The Drip, Drip, Drip of Skin Cancer
Last updated: January 2023
The feeling when I head to the dermatologist is usually a level below apprehension but above mere curiosity. What will she find this time? There’s always something, even if it’s what she sometimes calls a “little guy” that she needs to zap. The guys like to hang out in groups on my hands and arms – the areas with the most sun damage. They could be squamous cell carcinomas, actinic keratoses, yucky warts, or generic little raised red dots from dry skin or irritation.
Dealing with skin cancer recurrence
Skin cancer is a drip, drip, drip. It didn’t come on with a bang like when I got leukemia in 2003. It started happening in small encroachments after I got a stem cell transplant (also called a bone marrow transplant). It is likely that I will keep getting skin cancers. As I stated previously, they’re a product of past sun exposure, long-term prednisone use, and the increased risk associated with allogenic stem cell transplants (those that use cells from a donor or cord blood.)
I had one basal cell, in my ear of all places. Countless others have been squamous cell carcinomas in situ – on the skin. My “squamous cell radar” can usually detect their beginnings in little areas of flakey skin. When I got my first one, I was more nervous, since it was new. I was alarmed when I heard “skin cancer,” but the “in situ” part calmed me down. I asked her to repeat that it was on the skin only. I asked her to repeat that it was not a melanoma.
Understanding squamous cell carcinoma
Definitions, if you look them up and see them on paper, er, um, I mean, on the screen, can scare you with their worst-case-scenario descriptions. Such was the case when I looked up “squamous cell carcinoma in situ” and found this definition from the National Center for Biotechnology Information.
“Squamous cell carcinoma in situ (SCCIS) is a superficial growth of cancerous cells on the skin’s outer layer. It is not a severe condition but could develop into a full form of invasive skin cancer if not detected early or well managed. It is also known as carcinoma in situ in the literature or as Bowen disease after John T. Bowen, an American dermatologist who first described the condition in 1912."1
Assessing the threat of recurrence
After feeling reassured by the “not a severe condition” part, I got scared by “could develop into a full form of invasive skin cancer.” Red alert! You can go from calm to crazed without even knowing it has happened. But then if you step back and take it in context, it is not so threatening. The rest of the sentence is what counts: “if not detected early or well managed.” 2
A dermatologists checks my skin every three months. To me that sounds “well managed.” I go to Boston, 90 miles from home, for these appointments. These trips can be tiring, but it’s the best medical care around. I assume that others in Skin Cancer Land are also carefully monitored.
Fear of skin cancer spreading
When looking up the relationship of skin cancer to stem cell transplants so I could describe it correctly, I came upon a report about a woman, with a history similar to mine, who died after a squamous cell cancer spread through her body. Another red alert! As I said, we need to remember that when we read about dire scenarios, or know of someone who had a bad outcome, it doesn’t mean the same thing is going to happen to us. Still, I kind of wish I hadn’t read it.
Do you sunscreen in the fall?