Dermatologist - update

Barb and I accompanied Dad to the dermatologist (Dr. Iwasaki) on Tuesday, and we discussed in more detail the diagnoses and recommended treatments.

The squaemous cell cancer is on Dad's forehead. It is relatively large, and the doctor explained that surgery would require even larger excision. She recommended doing MOHS surgery (referred to another doctor for this), which provides the opportunity to test during the surgery to determine the depth required to remove all cancerous cells, as well as doing any required skin grafts or skin flaps to repair the surgical excision and minimize scarring.

The basal cell cancer is in a crease between the nose and mouth. Dr. Iwasaki said she would be able to do this surgery in her office, but that we should do the others first.

The melanoma (the most serious), is on Dad's right cheek. Dr. Iwasaki recommends MOHS surgery for this as well. She ordered one more test to be done on the biopsy sample (called a 'stain'), which will verify whether the cancer is superficial (extending only into the first layer of skin) or if some cells have extended further. If the cancer has extended further, it may be necessary to do a lymph node test to see if it has actually penetrated to a lymph node. Results should be received soon. The MOHS surgery has been scheduled for next Wednesday, April 15th.

Only one MOHS surgery can be handled at once, so a second appointment will be required for the squaemous cell cancer, once the first is done.

Once all of these surgeries are complete, Dr. Iwasaki suggests doing a full body inventory of Dad's skin marks to identify any other potential problems. She visually noted at least one on Dad's face (near his eye), but wants to wait until all the current surgeries are done before completing the inventory and determining a treatment plan according to priority.