The Mohs Procedure Used to Remove My Basal Cell Carcinoma
The Mohs Procedure
Dr. Frederic E. Mohs developed the procedure for removing basal cell carcinoma in 1936. It is widely used now by dermatologists. I think by now everyone is aware that chronic exposure to the sunlight is the leading cause of basal cell carcinoma.
When I was a child growing up in the South, my mother knew the danger of the sun. When I worked in the fields picking cotton or hoeing the corn, she made me wear a sunbonnet with a wide brim. The men all wore wide-brimmed straw hats. As the years went by, however, it became important for me to get a deep, golden tan. I have always been a sun-worshipper. I no longer wore a hat when I worked outside in the garden. Now I am paying the price for years of exposure to the sun.
Protect Your Skin
To reduce the sun’s harmful ultraviolet rays, we should limit our skin’s exposure by wearing sunglasses, broad brimmed hats, and protective clothing. We should use a sunscreen, rated SPF 15 or higher, on our exposed skin. Yes, even on cloudy days! We should avoid tanning parlors. We should inspect our skin for any changes and routinely visit our dermatologist for skin exams.
Did you know it's possible for your dog can develop skin cancer from too much sun? Don’t laugh when you see a dog wearing sunglasses!
Basal Cell Carcinoma: Most Common Form of Skin Cancer
Basal cell carcinoma is the most common form of skin cancer. It can cause destruction of the surrounding tissue. It is most important to have it diagnosed early so it can be treated. Did you know 1 in 5 people will be diagnosed with some form of skin cancer this year? That’s more than any other kind of cancer.
Please don’t think that skin cancer cannot kill. It can. I lost a dear friend who developed melanoma. She noticed a new brown spot on her forearm and didn’t see a dermatologist because she just thought it was a new “age spot,” which is very common as we get older. By the time she did see a doctor, the melanoma had metastasized into her lymph nodes.
Watch for Any Suspicious Changes
Be on the lookout for any new spots or any changes to spots you already have on your body.
I go to the dermatologist if I see anything the slightest bit suspicious. I had a brown area on my forehead that looked like a bruise. I also had “something” about two inches away from that area that bothered me because it was raised, brown, and just unattractive. I also had “something” on my scalp that my daughter (who is also my barber) kept asking me to have checked.
I made an appointment to see my dermatologist, who is also a plastic surgeon.
Your Doctor Should Examine the Entire Body
The dermatologist did a complete body look; well, almost a full body look. He didn’t see anything suspicious on my body. Then he concentrated on my forehead. He remarked that the two areas I was concerned about were nothing to worry about. He commented on the area my daughter was concerned about, and said that was nothing to worry about, either.
He then called my attention to a tiny area in the middle of my forehead that I really had not even noticed before. He informed me that he wanted to biopsy that spot.
He gave me something to numb the area, and then he took a sample to be sent to a pathologist.
Dr. Mohs Developed the Procedure in 1936
Mohs Surgery, also called chemosurgery, was developed by Dr. Frederic E. Mohs in 1936. This surgery is performed by a trained and experienced surgeon. In my case, my dermatologist is also a specialist in the Mohs procedure.
In order to diagnose, common practice among dermatologists is to scrape, burn, freeze, use radiation and excision to remove suspicious lesions. This tissue is then examined by a pathologist. If basal cell carcinoma is confirmed, the Mohs procedure will likely be performed.
Using the Mohs procedure, tissue is excised and examined under the microscope immediately so that the entire process can be done in one visit. The advantage of the Mohs procedure is that it removes all the cancer, minimizes the recurrence, and leaves little scarring.
Yes, I Had s Basal Cell Carcinoma
The next day, the doctor called to tell me I had a basal cell carcinoma. I immediately did some research on the internet about this type of cancer. I found that it is a more common skin cancer. It seldom kills, but it can cause significant destruction and disfigurement of the surrounding tissues. These cancers affect 3 out of 10 Caucasians—and in 80% of these cases, they are found on the head and neck.
Most of these are caused by chronic sun exposure, and people who are fair skinned (as I am) are more likely to develop it. These usually start out as an open sore, a red patch, a bump, or just a scar-like area. I had none of these signs. As I said, I had not even noticed the tiny little “thing.”
He told me to return the following day for a procedure called Mohs Micrographic Surgery. He fully explained the procedure and what I could expect. It would be performed in his office under local anesthesia. The Mohs procedure offers the highest cure rate for basal cell carcinomas.
The American College of Mohs Surgery (ACMS)
Members of the American College of Mohs Surgery (ACMS) have taken a 1-2 year specialized course after completing their medical residency. To become a member of this organization, a surgeon must have completed at least 500 cases of Mohs surgery. My dermatologist is a member of the ACMS.
The basal cell cancers that are likely to benefit from the Mohs surgery are those that are located in sensitive areas around the eyes, nose, lips, scalp, ears, fingers and toes, or genitals. These are the large, aggressive types, and the usual procedures may not remove all of the cancer cells. In the Mohs procedure, all of the cancer cells are removed in steps.
My Experience With the Mohs Procedure
I was very nervous on the day on the procedure. If I were a drinking person, I would have belted down a couple of stiff drinks that morning before I went in. After some warm reassurance by my doctor that everything would be just fine, he anesthetized the area on my forehead, waited about 15 minutes, and then removed the first layer of cells. He told me to just relax and give him time to examine the tissue under the microscope. He would be able to tell if he got all the cancer cells, and that would be the end of the procedure. After about 45 minutes, he came back and said he needed to remove some more of the lesion.
It took three additional attempts to make sure he got all of the cancer cells. He assured me that the Mohs procedure removes only tissue containing cancer cells. By this time, I could just imagine a big hole in the middle of my forehead. Then he explained that he would make a clean incision across the area and suture it up. Later on, I saw five sutures in a neat little row.
I was instructed to use the antibiotic cream he gave me twice a day on the area, and then return in seven days for suture removal, which I did. It has now been four weeks since I had the Mohs procedure done. It is healing very nicely. I don’t think I’ll even have a scar.
I am disappointed that I still have the big brown spot and the other “thing” on my forehead, but at least the basal cell carcinoma is gone! He told me about some creams that may bleach out the brown spot. I might try one of those later on.
Learn to Spot Any Changes on the Skin
Be a Spotter! We know that it is impolite to point at other people, but you should point out a suspicious spot on another person—you could save their life! Learn how to spot changes in your own skin. If you see a “funny” spot on a friend or loved one, don’t hesitate to call it to their attention. Maybe they are like me. Maybe they just haven’t noticed it. My daughter, the barber, has found numerous skin cancers on her client's scalps.
Here are some important tips to protect your skin.
- Limit exposure to the sun
- Try to stay out of the sun between the hours of 12-3 p.m. Schedule your walks, etc., for later in the day.
- Wear sunglasses
- Wear a broad brimmed hat
- Use a broad-spectrum sunscreen, rated SPF15 or higher, on all exposed skin
- Avoid sun tanning parlors
- Inspect your skin regularly
- See your dermatologist regularly for an exam
Did you know your skin is the largest organ you have? Protect your skin, and it will protect you for the rest of your life.
A New Lesion
I has been about six months since I had the Mohs Procedure done to successfully remove the basal cell carcinoma from my forehead.
I noticed a new suspicious spot in a new area on my forehead. I made an appointment to go in and have the doctor take a look. Without hesitation, he said he needed to do a biopsy on it. I received a phone call from him two days later with the results. Now I had a Squamous Cell Carcinoma!
The squamous cell carcinoma is just as dangerous as the basal cell carcinoma, it seems. I need to have the Mohs procedure again. I set up the appointment and will have that done right away.
I am getting a little tired of having all this surgery done to my forehead. I am now paying the price of all those wonderful suntans I got on my face years ago.
The sun is a wonderful thing. Just remember to always use protection when you enjoy the sun!