Skin Stats and Stitches

I grew up southern. Our summers started in March and our clothes came off as the temps stayed high for the next 9 months.

I worked shirtless for summer jobs that included life-guarding at a summer girl’s camp. I fished from a river barge on the Tennessee one summer-long.

I didn’t wear caps. They didn’t play well with my shaggy blond hair. Tomorrow, I pay.

But I am not alone.

[su_quote]”A new Mayo Clinic study found that among middle-aged men and women, 40 to 60 years old, the overall incidence of skin cancer increased nearly eightfold between 1970 and 2009.”[/su_quote]

Much of that number is non-melanoma skin cancer–squamous and basal cell cancers. I have the latter. Again. Third time’s charm.

Most of these are first noted as “actinic keratoses” or pre-cancers, which I zapped chemically this time last year with Efudex. You may remember it was  not a pretty picture. This time, surgery will be required.

The bad news is that this one is on my face, right over my upper molars. The good news is that it was not large or deep, even though it has been showing up and disappearing off and on for more than a year. The bad news is that the incision will NOT follow my jaw-line and be covered by my beard. On no. It will follow the “grain” of the underlying dermis and run more or less vertically. I am thinking of getting an eye patch. Arrrrgggghhh!

Two percent of squamous cell CA goes on to kill the patient. Basal is rarely fatal but often disfiguring. And so I questioned my dermatologist why Mohs surgery would not be used–a method of biopsying each level of tissue removed before going wider and deeper so that enough is taken but not too much. This is typically used in cosmetically-important body places.

I consider my face cosmetically important. I could be wrong about that.

But I’m having the deed done by a plastic surgeon to, er, save face.

So for a week, I’ll be bandaged and stitched. I’ll have to put my head in a plastic bag from my neck up to take a shower. No wait. You’re not supposed to do that.

And I’ll scare little children. And the Radford University students I’m lecturing a week from today.


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Fred First holds masters degrees in Vertebrate Zoology and physical therapy, and has been a biology teacher and physical therapist by profession. He moved to southwest Virginia in 1975 and to Floyd County in 1997. He maintains a daily photo-blog, broadcasts essays on the Roanoke NPR station, and contributes regular columns for the Floyd Press and Roanoke's Star Sentinel. His two non-fiction books, Slow Road Home and his recent What We Hold in Our Hands, celebrate the riches that we possess in our families and communities, our natural bounty, social capital and Appalachian cultures old and new. He has served on the Jacksonville Center Board of Directors and is newly active in the Sustain Floyd organization. He lives in northeastern Floyd County on the headwaters of the Roanoke River.

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  1. As you know, Fred, I can well identify with what you’re going through, although (so far) I haven’t had to undergo such major treatments as you have. I imagine my time will come. Good luck tomorrow!

  2. Good luck buddy. Having gone through removal of skin cancer (thankfully, also basil cell) and plastic surgery (reconstruction of face after motorcycle crash) I’m confident it will work out. Let us know if you need anything.