Use That Sunscreen

Today was my 5th Mohs procedure..and it was a doozy.

For those unfamiliar with Mohs, it is a surgery that removes layer by layer of skin in order to excise cancerous cells. First, you or your doctor may see something that looks unusual on the skin; s/he may decide it’s nothing or that it looks suspicious in which case it is removed and sent to a lab. The pathology can come back as benign (nothing dangerous) or cancerous. In my case, it was a basal cell carcinoma–the fifth one I’ve had. In order to make sure all the cancer has been completely removed, the dermatologist or a specialist will perform the Mohs procedure. One layer of skin is removed and if the edges are cancer-free, you’re done; you get a band-aid and you go home (well, it’s a little more complicated). Every other time I’ve had a Mohs, that is the way it went down. If, however, there are still cancerous cells on the periphery, the doctor will do another layer. This keeps going until the peripheries are clear. The average number of times a patient will have a layer removed is 1.8. Today, I set a personal record with 4! I was at the surgeon’s office for nearly 4 hours…and if you think the bandage looks bad, you should have seen what the wound looked like before it was closed!

The doctor and I had a conversation about why I was on my 5th procedure (my first being about 20 years ago and the last 2 years ago). I am fair- skinned and as a kid no one really paid attention to UV rays or sunscreen. It was a regular occurrence for me to get a sunburn; sometimes quite painful. Who knew that 40 years later this would be the result? Now I have to be especially careful.

What I did not know is that all that sun damage has actually altered the DNA of my affected skin cells. Some of them are OK and will never morph into anything else. Others, however, may be at the edge (99% and ready to go) of going cancerous. What will determine the next steps? It is entirely in my hands–literally. Sunscreen.

From here on out, I will be wearing it on my face (a special one designed for that purpose) every day. I will also wear an over-the-counter on my other exposed body parts. Windshields and car windows, as well as clouds, do not filter out the damaging radiation that can trigger these cells. Only a good sunscreen with a high enough SPF will work.

I am getting to be pretty high maintenance! Actually, this is a relatively easy step to add to my routine each morning…and later in the day if I am outside quite a bit.

I have been fortunate. So far, all have been basal cell carcinomas–easily treated. Next time, who knows?

My warning to you, my readers: the future of your skin is in your hands too. Sunscreen every day!

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