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!