Easy, Peasy Cryosurgery

This is the feel good blog, the one to reassure you about a medical procedure.  I have a friend who worries that my blogs scare people… and maybe they do, but they’re meant to be informational – just informational.  Except this one.  This one is definitely meant to be reassuring.happy-woman

With all the medical messes, we’ve had lately (she writes as her chest burns and a headache creeps in) the solution to this one was the safest and quickest. The procedure to correct it is non-invasive, doesn’t enter the body in any way, and – therefore – is totally safe for Chronic Kidney Disease patients.

I know, I know, slow down.  Okay, from the beginning:

Skin cancer is responsible for almost half the cancer cases. According to the American Cancer Society’s “Skin Cancer Facts,” it is expected there will be 76,600 cases of melanoma this year alone. Melanoma, the most dangerous of the skin cancers, has made its unwelcome appearance in my family, so every year – well, it’ll be every six months after this episode – I submit to a full body scan by Dr. Christle J. Layton of Affiliated Dermatology right here in Glendale, Arizona. I say submit because I’m an old fashioned prude these days.  However, she does manage to put me at ease each time.

During this last exam, Dr. Layton found something on my forehead… but it wasn’t cancerous, just precancerous.  That, of course, was enough to get me researching.  Here’s where I insert the usual disclaimer: I am not a doctor, folks, just someone with CKD who doesn’t want to make her kidneys function even less effectively because she unwittingly had some medical procedure she shouldn’t have.

IMG_4813What Dr. Layton found is called actinic keratosis.  This is also called solar keratosis and senile keratosis.  I immediately latched on to the last name for this kind of precancer.  According to http://www.healthy-skincare.com/senile-keratosis.html, “Senile keratosis is essentially a form of solar or actinic keratosis. However, the difference is that the senile form of this skin condition specifically refers to the elderly. Generally, this form of keratoses appears in individuals who are older than 50.”  That’s the second time in one week this 66 year old has been referred to as elderly.  Oh right, don’t get side tracked.

Then I checked solar keratosis and found the following at http://solar-keratosis.com/, an Australian site. “Solar Keratosis (Actinic keratosis) is a common premalignant skin lesion seen on areas of the body that have been exposed to sun. Premalignant means that the lesions have the potential to become skin cancer.”

So, solar, senile and actinic keratosis are the same precancerous condition.  One thing that disturbed me about the information is that while I am light skinned-  and so – prone to this type of precancer, it was on my forehead.  Those of you who know me also know that I always have curls tumbling down across my forehead, including the affected area.  This means it wasn’t exposed to the sun and I avoid the sun at all costs anyway.  This IS Arizona.

I was puzzled and dug further. MedicineNet at http://www.medicinenet.com/actinic_keratosis/page2.htm must have been listening to me.  This is what I found there: new headshot

When patients are diagnosed with this condition, they often say, “But I never go out in the sun!” The explanation is that it takes many years or even decades for these keratoses to develop. Typically, the predisposing sun exposure may have occurred many years ago. Short periods of sun exposure do not generally either produce AKs or transform them into skin cancers.

I do remember being talked into (I didn’t develop this strong personality until later in life) using aluminum foil to make a sun reflector so I could tan as a teen ager.  I was so fair that it never worked.  Come to think of it, no one really knew about the ultraviolet rays of the sun/skin cancer connection at that time.  Did they?

Ready to find out about this painless, quick, non-kidney threatening treatment?  It was cryosurgery, which I’ve discussed before.  The simplest definition is the one I found at WebMD: “Cryosurgery is the process of destroying a skin cancer (lesion) by freezing it with liquid nitrogen. Liquid nitrogen is applied to the lesion using a cotton applicator stick or an aerosol spray.” You can find more information about this at http://www.webmd.com/cancer/cryosurgery-for-nonmelanoma-skin-cancer.

When Dr. Layton was done spraying the area, I asked her what was next.  She started telling me I need to clean the area with soap and water, then pat it dry.  I thought that was an odd answer and asked again.  We both realized at the same time that there was no ‘next’ for this procedure.  It was done.cryosurgery

Sometimes, there’s a blister after the procedure.  If so, I was to use an antibiotic ointment and perhaps a band-aid over the area until the blister dries. I may have a scar.  Good, maybe it’ll balance out all the scars on my arms (carpal tunnel surgery, a crazy very big dog we had, bad attempts at food prep and ironing, etc.).  It may also remain white.  Who cares?  It is under my curls, as I’ve mentioned.

I never experienced the burning sensation or pain that others might in the first 24 hours.  It, well, spidey tingled. Whoops!  I think I’m aging myself again.

I am relieved and gratified that this was so simple.  I’m also gratified that European sales of the book are doing so well.  Please spread the word that if you have EVER bought a print copy of the book on Amazon, you can now buy the digital edition for only $2.99 instead of the regular $9.95.Book Cover

I have been sick for ever, or maybe it’s more like 10 days, and have had to cancel attending numerous events (like SlowItDown’s kidney education class on the Salt River Pima – Maricopa Indian Community,  some Landmark events and classes,  appointments with friends).  The world didn’t end.  Lesson learned: rest when you need to; the world will be waiting when you get back.  Thank you to our children and neighbors for coming to our rescue when we just couldn’t do for ourselves, to the EMTs when Bear’s fever was out of control, and to those who kept my spirit up via texts and Facebook posts.  It got us through!

Has anyone ever read an advice column called Dear Annie?

Until next week,

Keep living your life!

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!