Emotional impact after mohs surgery

Hi , welcome to the online community, I’m sorry to hear your feeling anxious at the moment, what helped me when I had my diagnosis (metastatic melanoma) and was feeling anxious was to accept that the anxiety was very normal, well who wouldn’t feel anxious. I had the consultants appointment where they ask about your history and being in the sun, and it does male you think how you’ve described, have I done something wrong is it my fault, is it my parents fault from when I was young as sun damage is cumulative. I suppose they have to go through the questions so that they can give the advice on safety, think of it as box ticking and them trying to be helpful rather than judgemental, they are trying to prevent things getting worse for you than trying to make you feel bad about yourself. 

I found soon after diagnosis that I found myself crossing the street to be in the shade, a bit like a ninja, or like those films where Dracula turns to ash if he’s caught in the sunlight. I think that was for me because I hadn’t got in a routine of thinking some sunlight is good for us due to the vitamin D that it produces but any change in colour of the skin is best avoided, so I have suncream and a hat and sunglasses with me routinely now. I am a lot older than you and was wondering if the group diagnosed at a young age might be a good group for you to as you have just joined the community and perhaps emotional issues. I’ll put a couple of links in for you to have a browse. 

https://community.macmillan.org.uk/cancer_experiences/emotional_issues/discussions

https://community.macmillan.org.uk/cancer_experiences/diagnosed_at_a_young_age/discussions

All different types of cancers will be in those groups but I’m thinking we all feel a bit of guilt, I think it’s because we go through a sort of grieving process when we get a diagnosis lots of different thought pop into our head and sometimes we get stuck on a thought rather than moving through it. I found it useful to read the information and support pages on emotions and coping.

https://www.macmillan.org.uk/information-and-support/coping/your-emotions

Of course you are going to be concerned about your future, until you work through those feelings and unfortunately they may not disappear altogether but pop back into your head at anniversaries, near appointments, when you mind wanders but gradually the feeling will get less and less. 

Im glad your able to identify and talk about it as that’s the first step, and I hope it feels better to express it. 

Sorry I just popped in from the melanoma group that I’m usually in, as I identified with you, and my daughter happens to be the same age, I hope some of what I’ve said helps. I have had a set back with a recurrence and the feeling was worse than the first time, and it sounds like that's what your going through. I created a blog on here, when that happened to me to get all the feelings out and put in order so that I could then think more positively. We all have our own way of coping.

Best wishes

Hi I'm a bit older than you, but the nurses thought that I was bit young to have 2 BCC. I had both of them removed nearly a month ago and I have to admit that its made me think. I regularly go abroad in the summer and I'm not a sunbather and I'm the one who regularly use SPF 50 including on my scalp (I have really short hair). I now realise that this is not enough and I'll have to be even more careful in the sun.

I think now that you've been through this you'll know what to look for, checking is now a monthly ritual for me. I would try not to feel guilty, I had similar feelings but I've been really careful in the sun.

One thing to watch though is to make sure you are getting enough vitamin D, I found out the hard way after nearly a year of aching joints. After a blood test at the doctors it was found that my levels were very low and prescribed tablets to bring them up. So now I take regular supplements. My main problem now is trying to find a hat that I'd be happy to wear!

I hope this helps in some way.

Hi and a second welcome to the online community

Like KTatHome I was diagnosed with melanoma and certainly have had thoughts around what I could have done better in the past to have prevented this. However, try not to dwell on 'what could I have done differently' as it's done now but you can protect yourself better in the future.

Please don't feel that the consultants who have spoken to you about how you have protected your skin against the sun in the past are criticising you. They are simply doing their job in understanding how you have developed BCC and hopefully have given you advice on what to do in the future. In case they haven't, here is what I was advised:

1. Stay out of the sun during the strongest time of the day (11am to 3pm) between April and October inclusive in the UK and in all months of the year in any other part of the world
2. When going outside wear long sleeved tops and trousers/skirts made from natural fibres like cotton
3. Wear a broad brimmed hat (brim should be at least 3 inches) and sun glasses
4. Sit in the shade and never sunbathe (or sun bake as the Australians call it!)
5. Any part of your body that is not covered, ie face, neck, back of hands should have a sun protection cream of SPF 50 that is effective against both UVA and UVB rays
6. Re-apply the sunscreen every couple of hours or immediately after swimming
7. Never use sunbeds
8. Don't use sunscreen instead of covering up

The first summer after I was diagnosed with melanoma was the hardest as I used to enjoy sitting in the sun with a book. However, it's surprising how quickly you adapt and I now have a selection of hats to choose from when I go out. I also decided that I now needed a whole new wardrobe so went on a shopping spree. So, every cloud has a silver lining!

I leave a hat permanently in the car so if I forget to take one with me I know I'll have one. Leaving a tube of sunscreen in the glove compartment is a good idea too. It's not about not going outside at all but just about being sun safe from now on. 

I do understand how you might worry that you'll get more BCCs and I'm sure that everyone does. I know that whenever I spot a change to my skin I always keep a close eye on it. However with time (I was diagnosed with melanoma 3 years ago) I've learnt not to panic and hopefully you'll find the same. 

You do need to be vigilant as for all of us having had one skin cancer means we're more at risk than the general population of getting another. However, you now know what to look for so checking your skin once a month would be a good habit to get into.

x

Hi Calgirl35,

I'm new here too but have already found that there are people here that really are feeling and experiencing what you are. Maybe no one has answers for some of it, but it sure helps just to talk it out and feel like you aren't alone. I'm sorry for what you are going through. I too had MOHS for BCC on my face and unfortunately have also had to go through reconstruction to rebuild my nose. I'm on my 3rd surgery and not done yet but making progress. I have seen so many healthcare professionals in this journey and know exactly what you are saying about feeling guilt or feeling like you are being "blamed" for your cancer. I don't think that anyone who has not experienced this personally can quite understand how certain words can be interpreted as blaming when we as patients are in such a vulnerable and emotional state. I do believe that most are just trying to be sure that we are well informed about sun protection and other risks for skin cancer. 

My dermatologist is a personal friend and previous healthcare colleague. He discussed skin cancer risks with me including sun protection and exposure but he also talked with me about genetic predisposition. He made a point to say not to blame myself. As an adult I use sunscreen, wear hats and limit exposure but I am still an athlete and very active and do spend time outdoors. While sun is likely the most significant factor, we shouldn't discount other factors and play the blame game. I haven't spent much time researching the genetics of this as I have been busy just trying to get through each day but I have read some studies that also address the genetics of BCC. Until yesterday, I somewhat discounted this. No one in my family had ever had BCC. My father had melanoma on his ear but he had spent a lifetime working in the sun. Then my mother called saying that she had just been diagnosed with the same Infiltrating BCC on her forehead that I had removed from my nose a few months ago. My mother has not spent a day in her life without sun protection or avoiding sun all together. She detests the outdoors and has never enjoyed the sun. We are fair skin and fair haired and she preferred the untanned fair complexion look her entire life (now age 70). While this may all be coincidence, feeling guilt just creates more anxiety and we certainly don't need more of that in our lives!!

Do you have a follow up plan? Discussing follow up and what to look for has given me a little comfort.  I have a plan to do every 3 month skin checks with my dermatologist and if I see anything sooner, I go in for an appointment. I certainly spend plenty of time in front of the mirror these days in contortions to see every inch of skin! 

Try to stay positive. Some days are easier than others. 

Teddi

Hi Calgirl

I think it’s normal to be anxious, I am starting my journey next week, MOHS, forehead flap then nose reconstruction, am really in a state of anxiety, but know it has to be done, I knew very little about Bcc before my diagnosis, from all the research I’ve done, they are not quite sure exactly what causes it, I don’t believe it’s all down to the sun as a definitive of cause. I am 56 and although I like being outdoors, I mostly always wear a hat in summer months, don’t use sun beds and always wear a sun screen, my dad had bcc and 2 of my children have had malignant Melanoma, so I feel there must be something genetic.
I am sorry the medics have made you feel they were judging you, you shouldn’t feel like that but am sure if you told them how you felt they would reassure you. 
take care 

Frankie1