Friday, August 27, 2010

Skin Cancer



Earlier this year I noticed what looked like an ingrown hair on the back of my neck. When it didn’t go away after four months, I went to a doctor. She gave it a light squeeze and said it was nothing to worry about. I’d had ingrown hairs before and I know that they go away after a few weeks. Unsatisfied, I asked for a referral to a dermatologist.

The dermatologist looked at it, squeezed it and also said, it's nothing to worry about. He suggested, if I wanted, that he could take a biopsy and send it to the lab. That was what I wanted. So we did.

I got the call back that it was, in fact, squamous cell carcinoma and I needed to see another dermatologist to have it removed. She dug a giant hole in the back of my neck. In order to ensure removing the offending tissue in its entirety, they also remove a ‘margin of healthy tissue.’ In my case, she wanted to remove 4 millimeters all around.

Check out the hole in my neck, here.


I was instructed to keep Aquafor or Vaseline on the wound while it healed and to come back so she could observe the scar. By the way, she was trying to get me to agree to a smaller scar that would require stitches, but it also required that I didn’t exercise for a a week while it healed. Knowing that I wasn’t going to go a week without moving, I opted for the larger, round scar that didn’t require stitches and allowed movement during the healing process.

A month later I came back. She liked the scar and how it was healing.(Although she did try one more time to convince me that she could make it a ‘prettier’ scar if I allowed her to use stitches.)

I pointed out a brown spot that had appeared near my side burn. It looked like a mole, but I didn’t remember it being there before, so I thought it was worth mentioning. She looked at it and said it was an age spot. Again, the look on my face must’ve been one of extreme doubt and concern because she again suggested we take a biopsy and send it to the lab.
Two weeks later, I return to get the news: This spot is what they call ‘pre-cancerous’ meaning the cells are dividing rapidly, but it hasn’t yet gotten to the point they officially call cancer. Although it is inevitable. The lab suggested we either remove or destroy the spot.

I didn’t like the idea of another giant hole in my face, so I asked about the ‘destroy’ option. I guess it was the option she was going to suggest anyway, which is topical chemotherapy.

So now, I’m supposed to apply this chemotherapy drug to my face on three places: the area where we found the spot (side burn) and the tip of my nose and the area above my left eyebrow. Both of the two latter spots are places where I’ve experienced unusual flakiness or crustiness on occasion, but nothing I’d consider cancer. She said “Oh NO, Don’t tell me that!” (Just what you want to hear your doctor say, right?).

The idea is that this drug, Imiquimod, will irritate rapidly dividing cells. So it sort of exposes precancerous cells by creating a lovely rash. In the process of uncovering the pre-cancer, it also destroys them. However, any time you destroy cells you have cell death. Which I guess can end up looking like a rug burn, or even open, oozing sores. So, this is something to look forward to.

I thought I'd post one last goofy picture of my smiling mug before the damage begins.


I had to contact all of my modeling and acting agents and tell them to book me out for the next two months unless they get a call for an actor/model with a pizza-face.

I first went to Osco Drugs to have the prescription filled. It's a locally owned and operated pharmacy. I always prefer to patronize the small business over the mega-giants. But they quickly told me that they couldn't fill the prescription because it 'wasn't stamped' and handed it back to me. I said, "I don't know what that means" and they told me "your doctor has to stamp it". I was incredulous. "You mean this is no good?" I wanted clarification, but instead of an answer, all I got was a repeat of the original statement "you have to have your doctor stamp it."

I left and thought I'd try my luck at a different pharmacy. Duane Reade was the next closest one (big surprise). The pharmacist there seemed willing to fill my prescription but his concern was that I didn't have prescription coverage on my health insurance. "Yes, I know. My insurance is very minimal-only to cover major expenses." So the cost for a months-supply (I was told to probably expect up to three months on it) was $850. I asked if there was any way to get it cheaper and he said, "I can sell you 12 instead of 24, for $450." I said, that's not less, that's more. The pharmacist suggested I ask my doctor for a different option.I was stunned. Didn't know what to do. I walked home and got on the Internet looking for answers. I found a place called Planet Drugs Direct. They seem to be some sort of distribution center and they offer drugs at discount prices. I found the drugs I wanted. 24 packs of Imiquimod were only $161. So, I ordered it and am now waiting for it to arrive by mail before I begin the treatment.

There are THREE lessons here....

ONE: Wear your sunblock. Even though I haven’t been tanning in decades, and I’ve literally avoided the sun as much as possible, I am now paying the price for my childhood days in Santa Barbara where I spent my life working on my tan. I never wore sunscreen; wouldn’t even have considered it. In fact, I wore things that were supposed to actually accelerate the tanning process, so who knows what kind of damage that may have contributed.

TWO: Don't trust Duane Reade to have low prices. Shop around.

and finally...
THREE: Just because your doctor says “It’s nothing, don’t worry about it.” Doesn’t necessarily mean that it’s nothing. I’m not saying you should worry, because I’m not a big proponent of doing things that don’t help, but if you suspect something is wrong, then you should pay heed to that suspicion and don’t back down. Fight until you are absolutely convinced that it truly is nothing. If I had listened to my doctor, I’d still be trying to squeeze an ingrown hair on the back of my neck as it was gradually metastasizing.

My mother had a strange spot in her eye that she didn’t think much of. Then when she started feeling ill, the tests finally showed that what was actually a rare form of eye cancer had fully metastastized and was now in her liver. They gave her six months to live. She lived four of them. Had she acted sooner.... when she saw the strange spot in her eye.... Who knows?
R.I.P. Mom. I love you.

5 comments:

danielle said...

holy crap, Jason. That is a cautionary tale. Thanks for sharing.

Peter said...

Jason.. as always.. find your sharing of your life journey inspiring, informing.. and as always sprinkled with your touch of humor... you are a life hero!

Ziggy said...

Glad you listen to your instincts, and are vigilant!

You are always an inspiration to me, Jason!

Anonymous said...

Jason- I've been a pharmacist for 15 years. Imiquimod is very expensive. Looking for better pricing is fine, but stay with a pharmacy you know. The cost of Imiquimod to your pharmacy is over 800 dollars...It is VERY likely that the on-line pharmacy is selling counterfeit imiquimod, which means it has no acitive drug. $900 is inexpensive vs. the alternative.

Michael Fox said...

The skin cancer is painful and causes us burning and it burns which is the affecting so I take hydrocodone.