exist back then?? I can't ever remember seeing it (I'm 45) and people certainly didn't use it.

I hope your little brother is ok. It's very good that he's getting things checked. I'm nagging everyone I know.

I hope you're relaxing about your upcoming surgery, knowing that it won't be bad at all and that it will soon be behind you.:)

paulcindy88
04-23-2009, 06:03 AM
I just wanted to pop in and say that my best friend had basal cell on her nose and just had her surgery done to remove it.

I wanted to mention that I am not sure what kind of surgeon you are seeing, but I would highly recommend a Plastic Surgeon. One that has come highly recommended. Especially for your face.

My friend had hers done, and you can barely, barely see her scar.

I also just had 5 atypical moles excised completely on Tuesday, by a plastic surgeon(not on my face), and I am very pleased. I am just nervous about path results.

Good luck and keep us posted.