tlc13 wrote:
EyeRunMD wrote:
I’m recently diagnosed with cutaneous squamous cell carcinoma so that’s why I went looking for this old thread. It’s amazing how quickly these can pop up. I developed a spot right beside my nose that I thought may have been an inflamed sebaceous gland or something. It didn’t go away, and then failed to heal up after I accidentally nicked it while shaving. This all occurred over about 4 weeks. Went to the dermatologist and she said squamous cell carcinoma and I should have Mohs surgery done.
The day of the Mohs procedure ended up taking about 6.5 hours. Had to have two different cuts because the margins were not clean with the first round. Luckily, she was able to get clean margins with the second round but I was told I have a “high risk” SCC. Went in with a spot not even as big as a dime and ended up with an incision about 2.5 inches long, beside my nose.
Because of the high risk nature of my SCC, I had to have a CT scan done. This is just one more example of how our health care system is screwed up, and insurance companies have way too much power. Because of the risk of metastasis, a CT scan was ordered of my head, sinus area (face), and neck. The insurance company said “we will only approve the head CT, and not the other two”. In my mind, this was the least useful of the three CT scans because the biggest risk (with my particular cancer) was looking for lymph node metastasis. So, I told the imaging center to not cancel any of the CT scans and I’d just pay for the other two out of pocket. I already had enough fear/anxiety and I did not want to wait any longer. I’m very fortunate I can pay for these scans but it saddens me to think of how many other patients don’t have the money to pay for these, and possibly get inadequate coverage, and live in fear of the unknown. It’s maddening.
After the CT scan was an ultrasound guided lymph node biopsy for two palpable nodes on the same side as where the cancer was found. Very very thankful these came back NO cancer as well. Doc said they were most likely a “reactive” lymphadenopathy because of the large incision on my face and the immune response to the healing. It still freaked me out.
After the Mohs, sutures out a week later. No heavy lifting, or strenuous exercise, until one week after the Mohs. Advised no running for two weeks. Derm follow up every three months, and self check of neck for lymph nodes constantly.
Main reason for the post is to remind everyone to please take the possibility of skin cancer very seriously. Use your sunscreen and reapply frequently!!! I did not think about it because I “tan easily” and was very nonchalant about using sunscreen. This cancer diagnosis really kicked me in the nuts and woke me up bigtime.
This really hits home. Yes the ct scan immediately is a good idea. I just finished 7 weeks of chemo and radiation on squamous cell from old lip moh’s that attached to trigeminal nerve behind the lip and traveled all along it leaving a trail of cancer and leaving a tumor at the base of my brain. I am being treated at Mayo Clinic and their current procedure for squamous in the lip is the moh’s along with current ct scan and radiation to avoid shit that I am going thru. 10 years ago not the procedure which my doctors say mine was traveling up into my head for up to 10 years. Just clean lines is no gurantee but very rare to travel up, and if a cancer cell escapes it typically will go to the lymph nodes.
Wow, I’m sorry you are having to deal with this. It’s all so stressful, especially all the unknowns. Was the treatment very harsh on your body?
Did you have Mohs performed 10 years ago, around your lips? Did they find any nerve involvement at that time? Or, is this all new procedures and diagnosis?
Bad part about cutaneous squamous cell carcinoma is there’s not much in the way of prospective studies looking at what’s the best course of action to treat a tumor if it is at X stage. There are a lot of case reports, and retrospective reviews, that provide some guidelines. From what I read, some docs suggest adjuvant radiation therapy if there’s any nerve involvement at the initial procedure. Others say there’s no solid proof it is of benefit if there are clean margins. Same with post surgical scanning. Some docs say CT scan and others advocate for an MRI. Of course, insurance will be very unlikely to pay for both.