I visited a dermatologist last week for a routine yearly examination. This is a ritual debasement in which I have to strip down and a doctor scans every inch of my pasty flesh, looking for anomalies. Like she usually does, she scanned me and said I was boring, nothing exciting at all (this is the comment I always get from women.) Then she noticed something…
“What’s this circular brown spot on your abdomen?”
“Oh, it’s nothing — I got spattered by some hot liquid in the kitchen…”
“OK, nothing to worry about then,” as she turned to fill in some forms.
“…a couple of years ago.”
She perked right up at that. Something interesting at last! It hasn’t healed up at all well over the last few years, so something is going on there.
She quickly whipped out a hypodermic and numbed the skin, and then did a shave biopsy, which was not fun. It wasn’t particularly painful, but now I’ve got this small wound I have to wash and bandage every day, and it hurts. Nothing at all debilitating, more annoying than anything.
I got the results from the lab yesterday. It’s a benign squamous cell carcinoma in situ.
Gross Exam:
Received in 10% NBF is a shave biopsy that measures 6 x 5 mm. The specimen is divided into 2
sections. All of the tissue is submitted for processing.Microscopic Exam:
There is hyperkeratosis and acanthosis, but no significant dysplastic changes within the
epidermis. The dermis contains a mild, nonspecific inflammatory cell infiltrate.
Fortunately, I have taught cancer biology for years, so I know all the lingo. There’s nothing to panic over.
To be on the safe side, though, I have been scheduled for in-patient surgery for mid-August, after the biopsy damage has healed. They’re going to scrape off a big patch of skin, about a centimeter across, to scour out all the nasty little cancerous cells. That’s the part I dread: if this little biopsy slice is hurting right now, that bigger extirpation is going to hurt even more.
Boy, this summer sucks.
This is called Bowen’s disease, and it is not benign just because it technically can’t metastasize.
I’m just using the term the doctor used. I think generations of soap opera watchers have learned there are only two kinds of cancer, benign (good) and malignant (bad!) so she was phrasing it in the most non-threatening way she could.
Yeah fair enough. I should have said, it can’t metastasize yet. Have it cut out.
I was a soccer referee in SoCal for 25 years. My dermatologist frequently finds work the the itinerant MHOS surgeon that comes to the office every month. For a while it seemed I was keeping him in business. No biopsies need last week for a change. I think there was one each of the last three visits. Very annoying, but at least everything has been caught early before it had a chance to turn nasty.
I’ve had one melanoma and one BCC, still waiting for a SCC to get my skin cancer trifecta. I have my next dermatology appointment July 8. What would I tell my younger self?
“Wear sunscreen, jackass.”