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When Good News Isn't Great News

Typically, receiving good news can make us feel great. Ecstatic, even. Like all is right in our world. But there are other times that receiving good news doesn’t always make me feel all that good.

Another excision

Like yesterday, for instance. Three days ago, I had an excisional surgery to remove a small area of basal cell skin cancer from my chest. My dermatologist did the surgery in her office over my lunch hour. An excisional surgery is a relatively fast procedure, and I was in and out of her office in just over half an hour and then went back to work. My doctor told me she should receive the results in a week or so and would call me.

Not great news

Last night, my phone rang and I saw that it was Dr. K. She said, “We’ve got the results back,” and then she paused. And my heart sank. She told me that we have clear margins, but they are narrow margins. I realized at that point that I was holding my breath. Dr. Keller reassured me that this doesn’t mean that we have to go back in and do another surgery to cut out more tissue, and it doesn’t mean I’m going to get skin cancer in the same place again, but that does mean we need to keep an eye on it.

What does it mean?

As a background for anyone unfamiliar with excisional surgery, it's a common procedure to treat skin cancer. It basically means that a dermatologist surgically removes a suspicious area and the area around it. The area around it is called a "margin," and the derm removes it to make sure all the potentially cancerous cells are gone. Then it's sent to a pathologist who makes sure the "margins" are clear, or free from cancer. This basically means that enough was cut out to get all the cancer.

In my case, this time the margins are clear of cancer cells, but apparently not by a whole lot.

I just didn't expect it

I’ve had more than a few excisions to remove skin cancer over the past 24 years, and if my memory serves me correctly I have had one other instance of a report of "narrow margins" (and thankfully had no recurrence of skin cancer), but it’s been so long ago that happened that I wasn’t expecting to hear it.

So, I will keep an eye on this area. If there’s one thing I’m good at, it’s keeping an eye on my skin. In fact, I’m pretty sure I subconsciously do a skin check every time I look in a mirror. Almost all of my skin cancers have been on my face and chest, and I frequently check for any new, unusual places.

I'm just tired of this

I am thankful that no additional surgery is necessary (honestly, I can’t imagine getting a freshly excised area cut open again), but daggonit, I’m tired of this. I’m tired of having skin cancer. I’m tired of getting stitches. I’m tired of wondering when I’m going to have a new area pop up. And I’m tired (literally) because I can’t find a comfortable sleeping position due to the area where my excision is, and I wake up every time I turn over because it hurts. I know I should be happy with the good news that all the skin cancer is gone, but right now I’m having difficulty rejoicing.

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