This is not a post about avoiding skin cancer. Most people know, or should know, how to reduce their risk of skin cancer.
This is a post about the weird moles, scaly patches, and sores that don’t heal, the things we ignore because “so-and-so had the same thing and it was nothing” or “my GP or gynecologist said it’s a normal mole.” Your GP or gynecologist is not a dermatologist. My mother’s GP told her that the sore at the corner of her mouth that hadn’t healed for a year was a cold sore, but that she should see a dermatologist (my mother spent over a year caring for her sister who has Alzheimer’s and dementia and ignored her own health). My aunt finally went to a nursing home, my mother finally went to a dermatologist. Basal cell carcinoma.
Today we spent three hours at another dermatologist’s office, a surgeon who specializes in Mohs Surgery and the cancer was more extensive than we thought. We were expecting removal of what we thought was a small cancer and a few stitches. The surgery involved over an hour of reconstruction, two skin grafts, and a lot of stitches.
My mother smokes. The nurse told her not to quit cold turkey and throw her body into more shock immediately after surgery; rather, she said that my mother should cut way back and then quit. The nurse said they had a patient who smoked and refused to quit after having two cancers removed from his nose. His skin grafts died. Now he doesn’t have scars. He has two holes in his nose.
You should go to the doctor as soon as you realize that a mole is new, has changed, gets sore and then scabs up and seems to heal. You should go to the doctor if you notice scaly patches, particularly on your face, ears, shoulders, and chest. These are all areas that receive a lot of sun exposure. Sores that don’t heal are red flags. I had a neighbor who developed a big tumor on her lip directly where she always held her cigarette. That tumor started off as a small sore and grew quickly.
I don’t think that my mother would be dealing with two skin grafts, over a dozen stitches, and so much swelling that she looks like she has the mumps on one side of her face if she had gone to the dermatologist a year ago.
This is one of those, you have to put your foot down and make time for yourself things. Even though we don’t think as going to the doctor as “time for ourselves,” we neglect our health because caring for a family member or work or school are more important.
You can’t do any of those things if you can’t even bend over because you just had surgery and it might make your incision start bleeding.
Take the little sores and funny places seriously as soon as you notice them and don’t just go on your GP’s word. If you have insurance and you think you may be in danger of losing it due to job loss or divorce, go to a dermatologist for a mole check. I did before my divorce was final and had a problematic mole removed. The dermatologist told me that you can get a mole anywhere on your body. She said her teenage daughter had a mole in the white of her eye.
A cold sore eventually heals, although it may recur at any time, particularly if you are under stress. Cold sores do not hang around for a year.
Canker sores are inside your mouth and may be referred to as ulcers. Your dentist can refer you to a dermatologist if she’s concerned about a canker sore.
DO NOT BE AFRAID TO GO TO THE DERMATOLOGIST. Do not put it off because you’re concerned about scars. Read that link above about Mohs surgery and scars. Mohs is designed to preserve as much tissue as possible while leaving the least scar, without the necessity of a plastic surgeon (although you may choose to have a plastic surgeon as well if your insurance covers that). Healing times for skin cancer surgery range from six months to a year.
DO FOLLOW ALL AFTERCARE INSTRUCTIONS, PARTICULARLY REGARDING ICING THE SURGICAL AREA AND QUITTING SMOKING. It is imperative to go to all follow-up appointments. You will go back to the dermatologist every 4-6 months to have the area re-checked.
The cure rate for basal cell carcinoma is in the high 90% range with Mohs surgery.
Don’t be afraid to get a second opinion even if your GP dismisses a sore as not a concern. If you’re afraid of offending your GP, you need to find another GP.
Medicare covers 80% of Mohs surgery. After my mother’s extensive surgery, she owes only $350, and the billing office said they would be happy to work with us as long as we have a payment plan.
Just go get it checked out.