Just What The Devil Does Precancerous Mean?

I had this week’s topic all picked out, half my research done, and was chomping at the bit to start writing when the phone rang. I’d already been interrupted several times by Bear who just had foot surgery and couldn’t get around much.  I’d expected those interruptions, and was more than glad to help my sweet Bear with whatever he needed.Bear's foot

But the phone?  What made me pick it up?  I know how to let calls go right to voice mail if I need the time to finish whatever I’m working on.

It was the office of my dermatologist, Dr. Crystal Layton of Affiliated Dermatology here in Phoenix, a soothing, easy to talk to doctor. They had the results of the two shave biopsies on suspicious lesions I’d recently had during my annual full body scan.  (The second definition of lesion at The Free Online Dictionary at http://www.thefreedictionary.com/lesion is “A localized pathological change in a bodily organ or tissue.”)

The Mayo Clinic at http://www.mayoclinic.com/health/biopsy/CA00083/NSECTIONGROUP=2 explains a shave biopsy, the kind I’d had:  “During a shave biopsy, the doctor uses a tool similar to a razor to scrape the surface of your skin.”

shaveDr. Layton wanted me to know the as yet still unhealed biopsy site on my right forearm was benign.  Yay!  But wait.  The one on my forehead, the one I’d laughingly referred to as the hole in my head, was precancerous.

Just in case you need to know what happens to the biopsy material once it’s been collected, according to http://www.webmd.com/cancer/what-is-a-biopsy?page=2

“After the tissue is collected and preserved, it’s delivered to a pathologist. Pathologists are doctors who specialize in diagnosing conditions based on tissue samples and other tests. (In some cases, the doctor collecting the sample can diagnose the condition.)

pathologistA pathologist examines the biopsy tissue under a microscope. By noting the tissue cells’ type, shape, and internal activity, in most cases a pathologist can diagnose the problem.”

I knew that and I knew what a shave biopsy was and I knew what a lesion was and I still felt my stomach drop.  I also knew ‘pre’ didn’t mean cancerous, but there was cancer in the word.  We probably all know that ‘pre’ means before (from the Latin for prior).  Did that mean cancer was my inevitable future? Or my probable future if I didn’t do something about it?

Split second decision on my part.  “So, what do we do about that?” I asked, although I think I already knew the answer. The procedure is called cryosurgery (I can’t resist: cryo comes from the Greek for cold or frost.  Perfect!) which Dr. Layton’s medical group defines as “the treatment of lesions with the application of a cold substance.  In most case, liquid nitrogen is used to destroy the lesion.”cryosurgery

I made my appointment, ran to tell Bear of yet another one of those medical problems that seem to be ganging up on us lately, and came right back to my office to blog… and research.

How did this happen?  I’d had biopsies before but they were based on suspicious looking moles and were always benign.  I needed a source I trusted, so I went to Johns Hopkins Medical Library at: http://www.hopkinsmedicine.org/healthlibrary/conditions/skin_cancer/actinic_keratosis_a_precancerous_condition_85,P01335/ so, it was actinic keratosis we were dealing with this time.

What was that?  This is their definition:

“Actinic keratosis can be the first step in the development of squamous cell skin cancer, and, therefore, is considered a precancerous skin condition. The presence of actinic keratoses indicates that sun damage has occurred and that skin cancer can develop.”

I’m an optimist.  Notice the CAN in the definition?  That’s what I’m banking on.  That and the hope that my dermatologist can burn it all out so that it doesn’t get the chance to develop.

As for squamous cell, I needed help with that, too. I found it at http://www.skincancer.org/skin-cancer-information/squamous-cell-carcinoma.

“Squamous cell carcinoma (SCC) is an uncontrolled growth of abnormal cells arising in the squamous cells, which compose most of the skin’s upper layers (the epidermis). SCCs often look like scaly red patches, open sores, elevated growths with a central depression, or warts; they may crust or bleed. SCC is mainly caused by cumulative UV exposure over the course of a lifetime. It can become disfiguring and sometimes deadly if allowed to grow. An estimated 700,000 cases of SCC are diagnosed each year in the US, resulting in approximately 2,500 deaths.”Squamous-Cell-Carcinoma-in-Situ

The only risk factors I’d had were that I’d been fair skinned (I did notice my skin tone had darkened in the past decade since my move to Arizona) and I didn’t wear a hat.  I hadn’t thought I needed one since my curly dark hair always tumbled over my forehead thereby – or so I thought – protecting it from the sun’s rays.

I figured I’d better check this out to see if cryosurgery could have any effect on my kidneys.  I doubted it, but then I hadn’t known how dangerous the fluoride in toothpaste was either. I used the search term ‘liquid nitrogen’ since that’s what will be used for the cryosurgery I’ll be having.

While I may have scarring, there seem to be no indications that this substance enters the skin or blood stream much less that it exits the body via the kidneys.  Can’t exit if it never enters, right?

As for the scars, who cares?  I already have a scar on my forehead from a previous shave biopsy in this exact spot about eight years ago. That one came back benign.  Things change; be vigilant!

1395242_10202162033990289_511259525_nSince we’ve been absorbed with Bear’s surgery for the last week, there’s nothing to report on either book sales or SlowItDown.  The big news is that Nima, my daughter and computer guru, is in the process of adding a media and press page to this blog.  Thank you, Nima, for doing your best to keep me current.  I know I don’t make it easy.

Until next week,

Keep living your life!

My Turn For A Biopsy

I’m back!  But not quite on the Chronic Kidney Disease mark yet.

You see, I went to my dermatologist – my skin specialist.  That’s something I do out of duty to myself every five years or so.  There are multiple instances of melanoma in my family history so I took it upon myself to undergo a full body scan at least that often. According to the Merriam-Webster Dictionary of Medical Terms, a melanoma is “a benign or malignant skin tumor containing dark pigment.”

The doctor usually finds some little skin tags that can be snipped off so they don’t get in my way or some suspicious mole to be scrapped off so it doesn’t turn into cancer later on. This time was a little different.

Dr. Crystal Layton of Affiliated Dermatology here in Phoenix is a soothing, easy to talk to doctor.  And we did talk.  She found a couple of lesions that looked suspicious to her and asked my permission to freeze them off. I never agreed to anything so quickly before (except maybe co-habiting with Bear). The images of different melanomas are provided by sunsafekids.tripod.com.

The procedure is called cryosurgery which Dr. Layton’s medical group defines as “the treatment of lesions with the application of a cold substance.  In most case, liquid nitrogen is used to destroy the lesion.” Cold vastly understates the actual feeling.

Lesion sounded like a dirty word to me so I looked it up. The second definition of the word on The Free Online Dictionary is “A localized pathological change in a bodily organ or tissue.” *sigh* That helped. While blisters did form as my dermatologist warned me they might, the one on my face is (thankfully) dried up and gone while the one on my leg is in a slightly uncomfortable holding pattern after eight days.

I’ve always believed in not sweating the small stuff and this is small stuff in comparison to what happened next. You guessed it.  One week after losing a family member to breast cancer, I had not one, but two, biopsies.

Being an eternal optimist, I was not even thinking about the possibilities this could bring to mind until I got the results.  I’m great at acting immediately when necessary but also great about waiting until there is a necessity instead of going off half cocked (so glad Bear gave me a gun education when we met so I could comfortably use that term).

This may be a little hard to believe but just as I was about to hit the publish button on the blog site, my internet went down.  I immediately got a call from the dermatologist’s office telling me the biopsy came back benign (harmless)… and the internet came back up. Wow!

Referring to another of Affiliated Dermatology’s handouts, I confirmed my thinking that, “A biopsy is the removal of a small sample of a growth on the skin by your dermatologist. The sample is then sent to a pathologist, a doctor who examines this sample under a microscope and renders a diagnosis regarding the type of growth of disease present.”

The area was numbed so I could have watched the process if I’d cared to (hah!).  I am a firm adherent to recent research findings that NOT watching a medical procedure lessens the patient’s pain (none here) and anxiety (well…).  I attempted to take photos of the bandages myself, but the results were laughable.  See, I can find humor in anything.

As usual, I had to know exactly what the procedure was, and without watching it. Medilexicon was really helpful here.  They define the punch biopsy as “any method that removes a small cylindric specimen for biopsy by means of a special instrument that pierces the organ directly, or through the skin, or a small incision in the skin.” You can find this at:        http://www.medilexicon.com/medicaldictionary.php?t=10355

Dr. Layton performed a punch biopsy, and I’ve got the three stitches to prove it! The stitches don’t bother me a bit since the pressure bandages protect them. Depending upon which source you check, pressure bandages are used to stop bleeding (if I bled, I didn’t know about it) or to prevent fluid from accumulating in the wound. Unfortunately, the keloids (extra scar tissue formed over a wound) from biopsies in the same area twenty years ago may now have keloids of their own.

I actually saw the ‘plugs’ that were removed from my breast. It’s not something a doctor usually offers to show you, but since all my questions were answered as I asked them, I figured I’d ask to see the plugs. And they were shown to me. Oh, thank you to ehealthimages.com for the diagram.

I simply can’t think of a smooth transition into book news. I am so delighted with the biopsy results. So I will just switch.  Sales are growing which was a surprise to me since I hadn’t bothered checking. I’ve also gone back to donating to doctors’ offices and anywhere else people might find the book helpful.  Have you read my FB and Twitter offer to send you a free book when you donate to any kidney affiliated organization?

I still maintain it’s more important to get the information to people when they need it, where they need it, than make a million dollars. I wouldn’t mind recouping my expenses, but the book was never meant to be a money maker for me.

It is exhausting writing about your own health issues!

Until next week,

Keep living your life!