But I'm Too Young to Have Skin Cancer!

When the phone rang, I had a feeling that I would be receiving bad news. The caller ID unit showed that it was my dermatologist calling with the results from my skin biopsy. "I hate to tell you this...," the doctor paused, "Your biopsy results show that you have basal cell carcinoma. Or in other words skin cancer."

Skin Cancer? How could this be? I'm only thirty-nine years old. I've never been a sun-worshiper. I've never been to a tanning booth, or played outdoor sports, or had an outdoor job. I've never even taken a spring break vacation down south like all my other classmates. Of all the people in the world to get skin cancer, why me?

I did some research and was surprised to find that I really did have many risk factors. Risk factors include having light colored skin, blue or green eyes, blond or red hair, over-exposure to x-rays or other forms of radiation, or a history of skin cancer in relatives. I am a fair-skinned, blond hair person with green eyes and a family history of skin cancer. I was more at risk than I had initially thought.

Basal cell carcinoma is a type of non-melanoma skin cancer. It is the most common form of cancer in the United States. About a million new cases are diagnosed in the United States each year. The majority of these cancers occur on areas of skin that are regularly exposed to sunlight or other ultraviolet radiation.

I first noticed the red mark on my nose when I was thirty-seven years old. I figured it was just an old acne scar. Every day I would put concealer on it and wonder why it wasn't going away. There were days when it would bleed when I washed my face, but I figured it was just a dry spot. It would appear to be healing because a new layer of flaky skin would start to cover it, but it never healed completely. It became an accepted form of annoyance for me.

My inner voice kept nagging at me to get it checked out. I even called a dermatologist to set up an appointment. The next available appointment was three months away. I didn't want to wait that long, so I hung up without making an appointment.

A year later my Dad and Sister were discussing their recent skin cancer surgeries. My Dad was on his fifth surgery, and my sister was on her third. I told them about my nose and they told me to get it checked right away.

When I called the Dermatologist's office, I was surprised to find out they had a cancellation and could see me the following day. The Dermatologist agreed that the red mark on my nose looked suspicious and took a biopsy right there in his office.

The Dermatologist told me that cancer may appear as a skin bump or growth that is pearly or waxy, white or light pink, flesh-colored or brown. In some cases the skin may be just slightly raised or even flat. Chances are that it will bleed easily, won't heal, or it may ooze or crust over. It may look like a scar, or it could have irregular blood vessels in or around the spot. His advice was if it looks different, then get it checked right away.

To remove the skin cancer, I was sent to a specialist who does Mohs surgery. Mohs surgery is particularly suitable for the area around the eyes, nose, ears and mouth because it removes the least amount of skin. This type of surgery allows the Surgeon to remove areas of tumor that are invisible to the naked eye.

The procedure does not require general anesthesia. Instead the Surgeon numbs the area with a needle, which I felt was the only painful part of the procedure. The Surgeon then removes a small section of skin and examines the tissue under a microscope. If the Surgeon sees a safe perimeter of non-cancerous cells around the sample then you are done. If not, then the Surgeon will bring you back into the room, numb the area, and remove more skin. I really thought I would only need this done once since my spot was so small, but unfortunately I had to go through the process three times.

When the surgery was finished they sent me up to the Plastic Surgeon. He felt that my nose would do well healing on its own without plastic surgery. If I had gone the plastic surgery route, they would have had to cut skin from another area on my face to cover the missing skin on my nose. I wasn't too pleased with the idea of having two bandages on my face, so I was relieved that he thought it would heal on its own.

For two weeks I had to wear a bandage on my nose. It is in the process of healing, but it is still noticeably indented and I will have a scar there. I will always wonder if the scar would have been smaller if I had made my appointment when I first became suspicious.

In this whole process I have learned some valuable lessons. One is to never ignore medical issues hoping they will go away on their own, and two is that no one is safe from skin cancer.