Delaying Treatment, With My Doctor's Permission

At the end of June, I had my six-month skin check with my dermatologist, Dr. Keller. I had a small area on my face that my doctor wanted to treat with cryosurgery (freezing the area with liquid nitrogen spray), and another area on my chest that she said we needed to biopsy.

I'm no stranger to it

The biopsy result came back as basal cell carcinoma, which I’m no stranger to. I had expected this diagnosis. Dr. Keller said we could go ahead and schedule removal, which she would do in her office by excision. Without checking my calendar, I scheduled for a couple of weeks out. When I checked my calendar the next day, though, I realized I had a mammogram scheduled for the day after my skin cancer surgery. Mammograms and stitches on my chest did not sound like a good combination to me, so I called her office to reschedule.

Dr. Keller said that having surgery wasn’t a huge rush for this particular area. We caught it early and it was basal cell, which is the slowest growing tumors. While it definitely needed treating, it didn’t have to be treated within a matter of days.

I trusted my doctor's advice

Because I trust my doctor, and because the thought of having stitches during the middle of a long, hot summer didn’t sound overly appealing, I delayed surgery until mid-September, a delay of around two and a half months. I like to work in my yard in the summer, and I knew that once I had surgery I would be somewhat limited on what I could do for a couple of weeks. I also knew that with summer’s wardrobe of lighter fabrics (and tank tops on weekends), a large bandage would be very noticeable.

Once I scheduled surgery, I admit that I started second-guessing my decision. Was I being silly to not want stitches and large bandages in the heat of the summer? Would my basal cell area grow larger? Was I doing more damage to myself by delaying?

Did I make the right choice?

I knew that basal cell carcinomas were slow-growing, but I also knew that I had previously had a couple of basal cells that grew around nerves and my previous doctor had to move the nerve during surgery to get all the cancer, which left me with permanent numbness. Granted, those basal cells had been growing for years (long story, but I had no health insurance for an extended period of time, then I had bad health insurance for an even longer period of time, and I delayed seeking treatment.)

A quick internet search resulted in several articles that all typically said the same thing: basal cells tend to grow quite slowly, up to a half inch in a year. It’s rare for basal cells to metastasize to other parts of the body, but if left untreated basal cell can invade bones or other tissues underneath the skin (which is what I had experienced previously on a couple of areas).

Usually I was treated right away

Typically if I have an area of skin cancer, we treat it right away. I’ve had a couple of squamous cell carcinomas that I wanted off immediately; one bled, and the other one hurt. There was no way I would have made it an additional couple of months without getting those removed. But for this area, it didn’t bleed and it didn’t hurt.

While I wouldn’t recommend repeatedly delaying treatment, and I especially wouldn’t recommend delaying treatment by a year or more, I felt comfortable with my decision that a short delay in surgery wasn’t going to cause major harm.

No matter what, show your doctor

The key is to have your doctor check any suspicious areas. Listen to what your doctor says, and do your research if you feel you need or want additional information. I’ve had skin cancer since 1995, and I was fairly certain the area was basal cell carcinoma. However, I don’t rely on self-diagnosis; my doctor did a biopsy and based on those results told me a short delay would be okay. There could be times that you absolutely should not delay treatment, so do not just ignore any suspicious area. Make an appointment with your doctor, find out what you have, then you and your doctor can work towards the best treatment plan for you.