Monday, October 17, 2011

Mohs Surgery: Why You Should Use Sunscreen - Not for the Faint of Heart

I grew up two miles from Venice Beach.  I spent a lot of my school years at the beach.  We didn't have sun screen in those days.  It was called sun tan lotion.  I had a great time in the sun and surf.  But today there was some payback.

I had a basal cell carcinoma on my left cheek.  That was confirmed a couple of weeks ago and today I went in to have it cut out ("removed" is too benign sounding.)  The Mayo Clinic website says:
Basal cell carcinoma is a type of skin cancer. Basal cell carcinoma begins in the basal cells — a type of cell within the skin that produces new skin cells as old ones die off.
Basal cell carcinoma often appears as a waxy bump, though it can take other forms. Basal cell carcinoma occurs most often on areas of the skin that are often exposed to the sun, such as your face and neck.
Most basal cell carcinomas are thought to be caused by long-term exposure to ultraviolet (UV) radiation from sunlight. Avoiding the sun and using sunscreen may help protect against basal cell carcinoma.

I decided not to put up photos the normal way today.  Two of these are pretty gross.  So I'm embedding a Slide Show that you can view or not.  But if you think, as I did, that a basal cell was a minor issue, then look, and use your sunscreen.  What you see in the slide show is:

1.  Outpatient surgery room - leave your clothes on, lie back.  In five minutes or less he'd sliced out the cancer cells using something called Mohs Micrographic Surgery.  The description is from the college where they teach doctors how to do this, so I'm guessing it's not totally unbiased.

The Mohs procedure involves surgically removing skin cancer layer by layer and examining the tissue under a microscope until healthy, cancer-free tissue around the tumor is reached (called clear margins). Because the Mohs College surgeon is specially trained as a cancer surgeon, pathologist, and reconstructive surgeon, Mohs surgery has the highest success rate of all treatments for skin cancer – up to 99%.
"Mohs surgery is unique and so effective because of the way the removed tissue is microscopically examined, evaluating 100% of the surgical margins. The pathologic interpretation of the tissue margins is done on site by the Mohs surgeon, who is specially trained in the reading of these slides and is best able to correlate any microscopic findings with the surgical site on the patient. Advantages of Mohs surgery include:
  • Ensuring complete cancer removal during surgery, virtually eliminating the chance of the cancer growing back
  • Minimizing the amount of healthy tissue lost
  • Maximizing the functional and cosmetic outcome resulting from surgery
  • Repairing the site of the cancer the same day the cancer is removed, in most cases
  • Curing skin cancer when other methods have failed" [From Mohscollege]

2.    The surgeon sliced through the tissue to where he thought he got it and I was bandaged up until they could check that the tissue was cancer free.  That was about 30 minutes.This second picture was right after they took the bandage off to do the reconstructive surgery.

3.  The third picture is after they cleaned the hole.

4.  The last one is after they stitched it up.  When I saw the hole, I asked how they were going to pull the skin back together.  He said he would enlarge the hole to make it more a straight line and then he was sewing it up.  First he would sew up inside - and those stitches would dissolve on their own, and then he'd sew up the outside.  I go back Friday to remove those stitches, which you can see in the picture. It's covered by a big bandage now.

As I say, not for the squeamish.  But a good reason to use your sunscreen. 

Basal Cell Removed [UPDATE Dec. 17, 2011 - Two months later] Here's the scar now. (Compare to last picture on slide show above.

[UPDATE February 22, 2012: Here's what it looks like 4 months later:


  1. I don't need to look to know what it looks like. Here Down Under we have the harshest sunshine and the world's highest rates of all skin cancers. Me, too - just another statistic. The important thing is that *young people* get the message, because sun damage takes place when you're young but doesn't become evident for decades. The prospect of facial disfigurement isn't any more palatable just because you're over 40 and getting wrinkles anyway...

  2. Yikes! Glad you got it out. Hope your recovery goes well. - m

  3. Yes. a reminder of the stuff we're made of. Good to know you had this removed. One part of your story I don't believe you told us: how was it discovered? as this is an important part of fighting cancer, Mr. Science.

  4. I'm on my 7th basal cell.
    I go on 7th to a MOHs clinic.
    It's small this time, but I'm not watching!!!!

  5. Thanks for sharing. My husband has had two surgeries between his eye and his nose. The plastic surgeon did a great job, but they did have to graft skin from behind his ear both times. We were worried they might have to take his tear duct. It came back in the same place. He has since had other spots removed. This is serious stuff. Go and get yourself some Curad Scar Pads, order them online they are hard to find. I swear by them. Use them daily, all day if you can. Do not allow even a single ray of sunshine on that scar. If you can't find the pads, your doctor should be able to get you some. The Mederma Scar cream works good too. Good luck.

  6. Thanks for posting this. Had one MOHs surgery about 18 months ago for basal cell carcinoma. I was seriously impressed with the surgeon and his staff, but that big ol' hole in the side of my neck made me a bit queasy!

    If you're fair-skinned or have had a lot of sun exposure throughout your life you should make regular visits to the dermatologist to get checked out. That's how mine was diagnosed.

    Thanks again for getting the word out for sun screen!

  7. It came back in the same place. He has since had other spots removed. This is serious stuff.

  8. It looks almost impossible cover that hole! Impressive post. All the best, Steve.

    1. Moh's Surgery is very useful for skin cancer treatment. It is mostly used to cure this dreadful disease.

      Skin Cancer Treatment

  9. Hi There, I just spent a little time reading through your posts, which I found entirely by mistake whilst researching one of my projects. Please continue to write more because it’s unusual that someone has something interesting to say about this. Will be waiting for more!

  10. I have a friend who had a huge chunk of skin cancer on his nose. I don't know what kind of procedure he used to get the cancer removed. He did have a huge chunk taken out of his nose. He was just glad he was able to get it all removed before it could progress.


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