I Have Skin Cancer?
Editor’s Note: In advance of the summer season, HealthSource writer Erica Houskeeper offered to share her experience with skin cancer in the hope of helping others. Houskeeper’s experience can be instructive, according to Nathan Bombardier, MD, a Mohs surgery fellow in dermatology at University of Vermont Medical Center. Here, Houskeeper tells her skin cancer story, and Dr. Bombardier chimes in with some advice about how others can learn from her experience.
The pink, pearly bump on my nose looked like a wart.
Dr. Bombardier: “Many skin cancers are pink, and it is a good clue for patients to watch for pink spots.”
I was 28 years old and figured I was far too young for any serious skin problems.
Dr. Bombardier: “True, basal cell carcinoma is relatively uncommon for people under age 40. Patients between the ages of 50 and 80 years are most affected, and the median age at diagnosis is 67. Vermont has one of the highest skin cancer rates in America.”
I made an appointment to get the wart removed. The doctor used liquid nitrogen on the bridge of my nose to make it disappear.
After feeling a quick, cold sting, the wart was gone. Or so I thought.
A decade later, the bump resurfaced in the same spot. I also noticed a second one hovering below my left eyebrow. I told myself a dermatologist would know to burn these off my face for good.
Instead, I heard this at my dermatology appointment: "You need a biopsy. And those probably aren't warts."
Dr. Bombardier: “Any time a spot doesn’t go away with treatment like liquid nitrogen, we recommend that the patient follow back up with us as it can be a clue that it is a skin cancer.”
Those pearly bumps turned out to be basal cell carcinoma—a type of skin cancer that shows up on sun-exposed skin. You can usually spot a basal cell by seeing a change in your skin, like a growth or a sore that won't heal.
Dr. Bombardier: “We often hear patients describe the bumps as pimples, and many people note these spots tend to bleed with minimal trauma, like washing your face.”
Basal cell carcinoma is a less aggressive type of skin cancer compared to melanoma or squamous cell carcinoma. Still, I needed to remove it or face complications down the road. For example, an untreated basal cell carcinoma on the face can grow into the bones and eventually into the brain.
Dr. Bombardier: “We most often see large wounds rather than a deep invasion, but both can occur. There have also been cases of metastatic basal cell carcinoma although, again, very rare.”
To avoid any further damage to my body, I opted for Mohs surgery, an effective outpatient procedure during which a surgeon removes small pieces of skin and carefully examines the margins of each to assess if any cancer remains. The surgery continues until only cancer-free tissue remains.
Dr. Bombardier: “Mohs surgery has the highest cure rate for basal cell carcinoma that occurs on the head and neck.”
Once the surgery was over, I stayed in the clear for a while. A few years later, additional basal cells were found on my left ear and right nostril, requiring two more Mohs surgeries in 2014 and 2020.
I've been skin cancer-free for four years. Today, at age 53, I get my skin checked by a dermatologist once a year (sometimes twice if I spot a suspicious mole or rash during an at-home skin check). I also wear 30 SPF sunscreen, spend less time in the sun, and watch my skin closely for any changes.
Are more Mohs surgeries in my future? I hope not. But at least I know to immediately call my dermatologist if another so-called wart shows up.
How To Protect Yourself from Skin Cancer
- Stay out of the sun as much as possible between 10 am and 4 pm.
- Wear long sleeves, long pants or a long skirt, a hat, and sunglasses while outdoors.
- Use sunscreen with SPF 30 or higher. Apply it liberally and often.
- Don't use indoor tanning machines. Dr. Bombardier: “Generally, we recommend never attempting to intentionally tan. Instead, we recommend self-tanner or spray tans.”
- Check your skin for changes regularly and contact your doctor with any questions.
