I'm sorry about your DH, and will remember him (and you) in my prayers. I don't know anything about basal cell skin cancer, so I can't advise you in that regard.

If I were in your situation, I would check out the National Institutes of Health (NIH) to see if they are doing a study for which your DH might qualify. In my distant past, I worked at NIH; I was also a patient there many moons ago. It is one of the best medical facilities in the world, and treatment is free. It is certainly worth checking out. Their main facilities are in Bethesda, Maryland, but they do studies all over.

Good luck and keep us posted.

Are you going to a specialist? That is a dermatologist/and/or cancer dr. Do you have a big cancer center near you? You might contact the Mayo Clinic in Rochester MN for recommendations. Be aware, everyone has cancer in their systems, but not all are active. Maybe some blood work etc would help, but only by someone similar to the Mayo Clinic. Also, does he have cancer in his family? or is he exposed to something like chemicals in farm work, shops etc. Don't give up, just do research and ask lots of questions and get 2nd or even 3rd opinions.

Have you asked your oncologist or dermatologist this question? It's perfectly legitimate. My father - a typical pale skinned, blue eyed Irishman had many basal cell cancers. Most were on his nose and forehead and didn't require surgery. Luckily my DH is an oncologist and he'd keep an eye on Dad and start treatment as soon as they appeared. But he probably had at least 6 or 7 at various times and if you've had it once you're at an increased risk of getting it again. If there's a family history of basal cell it also increases your risk.

Basal cell is the most common skin cancer and is primarily caused by sun exposure and the face is the most common site. While your DH wears sunscreen now did he wear it as a youth or in his teens? Does he go to the dermatologist for an annual screening? It's really important to check areas that aren't exposed to the sun - especially the genital area and between the buttocks. Places that we don't normally examine. I was at a health clinic where a dermatologist talked about applying sunscreen- most people don't use enough or reapply it often enough and they seldom put it on their ears or along the hair line.

But there are other factors that may be involved - here's the link to the May Clinic that discusses risks.

Here is a link that might be useful: Mayo Clinic

Like Quilly said, most of the damage comes from being in the sun when you are young. DH grew up in Florida at a time when there weren't air conditioners in the houses, the kids played outside all day without shirts on and no one worn sunscreen. He has had a number of Basal Cells spots treated, removed, etc. He finally had the treatment where he put on the medicine that basically removes all the potential spots that might occur. I think it is a form of a chemo agent. That meant covering his face and part of his arms with it. His skin looked beat red from it for a couple weeks but its supposed to help. Perhaps your hubs can check into that treatment.

My DH works in a Cancer Center and from what he has said, basal cell does not come from another type of cancer. It rarely metatizes (sp?) as other cancers do, but you can get more basal cell spots in the same area. It doesn't mean that they didn't get a big enough margin, it just means that place is a new spot that has shown up. Like Quilly said, make sure he has regular exams and take precautions in the sun now. And spread the word that sunscreen is a must for children of all skin types.

Thank you Wanda, Marie and Quilly. DH worked in the outdoors when he was young, as an electrician and construction worker. He had a desk job for the last 20 years of his career. To answer your questions:
I don't know about the sunscreen as a youth He is 62, how many of us were even aware of the risks back then?
He has had a couple of precancerous spots removed from his face,about 20 years ago when we were first married. Since then he has been diligent with sunscreen. And hats. But not sure how much he put down in his ear.
No he is not exposed to any chemicals. Maybe in his youth in those jobs. Not since i have known him.
No cancer in his family.
He saw an oncologist who referred him to a plastic surgeon for the first surgery. We live in central Virginia, there are probably good clinics near Richmond and/or DC.

I will check out the NIH and Mayo clinic. I just want to be sure we ask the right questions and get to the right doctors. Thank you all for your help.

I found some information online about Mohs micrographic surgery procedure, done by specialized dermatologists, that says the procedure is excellent for this cancer especially recurrences and where it is located. I am going to have him call his doctor tomorrow about a second opinion with a Mohs doctor. There is one at VCU in Richmond. Near us.

Thank you all again

Not sure what your insurance situation is - where they allow you to go - or how inclined you are to travel out of your state. But in my opinion if you want the best expertise in cancer diagnosis and treatment, and have the ability and desire to travel to get it, I would go to a premier cancer center like Memorial Sloan Kettering (NY) or MD Anderson (TX). Not that you can't find an expert elsewhere but it's harder to tell if you've actually found one when you're going somewhere else.

Though I have been treated at MD Anderson I doubt that I'd go there right away for basal cell carcinoma. However if I kept having them and had questions and felt I needed to find an expert I would go there in a heartbeat. And I live 80 miles from the flagship Mayo Clinic facility. Mayo does a lot of great things but they do not specialize exclusively in cancer diagnosis and treatment.

Gibby, thank you for your recommendations. i will research them online. I do not know for sure what our insurance covers, that will be my next step.

Over many. many years, DH has had several surgical procedures to remove basal cell carcinomas from his skin. Every couple years. The ones on his face and neck were done by plastic surgeons. My sister also has the same problem.

Neither one of them have had any sign of any malignancies, and I can speak re" my sister - that no one in our family(one either parent's side) has had any malignant cancers in over the 4 generations that we have records for.

The term cancer is used to describe the situation of mutant cell growth - not all mutant growths are malignant, nor cause death (unless the size or location interferes with other organs).
Basal cell carcinoma is not a malignancy, but because sun exposure seems to be a primary cause, they show up on exposed parts of the body and detract from appearance. My sister was always on the beach or at the pool almost daily.

My Dad had the MOHS surgery at the Medical University of South Carolina (Charleston). That is definitely the way to go if you need it done. You wait while they test the excised skin and if all the margins aren't clear, they remove some more. They don't take any more than absolutely necessary. That said, my Dad had a huge section removed from his temple. He had squamous cell cancer and his dermatologist didn't correctly diagnose it. When I looked up pics on the internet, from what I saw, I could have diagnosed it. Daddy waited almost too long to have it removed. A former co-worker had the MOHS done on her nose and had very little scarring. She had it done somewhere in Norfolk, where she lived.

MOHs is the standard recommended surgery for basal cells. My husband has had to have several MOHs procedures done on his face. Dermatologists who perform MOHs aren't that easy to find, but that's the best way to go.

Helene

A common misconception is that one type of cancer can "turn into" another type of cancer.

Skin cancer cells are always skin cancer cells, even if they're found in the brain, bones, wherever (not saying it can spread, I'm ignorant of the ways of skin cancers).

For example - I had breast cancer. If it comes back (metastasizes) in my brain, it's NOT brain cancer - it's breast cancer cells growing in the brain (or the bones, liver, or lungs).

I hope you get answers for him soon.

Mama died from melanoma. As was mentioned above it wasn't in a very sun damaged area, her inner thigh.

It's this simple. You get screened. Every year you get a thorough check by a very qualified doctor. Especially if you have already been diagnosed with a skin abnormality.

It must be frustrating for those in the field. There is so much the medical community can do if a problem is caught early.

I've had skin cancer in three different places on my face -- forehead and left side of my nose were both squamous cell carcinoma, and the one right below the inner corner of my right eye was basal cell carcinoma. Had the MOHS surgery for the basal cell -- not because it was basal cell, but because it was so close to the tear duct in my right eye.

I will be 62 in August. I, too, spent all kinds of time outdoors as a kid, and never used sunscreen. No one knew then what we all know now about sun exposure and skin cancer. When I was a teen and young adult, we still didn't really use sunscreen. This was when we'd use baby oil or Coppertone Oil for a darker tan!

My first skin cancer (squamous cell on my forehead) was discovered around 1999 or 2000. The second, also squamous cell, on the side of my nose, was in 2001. The third was -- shoot, can't remember, but sometime around 2005 or so.

And I need to go into my dermatologist again - I've got some suspicious-looking moles that I want removed and biopsied. I go for a full body check every six months, and more often if I find something suspicious.

From everything I've read and everything I've been told, both basal cell and squamous cell carcinomas won't become malignant unless they are totally ignored. So if your husband is going in and getting checked, and having suspicious areas removed, he shouldn't worry unnecessarily (and neither should you).

Special thoughts from me to you!

Excellent informative post from the lindsey! Gold star on your board!

I had a recurring cancer on my lip- I don't remember if it was basal cell or squamous- A dermatologist removed it the first time but a different dermatologist sent me to a Mohs surgeon the second time it appeared. He tracked down all cancer cells and removed them. I was left with a big hole but a marvelous plastic surgeon repositioned my lip and the tissue beneath my nose- did a great job and it looks good. This was about 15 years ago and the cancer has never recurred. Mohs is the way to go, in my opinion.

I'm very fair skinned and I started going to a dermatologist for a skin check 2 years ago. She looked at me for maybe 30 seconds and scheduled an appointment for the following year. When I appeared the following year, she didn't even look at me and questioned why I was there and told me that since I had never had a history of skin cancer, I didn't need a yearly check. Is that true or do I have a lazy dermatologist? I was a little angry about it considering I paid $20 to sit there and be lectured about showing up to the appointment SHE scheduled the prior year.

I've had about 5 biopsies/removals over the years with normal results. I've never been a sun worshiper but I've had my share of bad burns in my youth. Melanoma is the #1 cancer in my age range and it's so deadly if not caught early so it's pretty scary. I'm very vigilant about self-exams but I didn't go to medical school so I rely on the professionals. I think I need a new dermatologist.

Theres other reasons for skin cancer too like after a kidney transplant immune system is down,I knew a guy he got a transplant he died skin cancer got so bad but it weas because of the transplant.My hubby is having problems he goes to skin doctor they cut a chunk out he goes couple weeks later another.

Well, bottom line here is that you need a reputable oncologist. Not a dermatologist, go to the top and get a oncologist. Ask around. Have your primary recommend one--you'll get in faster than if you try to set that appt. up yourself. We've both had cancer, and you need that oncologist.

MonicaPA.... thank you. I know that Basal Cell is not a malignancy, but I had to ask, since DD1 keeps insisting "something inside is causing it"
Jeannegallo.. Ironically, DH is in Charleston SC right now, spending some time with our middle DD (my stepdaughter) and her 2 month old baby. I just called him to tell him what you wrote, and unbeknown to me, when the Plastic surgeon called him yesterday with the biopsy results, he talked to him about Mohs and is referring him to a Mohs doc in our area. The Pl Surgeon said he does a lot of reconstruction surgeries for the Mohs docs (I guess when it is on the face etc and needs a fine touch?). I am so glad to know that someone had the Mohs and it was successful.

THank you Chloecat... that makes sense. Sorry to be so dense
Thank you Bluebird, DH was glad to hear another recommendation for the Mohs. Needless to say, he is getting pretty tired of this. The ear is a very delicate sensitive area to be cut on.

Lindsay Ca.... thanks. i just copied your whole post to email to DH. that really helps.

Vannie... I just talked about that with DH on the phone. When he sees the Mohs doc next week, we are going to ask for a quick referral to an Oncologist. IS there a particular type of Oncologist he needs to see?> Do they specialize in Skin Cancers etc?

Glenda and bulldinkie, thank you for your kind words.

I appreciate you ALL here at KT much more than you can know.

And yours too GMom74...

Chi83 that is Outrageous!!! I hope you found a different doctor! I too am fair skinned, (i am a redhead) and had some bad burns as a child. Back when DM said get out there and play don't come running back in the house. Those days! lol
I have not been to a Derm. but i probably should get a checkup myself. I am 61. DH is not fairskinned, and he tans, but like everyone says we did not know to use sunscreen. Did they even make it in the early 60s?

MBoston... i missed your post.

you said>... My DH works in a Cancer Center and from what he has said, basal cell does not come from another type of cancer. It rarely metatizes (sp?) as other cancers do, but you can get more basal cell spots in the same area. It doesn't mean that they didn't get a big enough margin, it just means that place is a new spot that has shown up. Like Quilly said, make sure he has regular exams and take precautions in the sun now. And spread the word that sunscreen is a must for children of all skin types.
" Thank you for the information from Your DH. I had a hard time understanding why if the margins were clear, another one kept cropping up. And my DH has used the Chemo Cream on quite a few spots on his face too. The surgeon had me put it on specific spots for about 14 days then he went back for a check up. It cleared up those pre-cancerous areas.

chi83 - You need a new dermatologist! However in some areas of the country it's getting harder to make an appointment. The dermatologist who removed the pre-cancerous spots from both my son and daughter is now primarily practicing cosmetic dermatology - botox, skin resurfacing (or whatever they call it). In most cases those cosmetic treatments are not covered by insurance so they have less paperwork and insurance regulations to deal with and the patients pay up front.

Even when DH diagnoses skin cancer he refers them to a dermatologist or plastic surgeon because oncologists don't routinely perform those procedures. When he examines a new patient he examines their whole body and if he sees something suspicious he refers them to a dermatologist who specializes in this.

My husband, being Irish and having THAT skin, has battled with skin cancer for over 40 years...We're lucky enough to have a dermatologist in the family and he has regular check ups....He has had so many surgeries, we've lost count but thankfully, it's under check and he doesn't have any scars....He's also had the MOHS treatment many times and it's excellent, a miracle treatment, I think....
As a youngster, he remembers never going without long sleeves, a hat and never ever sitting in the sun..He even had a large spot on his shin and here's a guy that never wears shorts....Some people are just prone and he's one of them. His visits to his doctor has just become a way of life....But, there is treatment, never give up!

Whatever you and hubby decide, I wish you the best and sending special thoughts for both of you.

Quilly... the first time DH was referred immediately to the Plastic Surgeon by our Family Doctor. I wondered at that time why not an Oncologist. The Oncologist he DID see was for another matter, he was in there for follow up for a blood issue, and asked about the skin cancer,that Oncologist really didn't say much.. just said to go back to the Plastic Surgeon. So your answer: " Even when DH diagnoses skin cancer he refers them to a dermatologist or plastic surgeon because oncologists don't routinely perform those procedures." ..now i understand.

SunnyDJ thanks for telling me about your DH's experience with MOHS.

WmbsgJane...thanks for the kind thoughts.

Everyone has been so helpful, I feel so much better today. It is very encouraging to have the KT members to talk to.
You all have a lovely day. I have been mowing and doing yard work. We had a cold front here in Central VA. Instead of the 98 degree days we have been having, today is a cool 84!!

My father, back in the late 1960ties, had basil cell skin cancer on both earlobes. They ended up removing & resculpturing part of the lobes. Then in 1974 he was diagnosed with liver cancer, which killed him exactly one month from his day of diagnosis. To this day, my sister still insists that there was some kind of a tie-in, & nobody can talk her out of it. So much so that I avoid mentioning the circumsances of Dad's death to her as I know she'll just start in on it again.

Over the last almost 40 years that I've known my husband, he's had several skin cancers removed, all from his face, except about 3 months ago, one from his arm.

I'm almost in my mid-70ties, and, though not a sun-worshipper, have certainly spent my time in the sun, gardening, running,etc., but have never had a problem.

Maybe some people, for whatever reason, are just prone to getting skin cancers, while others seem to have some kind of "immunity" to them. Who knows?

kfc37... My DD is like your sister, insistent that there is 'more to it than skin cancer'. I do not know how to talk her out of it.

Please take some time to read the web site of the American College of Mohs Surgery (link below). You can get a lot of information on the surgery itself, and you can also find qualified doctors in your area. I live in the greater Sacramento, CA, area, and my Mohs surgeon was Michael J. Fazio, MD. He was awesome.

Here is a link that might be useful: American College of Mohs Surgery

Lindsey Ca... thank you, I emailed the website to DH. (He is out of town)
Next question, do most insurance companies pay for this procedure? If not, we will have to find a way. Just wondered.

I think the biggest fear is fear of the unknown. I know that I felt a lot better after reading, and learning, from that web site.

Our insurance (Blue Cross) covered my surgery. It's not a cosmetic surgery, which most insurances don't cover, so I would think your insurance would cover it.

DH's insurance has always covered all of his treatments for removal, including the Mohs surgeries 3). My sister has had Mohs surgery on her forehead. Both of them had 100% coverage paid by insurance....Blue Cross and Medicare.

Both of them have exams by their dermatologists every 6 months, do self examinations very frequently, and now stay out of the sun or well covered whenever possible.

Recurrences can happen, but the intelligent patient looks for them, and when it happens, gets it taken care of ASAP.

Lindsey and Monica... we have Blue Cross, glad to know it should cover it.
DH has been very careful, wearing hats, high SPF sunscreen, whenever he is out of the house at all. He can't really see the places on his ear, but I can, so I watch it closely. I think we caught these last two very early. I am very interested in hearing what the Mohs doctor will have to say. His appointments are at the end of next week.