Welcome to Part 2 of the Skin Cancer Series! If you haven’t read Part 1, where I discuss how I was diagnosed, I recommend giving that a read before diving into this one. Today will be all about the options I was given for getting rid of my basal cell carcinoma.
Curing Basal Cell Carcinoma: Finding A Doctor
Once my biopsy came back positive for basal cell carcinoma, I was immediately referred to a surgeon. My doctor referred me to Dr Adrian Sjarif. I made an appointment with Dr Sjarif and visited him soon after my diagnosis.
At my appointment, Dr Sjarif looked at my cancer and gave me a run down of the best options for me. He mentioned that surgery would give the best results, and we talked mainly about surgical options. He did mention that there were some other options, but none had as quick and as precise a cure rate. Surgery on basal cell carcinoma can yield up to 100% cure rate.
Dr Sjarif told me that because I am so young compared to most of his patients, it may be a bit more difficult to cut out all of the cancer and create the least amount of scarring. To remove the cancer involves two operations: the first will remove the cancer, and the second is considered a “reconstructive surgery,” which will stitch up the hole caused by cutting out the cancer.
To remove the cancer, I had two surgical options: the first would be a surgeon guesstimating the area of the cancer and cutting a bit extra around it, and the second option is called Mohs surgery. Mohs surgery is a type of surgery in which the doctor will cut out what they think is the cancer, plus 5-10 mm extra. They will then test the piece that has been cut out (on-site), and within an hour will give you a result as to whether the edges had cancer or not. If the edges of the cut test positive for cancer, you’d go in and get a second cut. You’d repeat the process until the edges of your sample no longer test positive for cancer.
When I told Dr Sjarif that I was interested in Mohs surgery, he referred me to Dr Yiasimedes, who is a Mohs specialist. She was the woman who would cure my cancer. I made an appointment with her to talk about Mohs surgery. In our consultation, she told me all about Mohs surgery and how it works. Mohs surgeons go through an extra year of medical school to be able to do what they do, and they are highly specialized. I knew after my first consultation with her that I wanted to do Mohs.
I decided to go with Mohs surgery because it has a 100% cure rate. The doctor told me that if I went with the standard option, there is a possibility that the cancer may not be all cut out. In my case, it was a very good decision to go with the Mohs surgery – you’ll read why in the next post.
The doctor gave me other options (aside from surgical options) as well, like radiation and special creams, but none of those options had a 100% cure rate. I decided to go with surgery because that would give me the peace of mind that the cancer was all out on the first go, instead of trying things like radiation or creams. I wanted that cancer out of my head as quickly as possible.
For the reconstruction surgery, I was also given a few options. The cancer was not small enough to just cut out and stitch up, so we had to look at what we could do.
The first option was a skin graft, in which a piece of skin from another part of my body would be cut and stitched into the hole caused by cutting out the cancer. The downside of this would be that the patch of skin would never match the skin on my face, and I would still have a scar around the patch of skin. Dr Sjarif told me this would not be his first option, because I would have this little patch on my forehead for the rest of my life. He recommended a “flap.” The flap involves a more intensive surgery, where there would be a cut across my head, and then around the cut from the cancer. This would then be used to create a mini face-lift, which would help close the gap from the cancer.
I thought about my options for a couple of weeks, and then made an appointment to see him and schedule the surgery. I told him that I wanted to try the flap and I would use Mohs surgery to get the cancer cut out.