Sun exposure is not a laughing matter, cow-nose

So you don’t believe skin cancer will ever happen to you? You think your life will be over by then, anyhow?

Here’s what I want you to do: Look at the pictures on these pages. That’s me. Undergoing treatment for skin cancer. Becoming what some would probably consider quite unattractive.

Now ask yourself this: How would you like to look in the mirror and see this face staring back at you? Do you think that nice tan today is worth spending your final 30 golden years with such a face? Do you want to be called "cow-nose"?

Back in the day. I always had a tan when I was young. In my day, farmer daddies tied their sons—at least the more fractious of us—onto bald wheatland tractors around their ninth birthday and sent their mamas to get them when it was time to go to college.

There were no gimme caps in those days, and a decent straw hat cost you $5—10 hours of work, on a farm kid’s pay scale. Plus, it made the top of your head white and uncool. Nobody had ever strung the letters SPF together. If skin cancer had been invented, I never heard of it.

Now I’ve not only heard of it, I’ve got something like a layman’s Ph.D. Let me tell you about my recent Mohs treatment and how I was able to obtain these studio-quality pictures.

What started out as a small, scaly spot on my nose was determined to be cancerous by my doctor. Basal cell carcinoma is a form of non-melanoma cancer, the least dangerous form of skin cancer.

I’ve been getting sundry forms of skin problems for 30 years or more. It started with something called actinic keratosis spots—scaly little spots that are considered "precancerous." My lay understanding is that most of them are harmless. But some of them can turn into cancer. So my wife sent me to a skin doctor. He started by using liquid nitrogen to "freeze" the spots off. I’d go in twice a year, and he’d freeze off 10 or 20 such spots on my arms and face and send me home looking like a smallpox survivor.

Then, one day, one spot looked "suspicious." He took me in the back room, gave me a shot of numbing medicine and biopsied it. A few days later, I got a call: I had cancer. It turned out this wasn’t "cancer!" with an exclamation point, just "cancer" with a period. Basal cell carcinoma. "Non-melanoma cancer," the doctor said.

I’m lucky. This is the most common, least dangerous form of skin cancer. Left untreated it can kill you, but it takes a long time. Squamous cell carcinoma, the other main non-melanoma cancer, is a little worse. Melanoma is the worst. It’s the one they blame on tanning beds, and if you don’t find it early and get it treated, it will cut your life short. Sadly, having even the basal cell stuff indicates a susceptibility to the more dangerous forms.

So I went back in and the doctor numbed the spot again and cut it out while we talked about the cattle market. No biggie.

He said I should always wear a 4"-brimmed hat, long-sleeve shirts and sunscreen. I was spending a lot of time in the office, and I told him so. He frowned the way doctors and wives do when you question their authority. "You’re getting more sun than you think," he said. "I can tell."

A period of maintenance. I followed through with regular, quarterly visits to the dermatologist. We went through lots of liquid nitrogen. Every now and then, we’d biopsy a spot and dig it out. Then came my first Mohs surgery.

Mohs—named after the guy who first did it—involves having a surgeon cut away a cancer spot one layer at a time. After each cutting, he takes a sample to the lab and looks to see if he’s got all the cancer. If not, he repeats the process. Mohs is mostly used in sites where scarring would be a problem, such as the face, or where you don’t want to sacrifice more tissue than necessary.

After several Mohs treatments (and shots in the nose!) I was referred to a plastic surgeon for reconstructive surgery. A yellow bandage was sewn on until the Integra Flowable Wound Matrix, a cow tissue product, could be absorbed.

For the next few years, we did a lot of nitrogen, a bit of back-room surgery and the occasional Mohs procedure.

See Comments