Squamous cell cancer

I hear you loud and clear, and I understand the anxiety following a positive test for SCC. Having been Dx ten years ago, that was what I felt. I have learned that some dermatologists (mine included) easily burn out in private practice - in part because they see so many, it's so common. That is what my Derm said. After my first positive test, the secretary called me to tell me the news, and that when the Dermatologist returned from her vacation in a few weeks they would call me to burn them off. After a few days, I got progressively anxious and began to read about SCC and treatment. I decided to take responsibility for this and found a Moh's surgeon diplomat in another state. I called and made an appointment and had my test results sent to him. He found that one of the sites was deep - and had branched out. I asked if "burning it off" would have been adequate treatment. He told me it would not. On another visit two months ago, at a university clinic I had another SCC removed (in situ) they refused to send me to the Mohs clinic and proceeded with scraping it. I still have the pink spot and wonder...Furthermore, I asked about one spot that concerned me, and she said "Oh, I am not worried about that." I said, I was and liked a biopsy, which came back positive for SCC. I feel very poorly about the nonchalant attitude about SCC. I asked for the chemo-creme because I have so many scaly/pink spots on my face - which she prescribed. Now, as I finally got the gusto to apply it, I have huge amounts of deep red and crusty spots, especially on my lips. I wonder if our anxiety is read by the provider as something that just is an overreaction because it is so comen...

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I hate to say it but I would’ve found a new doctor- I’d be angry if asked to wait to see what happens! But I’m still angry after losing the love of my life - there was no sense of urgency. We lost so much time! I’m now paranoid about any form of skin cancer.

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Hello Ginger,

Thanks for your response, and for your support. With a compromised immune system, End Stage Kidney Disease as well as leukemia - you have a lot on your plate; my heart goes out to you. I wonder how I/we may be of support to you.
I have end-stage Neuro-borreliosis, a suppressed immune system, and a few other "rare diseases"; however, during the last 20 years, as these body malfunctions have piled up, I have been very fortunate to find excellent care - with time, and I am grateful for that. But this SCC is a different kind of a bird; so unpredictable, we need to care for this disease almost as we do a toddler, "did you get your sunscreen, your sun protective clothing, your BIG hat" and so on - and on. I had my car windows treated with the highest UV A & B quality grade. and sunscreen 70% +. I plan my day with careful attention to the UV index ....Yet - I find myself sliding my hands along my face, arms, and legs detecting these rough spots or scales. This has become a pastime - an unconscious reaction when I watch TV or the like. Well - I can live with this, it's like taking care of your body, That which is emotionally draining is the attitude I often experience from my dermatology staff, They make an effort to be professional and kind (to some extent) but the underlying judgment is very palatable. I find I have lost faith in their professional judgment of the skin manifestations as well as treatment choices such as burning them off, electrocuting them, or referring to Moh's surgeries. I understand it is a matter of judgment - and what is the error margin? I am going to change until I find someone I trust.
Wishing you well Ginger, may your spirit soar above the clouds, and may you embrace every day. Grete

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I have had quite a few squamous cell carcinomas and basal cell carcinomas. These are the "good kind" of skin cancers with melanoma being the "bad kind". 'Quite a few', in my case, means about a dozen surgical removals, some of which were Mohs surgery and some just plain depending on location. I have had many dozens of smaller spots frozen with liquid nitrogen. Unfortunately this is not extremely rare to have many spots of these cancers. I have known people with just as many or more than me.
In general most of these types of cancer are slow growing and most of them are not very invasive. However there are exceptions. It has been best for me to get these removed surgically fairly soon after they are identified but no real urgency or panic. It has been best to go in once or twice a year to have all of my skin visually checked by a dermatologist. They know what looks suspicious and they are able to identify the little spots for freezing before they get big enough to require surgery.
The only thing that bugs me is when I get a bigger spot that looks just like previous spots that were cancer and required surgery. This new spot to me is obviously cancer and needs to be removed but they still insist on doing a biopsy to verify it. This is great for insurance purposes but it sucks for the patient. I have to heal from the biopsy which confirms it is cancer and then schedule the surgery to remove it and then I have to heal again from the surgery. And healing from the biopsy is usually worse than healing from the surgery. This does not seem necessary to me when it should be possible, given my history, for the dermatologist to identify the cancer with enough confidence to go straight to the removal. They could do pathology then to confirm it is cancer for insurance purposes.

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I am having the same issues. I have had 5 squamous cell spots removed by Mohs Surgery, only after being biopsied. I now have three spots that have reappeared at the spot of the surgeries and have had them biopsied. I have been referred to another dermatologist, but have to wait a month and a half to get in. They have told me that mine are aggresive and I have a terrible time waiting in limbo!

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@runner101 Welcome to Mayo Clinic Connect. Waiting to be seen for a dermatologist or any specialist for that matter, when you know there is something wrong, is hard on the nerves, isn't it? One thing that I found helps is to ask them if there is a wait list for cancellations. If that fits your schedule, you can certainly jump ahead in line. I have done that, and told them I'll take any practitioner, at either office. One office is 45 miles away, their other one is 30 miles in the opposite direction. Sometimes it works out.

And yep, they always have to biopsy them. I had two MOHS procedures in less than 3 months. Interesting, the one on top of my knuckle healed better than the other one further up my arm!
Ginger

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I chimed in here in early spring of 2022 when I had multiple biopsies of angry spots on my shins followed by two Moh’s surgeries. When the Moh’s surgeries had healed, my dermatologist ordered 4 to 6 weeks of Flourouricil ointment, which I call do-it-yourself chemo. I did it for 5 weeks until I couldn’t stand it any more. My skin turned an angry red from knees to ankles. The worst spots burned and itched and scabbed until eventually a layer of skin came off. Same doctor then gave me a prescription for two weeks of a steroid cream to “calm” my legs. After that she suggested a daily regimen of CeraVe over-the-counter cream to moisturize. I meekly asked if I could try on my legs two products that I have long used with success to fade brown spots on my face: Tretinoin creme (a prescription) and Amlactin lotion (over-the-counter). Best prices on both are at Costco. She shrugged and said I could try them if I wanted to. She gave me an Rx for a new tube of Tretinoin every 3-4 weeks. Well, the results have been amazing! I just had a six-month checkup, and the doctor found NO spots that she wanted to biopsy. A very few spots may continue to scab, but when those scabs fall off, there is beautiful new skin beneath them. I use the Amlactin all over my body after a morning shower, and I rub the Tretinoin creme from my knees to my ankles every night at bedtime. On any morning that I don’t shower, I slather Cerave on both legs. And I wear compression knee-high socks all day to improve circulation. The results were not instant. I started this regimen last November 1st, and it took at least four months before the skin on my legs began to look better. I may continue this regimen forever.

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