I had melanoma on 6/21 and in 1/25 Squamous cell in close area.

Posted by lokorn @lokorn, May 11 9:25pm

The melanoma needed 3 biopsies and was determined to have gotten it all. The incision healed very well and is not noticeable at all. Three years later --1/25--I had Squamous cell area removed which was below the right eye and just to right of nostril. After 1 1/2 years the scar is still noticeably visible and there is a "bump" still at the top of the incision.
If I have the area opened to see why this problem might this irritate the area and cause the cancer to return?

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@lockorn. Welcome to Mayo Clinic Connect. If I understand correctly, you had melanoma confirmed by biopsies and treated successfully as verified by clear margins. You then had a squamous cell carcinoma that sounds like it was removed by surgery (Mohs?) and closed with stitches, where there’s now a bump.

These types of little bumps can be due to a few reasons, such as a fluid collection, scar tissue build up, a retained suture - which the provider who performed the procedure or another qualified medical professional should look at to evaluate. It would be unusual for the cancer to return once clear margins had been determined and treating it properly would not be a reason for it to do so.

Have you been or would you be able to go back to where these had been treated?

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If you are concerned with the cosmetic results you could return to the surgeon for exam and discussion on scar revision. Laser or injections are some options.
I have had “absorbable” suture surface on year later.
More surgery can be problematic in some delicate anatomical areas.

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Yes, I have been back to have surgeon look at the scar and bump. We discussed going in (surgery?) and see what it the reason for the bump.
I am wondering if I should have another dermatologist look at the area just to be overly cautious, as this is close to my eye.
I am an outdoor person and love gardening, and I do wear large sun hats. And I love reading, so anything that might affect my eyes is very worrisome!

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Profile picture for lokorn @lokorn

Yes, I have been back to have surgeon look at the scar and bump. We discussed going in (surgery?) and see what it the reason for the bump.
I am wondering if I should have another dermatologist look at the area just to be overly cautious, as this is close to my eye.
I am an outdoor person and love gardening, and I do wear large sun hats. And I love reading, so anything that might affect my eyes is very worrisome!

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@lokorn Absolutely, this is certainly your right as a consumer. Seeking a second opinion is not to be confused with "doctor shopping" as this article from the American Medical Association explains. By doing so, you can verify your options and decide upon the best approach for you given the opinions and recommendations and possible reassurances expressed by each of the specialists.
https://www.ama-assn.org/public-health/prevention-wellness/second-opinions-are-good-idea-there-are-caveats
Do you feel that there is something holding you back from obtaining a second opinion?

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Profile picture for Susan, Volunteer Mentor @grammato3

@lokorn Absolutely, this is certainly your right as a consumer. Seeking a second opinion is not to be confused with "doctor shopping" as this article from the American Medical Association explains. By doing so, you can verify your options and decide upon the best approach for you given the opinions and recommendations and possible reassurances expressed by each of the specialists.
https://www.ama-assn.org/public-health/prevention-wellness/second-opinions-are-good-idea-there-are-caveats
Do you feel that there is something holding you back from obtaining a second opinion?

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@grammato3
Yes a little reluctant as I'm sure many people are. You don't want your original Dr. to think that you might be questioning the quality of their work, and not be as helpful to you in the future.

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Profile picture for lokorn @lokorn

@grammato3
Yes a little reluctant as I'm sure many people are. You don't want your original Dr. to think that you might be questioning the quality of their work, and not be as helpful to you in the future.

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@lokorn: I understand. You like many other patients feel you've developed a relationship and trust with your doctor that you don't want them to feel you're violating. A lot of these type of doctor/patient relationships have developed over time and they become thought of like family. But keep in mind if this is truly a professional you do trust and whose expertise you value, the emphasis is on their professionalism - and that extends to their wanting the best for their patients. This means respecting their patient's autonomy and right to explore their options - in fact, most doctors encourage it if directly asked. I know that's the response I've gotten when I've consulted on my own cancer diagnosis, or my potential need for hip surgery. And it's explained in greater detail here: https://www.lvhn.org/news/dont-think-twice-about-getting-second-opinion

You can be completely honest with your doctor by simply saying you've been very pleased with their care and you're not questioning their expertise, but this situation has been very concerning to you and before you commit to making a decision of this nature, you feel you owe it to yourself that you're doing what's best for you by exploring all options, which very well may be returning for the proposed procedure. If a medical provider objects to that, that might even change your impression. In all liklihood, you'll get your doctor's blessings and your future care will not be jeopardized in the least - by seeking and getting the care you have the right to receive.

Does that make the situation easier?

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Profile picture for lokorn @lokorn

@grammato3
Yes a little reluctant as I'm sure many people are. You don't want your original Dr. to think that you might be questioning the quality of their work, and not be as helpful to you in the future.

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@lokorn , how would the original doctor know you got the second opinion unless you tell him? If you go back to him, why would he need to know and if you prefer the second doctor, you’d just stay with the second one with future treatments.
I’m not a medical professional, but I am a licensed professional in another field. On a complicated case, I encourage clients to get a second opinion. It might help them feel more comfortable and get additional information. It doesn’t bother me at all.

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Profile picture for lokorn @lokorn

Yes, I have been back to have surgeon look at the scar and bump. We discussed going in (surgery?) and see what it the reason for the bump.
I am wondering if I should have another dermatologist look at the area just to be overly cautious, as this is close to my eye.
I am an outdoor person and love gardening, and I do wear large sun hats. And I love reading, so anything that might affect my eyes is very worrisome!

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@lokorn
If you are not confident with your
your surgery option you can seek
a second opinion preferably from
an experienced Mohs surgeon or
reputable plastic surgeon ,
Keep in mind opinions from surgeons often result in surgery.

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