On Skin Cancer | Basal Cell Carcinoma

I’ve been diagnosed with skin cancer. Basal Cell Carcinoma to be exact.

So, I’m just going to pour my thoughts and emotions out here, because they’re pent up, whirling around, and absolutely need to spill out.

Basal Cell Carcinoma and Mohs

I’m going in for a specialized surgery, called Mohs, next month to remove Basal Cell Carcinoma (BCC) from the right side of my nose. Mohs is a high specialized, microscopic surgery in which the cancerous tissue is removed one layer at a time until clean margins are achieved. It’s used most often to treat Basal Cell and Squamous Cell Carcinomas and the cure rate is incredibly high, 97-99%.

It’s also most often used to remove cancers from the face, because it’s the most tissue-sparing approach. Mohs surgeons often complete extensive fellowships and trainings that make them not only skilled at removing the cancer, but also skilled at reconstruction following the surgery.

It’s clear from that quick summary that a.) I’m about to undergo the absolute best possible treatment for this awful cancer on my face and b.) that’s an awesome cure rate with such a small chance of recurrence that I can look forward to (and certainly pray for) a great outcome.

Throughout much of this process, I’ve been quite flippant about the fact that I’m going to be having surgery to remove skin cancer from my face. I naïvely thought that it wouldn’t be a big deal; they’d scrape the cancer off (it’s on my skin, after all) and we’d be done. I could put a little extra makeup on my small spot, and no one would ever even know.

I was wrong. So, so wrong.

The truth and magnitude of this thing is sinking in and I’m a hot mess. First, it’s cancer. No, it’s not malignant melanoma or a thousand other far more scary, life-threatening types of cancer. So I am praising the Lord that it’s easy to treat and the outcomes are so great. This is no small praise. But it’s still cancer. There’s this tumor that has invaded my face and has done who knows how much damage under the surface.

There’s the fact that from now until the day that I die, I will need to be so vigilant about checking my skin, seeing my dermatologist, wearing protective sunscreens and clothes. I will get to know my dermatologist well, as I will need to go every 6 months for skin checks. I will always and forever have a higher risk for not just other carcinomas, but other types of skin cancers, as well. Yes, this is the most common type of cancer. And yes, the treatment is relatively easy in comparison to chemo and radiation and big surgeries. Please do not hear me say that I do not have some perspective on my situation.

But it’s still skin cancer. And it’s on my face.

The surgery leaves a hole where the tumor was…but we won’t know just how big of a hole until all the cancer is out. Will it require a few stitches to allow the skin to heal on its own or will it require reconstruction, skin flaps, and grafts? How big will the incision be? Will it just be the side of my nose or will it run from my forehead to my cheek? What will my face look like after it’s all over and I’m sent home? How long will it really take to recover?

Y’all, I’m scared. I’m scared because it’s cancer and that’s always scary. I look at my two precious boys and I absolutely praise Jesus that I have access to a great surgeon and this type of cancer is curable. But I also feel a little bit like my own skin is a threat to my life.

What if this mole becomes malignant? What if that spot is more than just a rash? What happens if some day I’m staring down the barrel of an aggressive melanoma? What if my future entails more surgeries or rounds of chemo or a greater threat to me being able to watch my boys get married and have their own children and grow old with Blaise?

I’m also scared because I’m still young and I’m a woman and this is my face. I’ve had this cancer for at least 3 years. THREE YEARS. From all of the research I’ve done, I’ve learned that usually the spot of BCC you can see on the surface is just the “tip of the iceberg,” and there can be pretty extensive damage underneath that reaches well beyond the original location. I’m terrified that it’s going to be massive and require extensive repair, large incisions, and a multitude of sutures, grafts, and flaps because I waited so long to get it checked.

It’s a little about vanity, of course, but it’s also about the fact that my face is the first thing people see. I’m supposed to cover a maternity leave this fall at school. I’m going to be standing in front of a classroom full of 6th graders every day. I will be leading case conferences with administrators, parents, therapists, and other professionals. What if my surgery leaves a sizable deformity and the reconstruction is almost as horrifying as the hole where the cancer had been?

I’m scared that I will terrify my babies when I come home and they see my face. Right now, the tears are pouring down the face my children know. They don’t understand what cancer is or what surgery and scars mean. They understand that this is their mommy’s face…the only one they’ve ever known. I’m scared I might traumatize them or confused them. I’m scared of how they’ll react. And how could I possibly explain this all to them? How can I possibly prepare them for this when I don’t even know what to expect? 

So that’s where I am today.

I know that God is going before me, beside me, and behind me as I enter the ranks of people who have battled skin cancer, and I do pray that His name will be glorified through this process. But just because I understand that it’s treatable, understand that it could be worse, understand that the eventual outcome will likely be pretty great doesn’t mean I don’t have to walk through some very real, very scary emotions in the process.

I’d love your prayers as I continue to process this and prepare for surgery over the next few weeks.

Do you see it? That little flesh-colored bump on the side of my nose? That’s the Basal Cell Carcinoma. It looks so benign that I didn’t even think anything of it for the first 2 years it was on my face. For 3 years skin cancer was growing! Don’t be as complacent as I’ve been; go get every single spot and mole checked out.

And if you can stomach it, Google “Mohs surgery nose” and see what I’m talking about. Those are not extreme, worst-case-scenario examples. Those are pretty standard. I am quite impressed with how great most everyone’s scars look 12-18 months after the surgery, but it’s a pretty lengthy–and horrifying–process to go from hole-in-the-face to barely-noticeable-scar. So again, pray for me!