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Facing Skin Cancer

When diagnosed with her third bout of skin cancer on her face, a Mass. Eye and Ear patient turned to Dr. Jessica Fewkes and the Center for Skin Cancer and Mohs Surgery for help. 

More than a decade ago, Jeanne was diagnosed with her first skin cancer – a basal cell carcinoma. She had noticed a rough spot on her face, and it had started to bleed a little.

It turned out to be a basal cell carcinoma, the most commonly diagnosed cancer in the United States. This type of skin cancer is highly curable (when detected early), and her dermatologist recommended Mohs surgery to remove it. But it was hard to say how much tissue would need to be removed to get it all.

“The first time I went in for surgery, I thought, this is not a big deal,” Jeanne said. “And then I walked out with 75 stitches.”

Though basal cell carcinoma lesions can be quite small on the surface of the skin, they often spider out underneath the skin.

With Mohs surgery, the dermatologic surgeon removes thin layers of skin around and under the tumor, carefully examining each layer under a microscope for cancerous cells, until no more cancerous cells are detected.

Not One More Scar

Following that first experience, Jeanne began seeing a dermatologist for regular skin checks. Five years later, she had a second basal cell carcinoma removed near her eye.

Then, last December, her dermatologist found another little spot she wanted Jeanne to have biopsied. It turned out to be Jeanne’s third infiltrative basal cell carcinoma.

“At this point, I said, I do not want one more scar on my face,” Jeanne said. “I decided to look around and see if there were any new methods for removing basal cells without surgery.”

She found some information online on a newer technique using radiation, but she wasn’t sure. At the same time, she began researching dermatologic surgeons in Boston, where she found Jessica L. Fewkes, M.D., Director of Mohs and Cutaneous Surgery at Mass. Eye and Ear.

“Dr. Fewkes looked me straight in the eye and said, ‘do the Mohs surgery.’ She said it would be much harder to operate on radiated skin if the radiation was unsuccessful,” Jeanne said.

Her confidence brought Jeanne, who had been grappling indecision over what to do for months, much relief.

“The indecision just had to stop,” Jeanne said. “It was really hard for me to make my mind up, but ultimately it seemed right to go with Mohs — the gold standard.”

Jeanne came in for Mohs surgery with Dr. Fewkes knowing it may be a bit invasive — the lesion on her face was about the size of a nickel.

But she felt confident in Dr. Fewkes, as well as her facial plastic and reconstructive surgeon, David A. Shaye, M.D., who works on the same floor as Dr. Fewkes and could close the wound immediately following Jeanne’s Mohs surgery.

Jeanne reports that her scar was very minimal.

“I couldn’t be happier. They did a marvelous job,” she said. “I’ve had skilled surgeons in the past, and I hold everyone to those standards.”

Preventing Skin Cancer

Basal cell carcinomas are indicative of sun exposure. Although Jeanne (who is now in her 50s) was first diagnosed in her early 40s, it’s highly likely that the tumor arose from sun damage that occurred before she turned 18.

Her family had a summer home on Cape Cod when she was growing up. She’s been sailing since she was 10 years old, and she even owned a Jet Ski rental business on the beach for 10 years.

Skin cancer is the most common cancer in the United States, with one in five Americans developing skin cancer in their lifetime. It can affect anyone, regardless of skin color.

Exposure to ultraviolet light, either from the sun or tanning beds, is a risk factor for all skin cancers. Dermatologists recommend limiting this exposure by seeking shade, wearing protective clothing and wearing sunscreen with SPF 30 or higher. (See more tips on prevention and detection from the American Academy of Dermatology.)

These days, Jeanne wears sunscreen daily. She also encourages her family and friends, including her husband and two sons, to do the same.

“Everyone loves the look of a tan, but it’s not worth the risks, as I’ve learned.”

The Mass. Eye and Ear Skin Cancer and Mohs Surgery Center specializes in the surgical treatment of skin cancers, including basal cell carcinomas, squamous cell carcinomas, melanomas and rarer forms of skin cancers. If you’d like to see a dermatologist at Mass. Eye and Ear, request an appointment online or call 617-573-3789.


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