Welcome to Mohs!

My appointment was at 8:30 a.m. I arrived in the second waiting room about 9:45 after having the first stage of treatment. As I walked in I said aloud, sort of to the surgical tech who escorted me, but mostly to myself, “Ay. They’re all wearing bandages!”

It was my attempt at an allusion to a line in the 1960 movie The Grass is Greener. Deborah Kerr walks into the billiard room and exclaims, “Ay. They’re all wearing glasses!” It’s one of my favorite movie quotes ever. You need to see the movie. It’s available on YouTube, Amazon Prime, and Google Play.

Anyway, no one seemed to think I was funny as I entered the room, having declared that they were all wearing bandages. An allusion isn’t meaningful if one doesn’t know the original work that is referenced. No worries. I didn’t say it for them. It was to entertain myself.

So, there are six of us stuffed into a small waiting room. Four are wearing bandages on their noses, one on his chin, and one on her neck (me).

We’ve all gathered here after having Mohs surgery. Ever heard of it? I had not.

Mohs surgery is named after the doctor who developed a procedure in the late 1930’s called chemosurgery. It wasn’t well known until the 1960’s when Perry Robins, MD, studied with Dr. Mohs and developed it into a procedure called Mohs micrograghic surgery.

It’s thought to be the gold standard treatment for basal cell carcinoma and squamous cell carcinoma, the two most common types of skin cancer.

The treatment involves scraping layers of skin and testing them through the microscope. Layers are scraped and tested until the cancer is gone. The patient waits at the doctors’ office between the scraping and testing. On the morning I was there, four patients had to have only one scraping. Three others had more than one.

They tell you prior to treatment to plan on being in the office for 2-4 hours. For me it is was 3. Fortunately I was one of the four whose cancer was removed in the first scrape. The doc said my cancer was very small.

Two weeks ago I went to the dermatologist for a head-to-toe check up where the doctor, or in my case, Sandy, a Physician’s Assistant (PA), looks everywhere on the outside of one’s body for things that might be skin cancer. She found a tiny pinkish grey “freckle” on my neck that she said might be basal cell. I hadn’t ever noticed it.

She gave me a shot in my neck, injecting a local anesthesia, and scooped out a piece of skin for a biopsy. I received a call a week later to confirm that it was indeed basal cell. We scheduled the Mohs surgery for the following Monday. That was the first time I’d ever heard anyone utter the name Mohs, except for homophone Moe’s!

Since then I’ve been reading up on it. And, at the same time, checking out the doctor who would be doing my procedure. I was not intimidated by the description of the surgery. I was pleased with my doc’s creds. He trained at M.D. Anderson. Having grown up in Texas, I have long been familiar with this preeminent cancer research institute affiliated with the University of Texas Health Sciences Center in Houston. It’s the “cat’s meow.” My doc also completed a fellowship and is a graduate of the American College of Mohs Surgery. It’s the highest level of training there is for this particular procedure. OK. I feel comfortable that I’m in good hands.

The procedure was really uneventful. Once again, the most painful part was a little stick of a needle for the local anesthesia. Well, that and when they peel off the sticky-backed paper they put around the surgical site to keep it as sterile as possible. I have a few sutures that will be removed in two weeks.

I’m glad to get it over with so I don’t have to worry about the cancer. Basal cell carcinoma is the baby of all cancers and the most common of all cancers. Almost no one ever dies from basal cell. It doesn’t generally spread to any other part of the body. But, it will continue to grow and could cause disfigurement if not treated.

I encourage you to get your head-to-toe check up if you haven’t had one in a year (or ever!). I wouldn’t have noticed my little pink-grey spot for a while, I guess, had I not been seen by the PA. The check up is not embarrassing. The professionals treated me with the utmost respect and I never felt uncomfortable.

My cancer was little and not serious. But they could find melanoma which is a much more serious type of skin cancer. It can be metastatic, and lead to death if not treated early.

So, don’t delay! Get on your merry way! (to a Board Certified dermatologist).



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