Squamous Cell Carcinoma

Factual Questions
1

I am not a doctor. Lemme get that one out there immediately.

But I had what I thought for the longest time was just a zit on my neck. My BF, who has had medical training (for when he was on long sailing races, etc), tried to lance it after I complained it had been there for a month. It didn’t help. Then my lymph node on the left side (same side as the "zit) became swollen like a golf ball. THAT he made me go see the doctor for.

I did not connect the two at all. I thought it was a blasted ZIT. Okay, this doc tells me it’s probably a cyst, and the node is most likely trying to fight of the infection around the zit. He sends me to an ENT specialist in Oakland (I am in SF), and the specialist, Dr. Lweis, thinks, yeah, it’s most likely a cyst, but he feels it should come out, or the possibility of it recurring would be good.

So I go to his office, he excises the cyst, we chat through the whole procedure. I like this guy a lot. Very calming, asking me every few minutes “Are you all right, am I hurting you, do you feel woozy at all…” I was fine, and was thinking - hell, after all the dental problems I’ve had, this is nothing. (Dental problems, different thread, most likely PIT bound.)

So, on Tuesday the 1, I head to his office to get the stitches out, Even I can tell what a fantastic job he has done - the skin is mending very well, there will be barely a scar once it’s all healed. He was careful to make the incision in a natural fold of the neck so you’d barely see it once it was fully healed.

So, I am sitting in his office waiting - for 45 minutes. But hey, it’s just stitches and I am reading the new Michael Chrichton (you know the one - where he tries to debunk global warning and all other environmental woes). Finally, Dr. Lewis comes in and sits down and smiles at me with his warm, generous smile. The smile that reassures me, because I know he’s studied at the Sorbonne in his youth, he’s spent a year in India doing relief work, and the week before I saw him, he was on a mission to the Phillipines for a week doing charitable medical work. He’s a fantastic, interesting fellow.

He gets on his little backless stool and scooters around the room, and approaches me sitting in the big medical chair and says, “Hi there.” I smile in return. I tell him Dr. Hebrard (doc who referred me to Lewis) thought he had done fantastic work and that the healing was excellent. He smiled in a genuinely modest way, and looked me straight in the eye - I love that about this guy - he is HUGE on eye contact, and said, “Well, it turned out to not a cyst after all. It was a tumor.”

Cut to Inky falling through the floor on an express elevator to hell. Well, that’s an overstatement, because I think I was in too much shock. When I am in shock, I smile, nod my head a lot like I am agreeing with him, and am very pleasant. You could ask me for anything when I am in shock, and I’d most likely agree to it. You get the idea.

Well, he was reassuring and said a lot of things that I confess I didn’t hear. But I DID hear him say that he wanted to biopsy the lymph node under my chin, as a precautionary measure. Now, Inky’s BF did not come to the stitch-removal appointment because it was supposed to be just stitch-removal. But BF DID most certainly come to the next appointment because he knows how I get when I am freaked out.

So, the questions were asked - it’s squamous cell carcinoma, which usually forms in cells that have been burned (like in a fire or something) in the past. Not me. Or it forms in scar tissue. Not me. Or in overexposure to the sun with bad burns. Not me.

It seems that the pathology report on the tumor said it was a good excision because there were normal cells all around the tumor, leading them to believe that they got it all.

However, the lymph nodes are of concern. So he stuck me with a needle seventeen thousand times without anesthesia (for some reason, a local anesthesia would cause the node to change shape, and he didn’t want that). He got a great random sampling of cells - I know cause I wanted to slap him, this doc that I adore.

Best case scenario, they may go back into the initial incision and remove a little more tissue around the area to make sure that the margins were large enough. Worst case, they would either remove all lymph nodes on the left side of my neck, requiring a night in the hospital and general anesthesia. Or radiation. They doubt they would have to do radiation AND the operation, but Dr. Lewis wanted to put it out there as a possibility.

Ao after my sob story here (and I apologize for the length), I was wondering if anyone had any experience with Squamous Cell Carcinoma, it’s recurrences, treatments, and any other pertinent experiences.

I am not looking for doctor-type information, unless it is pertinent to your comments. My doc seems to be a good guy. I am just looking for additional information from fellow Dopers. Will you guys be my friends while I am in this personal pity-party?

Inky

Sorry, I know I am being self-concerned right now, but I only found out on Tuesday, and I am still feeling a little “ME” about it.

2

I wish I could tell you something authoritative and useful and perhaps even reassuring, but I can’t. I have had a chunk carved out of my back, but I am not even clear on what kind of skin cancer it was. I’d just like to wish you the best of luck.

3

First of all, Inky, yes, we are here for you. Moral support is one of the things this community does best.

I know what you mean about not remembering what your doctor said. My wife’s oncologist tape-records visits like yours, and gives the tape to the patient. He says when you start talking about cancer, the patient often gets so rattled that nothing is remembered. You might want to take a recorder with you next time you go.

4

Thanks. You may have it right. I am generally good and carry a notebook for questions by the C word thre all that out my brain. Good thought, though, and I am grateful.

And yes - thanks for the moral support. You have no idea what it means.

Inky

5

I know a little bit about this as I have a family member who had the same type of cancer elsewhere on the head. Based on this, I think you’ll be asked to return for periodic follow-up visits to check that there is no more cancer present. Also, it may help to speak with another patient who has already had a similar procedure done. I know that helped my family member.

6

Wow, I suppose I am surprised more folks haven’t had to deal with something like this.

Don’t get me wrong - the responses here have been fabulous and helpful. Maybe I chose a wrong title or something.

At any rate - thank you deeply to those who responded.

Inky

7

I’m not a doctor, but I am a medical writer with some great M.D.s and Ph.D.s (including many cancer researchers) as sources.

Here’s a snippet of a story on melanoma I wrote that should let you rest easier:

"American Cancer Society statistics show that half of all Americans who live to age 65 are likely to have skin cancer at least once.

Ninety-six percent of those cases will be non-melanoma cancers such as basal or squamous cell carcinomas-cancers that affect the middle and lowest layers of the skin, grow slowly and rarely spread. As a result, they are nearly 100 percent curable when diagnosed at an early stage."

Sounds like your carcinoma was diagnosed early. Some people have those for years – even decades – before getting them evaluated.

Added bonus: a friend of mine had your kind of cancer removed when she was 26. That was 11 years ago and she’s had no problem since.

Hope this helps :slight_smile:

8

oh golly, that makes me feel a whole lot better.

If the results on the lyymph node conme back negative then I am buying you a beer/beverage of your choice!

Inky

9

It wasn’t skin cancer, but I have an aunt who had cancer in her early 20’s, it was caught early, successfully treated, and she’s now almost 50 years past that without a remission. So cancer is not necessarially the end of the world, OK? It’s scary and nasty, but lots of people survive it, especially with modern medicine and all the advances of the past couple decades.

IANAD, but squamous cell is not as aggressive and deadly as melanoma. It grows much slower and, as someone else said, spreads slowly when it bothers to spread at all. Yours was probably caught early, they docs are just being cautious, and now that you’ve had a skin cancer you’ll need to watch your skin for the rest of your life… but now that you know what the little beggers look like and you’re on the lookout you should catch any others (if you even have them) even earlier.

Try to stay as calm as possible, listen to your doc, and come back and let us know how you’re doing, OK?

10

“Squamous” always reminds me of the dogfish sharks we dissected in high school. The technical name of the dogfish is “squalus acanthias.” The squamous cell carcinoma is not as agressive as the dogfish, though.

11

Reminds me of that scene is Jurassic Park:

“Dodgson! We’ve got Dodgson here!!!” See, no one cares!!
SQUAMOUS. SQUAMOUS!!! See, nothing to worry about.
aaaaargh. Or so I keep telling myeslf. PET scan today.

Broomstick I know I will have to be careful in the sun for the rest of my life, but does that rule out vacations? I was honestly hoping to get to the Jamaicas or Puerto Rico and now BF is second-thinking it. I told him if I wore SPF9000 I should be okay. I was never a lay on the beach-type, but I am a lover of swimming in the ocean. I can get a waterproof and reapply afterwards and then sit in the shade and read, can’t I? (I understand YANAD.)

12

Okay, IANAD, but I have to say… I find it hard to imagine that you should really be worried about taking vacations, because of this. I mean, yes, you should definitely wear sunscreen and not fry to a crisp–just like everyone shouldn’t. I think you should also take it as a given that you will get more cancerous spots in your life, even if you never go outside again. I basically don’t know anyone over 40 who hasn’t had at least one taken off, and I know plenty of 20-something former lifeguards who have had half a dozen. I had my chunk carved out when I was 22 (it was basal), and I have never gotten a tan on purpose in my life.

I dunno. I find the scars sort of poignant. Look! I’m mortal!

13

Thankas for everyone’s kind words and advice. Biopsy was negative,no surgery, no radiation, it’s all good.

I appreciate everyong sharing with me. It helped ina major panic mode for me.

Now, is it NORMAL to have a reaction like, I just girded my loins for ther battle of my life, and then everyone else on the field went home and I am left there standing alone, saying, “What the hell?”

Mebbe it’s delayed reaction. I am grateful, believe me!! But I am also hitting my anger stage…was I supposed to do that earlier, or once I was diagnosed as positive? Is it okay to be angry now?

Any rate, y’all have been stupendous. Thansk for everything. Just wanted to give an update, in case anyone ever was watching.

Even thogh my name is not Truman. And I am not that nice.
Inky

14

DAGGONE IT, SPELL CHECK PLEASE.

I am not illiterate. I am just self-taught at typing.

Crud.

Inky

15

Well, of course it’s best to consult a dermatologist…

However, a very high SPF sunblock reapplied frequently would certainly be a good idea in sunny climes. If you throw a shirt over yourself, or elegant caftan (something flowing and classy) it will provide even more protection AND make a fashion statement (think creatively! - but thin, sheer clothing requires sunblock underneath it, as the sun can penetrate it). Beach umbrellas are a good thing. I would expect a wetsuit would also protect large areas of skin, but I’m sure of the feasibility of that for casual swimming.

I’ve had extremely sensitive skin all my life - I’m a white streak dashing from tree to tree all summer. Sunblock and loose clothing, along with a hat (which can also be quite dashing and feminine, or outdoorsy and adventureous, depending on your mood) are your best friends.

And, like anywhere, avoid the direct sunlight between 10 am and 2 pm local time. (Only mad dogs and Englishmen go out in the noontime sun, anyway :wink: ) Time your extensive outdoor time for morning and evening. By all means, discuss practical sun protection with your doctor. You needn’t stay inside for the rest of your life, but you will need to think more about your sun exposure in the future.

16

You feel how you feel. Cancer IS a serious thing, even a “little” or “minor”, or “early” cancer. Yeah, your reaction seems pretty normal, compared with other folks I’ve known with similar cancers that, it turned out, were caught early and easily treated. The news is shocking at first, it takes some time to sink in, and then you ride a bit of a roller coaster until things settle down again. You’re OK, hon, and it’s alright to be stressed and upset over this. Take a deep breath, you’re going to be OK.

Glad to hear it was relatively good news. Try not to get too paranoid. And regular visits to a dermatologist are probably a good idea. If you play your cards right and take care of your skin, you might wind up looking better in your 60’s than many women who give no thought at all to these things.

17

Yes, it’s ok to be angry. You’ve just been given a very strong dose of “I’m not immortal”. It’s sudden, it’s scary and it’s worrisome.

So be angry, yell at the world in general, and then hug your BF, find out all you can about reducing your chances for a reoccurance, and take the vacation.

18

I’m glad everything has gone well for you. I remember when my son had heart surgery…well, it was a little-bitty heart surgery and… :dubious: …

Anyway, I live in the south and on the coast, so squamous cell is pretty common down here. My uncle went untreated for a while and lost a small margin of his nare (edge of nose). No recurrance. My friend had one on the cheek and has a dimple there now. Also no recurrance. My friend is a hair stylist and has recommended visits to the Doc for some of her clients (which makes me wonder if hair cutters should be trained to spot the spots!).

Best Wishes~

19

Always wear sunscreen.

Always wear sunscreen with an SPF 30. (Neutrogena & Oil of Olay have good facial sunscreens wtih a 30 rating.) Then you can coat the rest of your body with the run of the mill SPF Generic/ No-Ad sunscreen.

Always wear sunscreen even if you live in a shit state like Michigan.

The highest rating really is a 30. Anything with a higher number (45) is really only a 30+. Giving you only a few minutes longer protection. It is all marketing.

Reapply it often. Like four times a day if you live in sunny climes. Wear hats with brims on it. Long sleeves.

Don’t forget lipbalm.
Glad you are given the all-clear.

View that as a second chance in life.

20

I went through the exact same thing a couple of months ago. Except the doctor said:

“I’m sure it’s nothing, and even if it is melanoma we have plenty of options.”

At that point, my hearing also completely vanished. And it was a l-o-n-g two weeks waiting for the biopsy. Mrs. Kunilou was totally fine, prefering to save her emotional turmoil in case the news was bad. I was nervous, but spent a lot of time looking stuff up on the 'net, so I kept occupied. Oddly enough, it was an old friend of mine who broke down and cried.

Yes, everything is fine. Yes, I felt both relieved and cheated.

And yes, I look for moles a lot more often.

Here are two tips:

  1. Sunscreen is your friend.

  2. If you have any freckle, mole, birthmark, lesion, funny spot or anything else that can’t be completely hidden by the eraser end of a pencil, have it checked out.