Mohs Surgery

Yesterday, I went to the Lahey Clinic to have Mohs surgery on the squamous cell carcinoma on my right cheek.  Mohs surgery (named after the surgeon who pioneered it) involves taking a precise section of the tumor with small margins to preserve healthy tissue.  This section is then examined microscopically while the patient waits to see if any of the tumor remains.  If so, the area that was missed is further resected, and this process is repeated until the removal is complete.  In my case, it took two cycles to get it all.  I was there about 5 and 1/2 hours from start to finish.

I was a little concerned at first about the diagnostic letter I had received from my dermatologist, Dr. Reohr, suggesting this was a "possibly invasive" carcinoma.  Did that mean that it could possibly metastasize?  I was also a little freaked out by an article this past Sunday in the Boston Globe Magazine about a woman who also had a squamous cell carcinoma on her cheek that had metastasized.  After several years of treatment and remission, it has finally spread to her liver and she is now terminal.  It's a heart-wrenching story.  Gretchen asked me the day before I went in if I was nervous.  I told her no, since I didn't want to mention this poor woman's story to unnecessarily upset her.

I casually brought this subject up to the surgeon, Dr. Mollie MacCormack, and she said this was not an issue because mine was an in situ tumor.  In situ means it is confined to the upper skin layers and has not penetrated into the blood stream, so it has no chance of metastasizing.  A number of years ago, I had a Stage 0 melanoma in situ, which was also removed without any concern about metastasis, so I knew the significance of the term.  The letter I got from Dr. Reohr didn't mention that this was in situ, which would have put my mind at ease.  In any case, the bottom line is that Dr. MacCormack got it all and there is no further risk.

Before closing up my wound, the scalpel blade fell on the floor.  Mollie said there is no "5 second rule" in surgery,  so she got another one.  Thanks, Mollie, good choice.  My incision is near my right ear, so she had to stretch some skin to close the wound.  The attending nurse said I had just gotten the equivalent of a "lunch-time facelift".  That would be great if it wasn't just on one side.  At least I now know which profile to use in photos, assuming I'm not horribly scarred for life on that side.

Tomorrow we are driving down to New Jersey to visit Brian, Pam, and Logan to celebrate Logan's 4th birthday party on Saturday.  Wow, he growing up so quickly!  Jeff will also be joining us.  We plan to have dinner tomorrow night at the famous Peter Luger's steak house in Brooklyn.  That place is kind of special to us, because that is where we celebrated Brian's bachelor party.  It should be a fun weekend.