Let Me Tell You What It's Like to Have Skin Cancer

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Skin Tips

Three Things I've Learned That You Should Know

1. Trust your instincts
If a spot on your skin is changing, doesn't seem to heal, bleeds sometimes, or is just bugging you, make an appointment with a dermatologist to check it out. It doesn't matter if it looks nothing like the lesions you see on the skin cancer websites. Mine never did. "I always tell patients that skin cancers don't read textbooks," says Dr. Kriegel. "Patients know their skin. There are times when I look at a lesion and it really looks okay to me. But the patient pushes me a little bit, I biopsy it -- and it turns out to be a malignancy."

2. Get a second opinion
I had two new tumors on my forehead and scalp. How big a scar would the surgeries leave? Would they have to shave my hair? My whole head? Would I end up bald and disfigured? A second opinion just seemed like a smart idea. It's good to find out if there's a different approach, or to confirm that the approach you're getting is the right one. Your insurance should cover it, and don't worry; your doc won't be offended. "A patient should never feel uncomfortable about getting other advice," says Dr. Kriegel. "It's not a slight to the physician; it's just responsible health care."

3. Consider a plastic surgeon
I requested that a plastic surgeon sew up the wounds after the Mohs surgeries on my forehead. Mohs surgeons close many of the wounds themselves, but they also work regularly with plastic surgeons, especially when the cancer is on your face.

You may want to see a plastic surgeon if your skin cancer is on the eyelids, near a tear duct, over a motor nerve to the forehead or the mouth, if it involves the lips or requires reconstruction of the nose, says plastic surgeon Dr. Lesesne.

Also, bear in mind that if you're in your 20s or 30s, your skin isn't as pliable as when you're older, says Robert M. Schwarcz, MD, a New York facial cosmetic surgeon who often works with Dr. Kriegel. "The closure may be more complex when the skin doesn't move as easily, and a plastic surgeon can help." Ask for a plastic surgeon who does repair for Mohs regularly, he suggests. Otherwise the Mohs surgeon might be the better candidate to close you up. "Many of my Mohs surgery colleagues do unbelievable closures," he says.

Scary Skin Cancer Facts

Basal cell carcinoma is the most common type of skin cancer, with about 2.8 million diagnosed in the United States each year. It's rarely fatal but can grow and become disfiguring if not treated.

Squamous cell carcinoma is the second most common form, with about 700,000 cases diagnosed each year, resulting in approximately 2,500 deaths. Between 40 and 50 percent of Americans who live to age 65 will have either of these non-melanoma skin cancers at least once.

Melanoma is the most dangerous type of skin cancer. Cases of melanoma increased 45 percent between 1992 and 2004 and continue to rise, especially among people under age 40. Nearly 124,000 new cases were diagnosed in the United States in 2011. Women under 40 have a higher probability of developing melanoma than any other cancer except breast cancer. The survival rate for patients whose melanoma is detected early, while the tumor is still confined to the epidermis, is about 99 percent. The survival rate falls to 15 percent for those with advanced disease. There were nearly 9,000 deaths from melanoma in 2011. That's why skin exams and prevention are so important.

The Skin Cancer Foundation educates the public and physicians on all things skin cancer related. For resources on self-exams, diagnosis, treatments, and more, go to

What Is Mohs Surgery?

It's a specialized surgical technique in which the surgeon removes a layer of cancerous skin and then analyzes it in the lab (while the patient waits) to see if, and where, there are still more cancer cells that need to be removed. Then he repeats this, removing more layers as needed and analyzing each one in the lab till all the cancer is gone with the minimum amount of tissue removed. The whole process can take hours -- but it is effective.

"Mohs surgery provides you with the smallest possible scar and the highest cure rate," says Dr. Kriegel, who is also director of the division of dermatologic and Mohs surgery at Mount Sinai Hospital in New York City. Basal cell or squamous cell tumors that are large, are on your face, or have recurred after previous treatment are often good candidates for Mohs surgery.

See my slide show of exactly what happens during Mohs surgery:

Continued on page 3:  Sunscreen News


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