Earlier this month, for the first time in my life, I had cryosurgery! It’s less exiting than it may sound. No futuristic sci-fi suspended animation frozen cryostasis; just cryosurgery, the Dermatologist spraying a spot on my face with liquid nitrogen.
Doctors have been removing unwanted growths from my body for almost 50 years, so if you’d like to know what to expect when the doctor sends you to the dermatologist to have that spot “looked at” read on. If you’d rather not listen to some old guy talk about his medical condition, click on one of the other stories, maybe the one about Dirty Carrie.
Does that hurt, Dad?
The first time the doctor removed a growth from me, I was 10 years old.
My father had skin cancer. His was successfully treated, but it did result in heightened scrutiny of anything growing on me that didn’t belong.
To show me I didn’t have to be afraid, my father had me watch while the doctor first removed a growth from his forehead. Mistake. It must have hurt like hell. With no flesh to speak of on the forehead, even the Novocain shot made Dad wince. It was the also the first time I heard my Dad swear. So much for reassurance.
Then it was my turn. Mine was a small, but growing wart-like thing on my upper forearm. Novocain, a quick cone-shaped scoop of flesh out of my arm, and some smelly cauterization with what looked like a soldering iron, and the deed was done. It left a cool scar that for a long time looked like a bullet hole, at least to my ten-year-old buddies. Instant street cred.
“You should have that removed”
That was 48 years ago. In the intervening years, I have had dozens of growths removed, generally every six to twelve months. I cannot remember a visit to the dermatologist that didn’t include at least one bit of me being left behind. I feel fortunate in that only once was a growth cancerous, and that one appears after eight years with no reoccurrence, to have been treated successfully. More on that later.
Hold the Novocain
My favorite doctor, now retired, didn’t bother with Novocain or any local or topical anesthetic. His suggestion was that the shot hurt as much as the small scalpel-slice, so why not go straight to cutting? Made sense to me, and he was right. It was with this doctor that I set a personal best of 14 growths removed in one sitting. And I do mean “sitting”. A visit would consist of me sitting in my underwear in the exam room while the doctor found and harvested those growths that he considered suspect and/or the ones that I asked he remove for being annoying. The nurse would follow behind, applying a band-aid to each spot. Get dressed and leave. No big deal.
Dermatologists today insist on using Novocain and require that I lay down for any biopsy. I don’t know if this is due to their application of best practices, insurance requirements, or my aging.
Liquid Nitrogen
The procedure that has been in use for about a hundred years that I just now experienced for the first time, was cryosurgery or freezing to remove a growth on my face. I had a spot on my cheek for years that was just a discoloration. A few weeks ago it grew lumpy until it became difficult to shave without cutting the growth. My doctor reassured me it wasn’t cancer and listened as I expressed my concerns about scarring and being able to shave. He recommended freezing it.
The freezing is accomplished with a fine narrow spray of liquid nitrogen from an aerosol canister that looks like a small fire extinguisher. The liquid nitrogen is sprayed at close range onto the growth, lowering the skin cells’ temperature to the point that they die. Sort of directed severe frostbite. It did sting just a little, but the process took maybe 20 seconds for a spot the size of a nickel.
The frozen tissue died and scabbed over quickly, just a day or two. No bandage was needed, just some lotion to keep the skin flexible. The scab came off in less than a week. I then used Neosporin and a Band-Aid for a week. I am happy with the end result, not only is there almost no scarring, I can shave easily again and the original dark color is gone as well.
Two Months Later – An Update
When I went back for a checkup on the outcome of my first cryosurgery, the doctor offered to freeze off the myriad small growths around the sun-exposed area of my neck and upper shoulders. Being so pleased with the result of my first experience with liquid nitrogen, how could I refuse?
So I now have a new personal record of 30 growths removed in one sitting. There was some minor discomfort during the healing process, but only because of the high number and concentration of sites. And again, the result is outstanding and the scarring is almost nonexistent.
Okay, this one needs to go now!
In 2001, I had a growth on my thigh that appeared rather suddenly and was getting bigger fast. With some angry red around the edges, it was more nasty-looking than the usual ones. Carrie convinced me not to wait for my annual check-up and make a doctor appointment. The visit was routine. The biopsy included a shot of Novocain, a pinch to raise the growth, and a slice with a scalpel to remove it. The little bit of skin was placed in a vial, labeled and sent to the lab.
Then things got interesting. The doctor called about a week later to tell me the test showed the growth was cancerous. The good news was that it was Squamous, a cancer characterized in part by it being confined in its early stages to the outer layer of the skin. However, it can spread and be very disfiguring and can in extreme cases be fatal. Squamous causes about 2500 deaths a year in the US. My doctor successfully communicated the urgency of getting treatment, or said another way; he scared the crap out of me.
The treatment for Squamous is excision, meaning the surrounding tissue is cut out to remove and prevent the spread of any potentially cancerous cells. Microsurgery is often used when the cancer occurs someplace that shows, like the face, to minimize the loss of healthy tissue. As mine was on my thigh, the doctor said a standard excision would be performed. I of course had no idea what a “standard excision” was.
Things moved fast. I got the “cancer call” from my doctor on a Monday. That Wednesday Carrie took me to see the surgeon for my “standard excision” and what I thought would be an outpatient procedure. Being a good patient I wore shorts to make it easy for the surgeon to see his target. The surgeon explained that this was just a meet-and-greet ahead of surgery. He went on to say that he would be removing too much flesh to make this an outpatient procedure and that I would be under general anesthesia.
“How much flesh?!” I asked. I soon wished I had not worn shorts. He took his purple medical magic-marker and drew an outline on my thigh. Okay, it was only the size of one large chicken-breast, about seven inches long and four inches wide, but that was so much bigger that I had guessed, I was shocked.
Carrie said I was pale when I walked back into the surgeon’s waiting room. We drove straight to the hospital where we did the pre-op paperwork and I took the pre-op tests. Surgery was scheduled for that Friday.
The surgery was as uneventful as surgery can be. Hospital gown, nurses, IV, shots, pass out. I woke up on a bed in post-op to the sight of Carrie’s lovely smiling face. I saw that my incision had been closed with glue, not stitches. Pretty cool. Glue minimizes scarring, reduces the chance of infection, and eliminates the need for a return visit for suture-removal.
The Squamous has not returned. Often there is a recurrence within two years as the surrounding area has often been equally affected by sun exposure.
Gory Details
If you’d like some more detailed medical information about skin cancer, squamous, and its evil cousin melanoma, here are some links. But a word of caution, the pictures on the Mayo Clinic site are somewhat gross; which may be good if you are looking for the motivation to go to the doctor to have that spot “looked at”.
