Results: Basal Cell Carcinoma

This afternoon the surgeon called and told me that the results of the biopsy showed that I have BCC, or Basal Cell Carcinoma of the eyelid. BCC is the most common form of skin cancer, and although a cancer diagnosis is never good, if one has to have some form of cancer, this is one of the best forms to have, because it's rarely life-threatening and is generally quite treatable. BCCs can become locally invasive and can cause disfigurement and permanent skin damage if left untreated, though, so prompt treatment is important. The only tricky thing about this BCC is the location: it's on my eyelid. That sounds so innocuous, doesn't it? When the PA at my dermatologist's finally agreed with the self-diagnosis that I'd made almost a year ago, I didn't understand why she immediately referred me to an oculoplastic surgeon. So when I got home, I Googled "lower eyelid cancer surgery" Images. Oh. Well then. OK. I see the need for the referral to an oculoplastic surgeon, because basically, the oculoplastic surgeon has to reconstruct the eyelid after the tumor is removed. 

I'm trying to balance out the positive and negative aspects of this. One of the negative things is that I've had this growth for well over a year, but one of the positives it that it seems to be nodular rather than flat and diffuse, and I think that's a big plus in terms of removal. Because I've had this so long, apparently it's more likely to recur, however, now I know what to look for. I'm grateful that I live in a place where I have access to excellent doctors who have experience doing this type of procedure.

I've been going to a dermatologist's office for annual skin cancer checks for over 20 years. I've just learned that eyelids are one of the most common sites for skin cancers to occur in fair skinned people, but not once in the 20+ years I've been going for skin checks has anyone thought to examine my eyelids. You've seen the pics of my eyelid. This BCC is just a tiny, pearly lump on the surface of my lower eyelid. It never bled or crusted over. It didn't hurt. The 2 main symptoms for me were loss of eyelashes where the tumor was growing, and a noticeable blood vessel going to the center of the tumor. It looked so innocuous that even when I made a special appointment 2 months after my annual visit and said the reason for my visit was that I'd been a bad patient and spent time on the net and was pretty sure this was a skin cancer, no one took me seriously, and it took 7 more months for anyone to believe me and biopsy it and confirm that it was indeed a BCC that must be removed, and the sooner the better. So, please, monitor yourselves.

Biopsy

15 September 2020 - So today I had the biopsy. I was told they'll have the results in approximately one week, at which time if it’s benign, I can decide whether I want it removed (YES) and if it’s malignant, there's no choice, I’ll be scheduled to have it removed.

 

I drove myself to and from the biopsy with no problem. For the biopsy, I did not wear the contact lens which I normally wear in that eye for reading. I was given an ice pack to hold against my eyelid for about 5 minutes before I went into the room where the procedure was done. Both eyes were then numbed with an anesthetic eye drop, after which the surgeon administered an anesthetic injection into my lower right eyelid. That stung a bit, but the eyelid became numb almost instantly. Then, keeping my eyes wide open, I had to stare up and to the left the entire time the biopsy was being done. That was actually rather difficult to do, because it meant that the very bright light which the surgeon wears on his forehead to do the procedure shone directly into my eyes the entire time. He had to go in twice to remove enough tissue for the biopsy. There was a slight stinging and tugging sensation as the tissue was removed, but really the most unpleasant part of the procedure was after the biopsy was over, when he cauterized the incision, because I could feel the heat and smell my flesh burning as that was done. Ugh. But the whole thing was over very quickly: 30 minutes from start to finish. Immediately afterward, my eye felt dry and my eyelid was so sore that I didn't even think about putting my contact lens in for the rest of the day. I turned down an eye patch, preferring the incision to be exposed to the air to heal. After I got home, I instilled Systane preservative-free dry eye drops in both eyes whenever they felt dry. Fingers crossed for the results.

Oculoplastic Surgeon Visit 1 2020.09.09

 

I like the oculoplastic surgeon. I met him on September 9, 2020. He asked me to state in my own words why I was there. He then carefully examined the lump on my eyelid and gave me some good news: he said it may not be BCC after all. He said it’s right on the borderline, in terms of characteristics. He said, “If this isn’t malignant, I won’t be surprised. But if it IS malignant, I also won’t be surprised. That’s why it’s got to be biopsied." I was momentarily surprised to hear this, because the Physician's Assistant at the dermotologist's office had FINALLY diagnosed it as Basal Cell Carcinoma. But then I thought back to when I'd worked as a clinician in pediatric psychiatry, about all the patients sent to us by other psychiatrists who had diagnosed them as Bi-polar, but whom we determined, after we'd examined them, had been misdiagnosed, and I realized that until a biopsy is done, diagnosing skin cancer by simply looking at the physical characteristics of the growth isn't really any different from that. So I’m going back on September 15th for the biopsy, but in the meantime I’m feeling optimistic.