From a Technician's Perspective
(Chicago, IL, USA)
In the three years I worked in a dermatology office, the worst of days were the days of performing Mohs testing as a technician. Whereas Mohs is normally for treating Basal Cell Carcinoma and Squamous Cell Carcinoma, Mohs for treating Malignant Melanoma is a far less pretty thing.
Mohs surgery is the physical removal of an area around a positively screened biopsy, normally until the cancer is 100 percent cleared from the margins, at times with multiple removals from the patient.
In the malignant melanoma cases, compared to a basal or squamous cell carcinoma (which is usually about the size of a bean to start), malignant melanomas START at about four times larger up to the size of a plum.
When technicians get a specimen, the first things done are labeling and thinking. We think about the size of the piece, the mapping, where the piece came from, and mostly, the patient.
This poor person lying on an exam table, with inches of skin cut out, lightly covered in gauze for the time being, who will have to wait hours sometimes and have to go to multiple appointments for suturing, grafts, and follow-ups.
This gentleman who would have to go multiple levels, only to be positive yet for the melanoma and have to seek alternate treatment. This grandmother who didn’t know that days in the sun may have been good and fun then, but is now thinking of calling her family to warn them of what she went through so they will not…
I dealt with this as most of my coworkers did. Apologize for their pain or the amount of time spent, told them that they did well and I hoped not to see them again, in the office anyways.
After seeing what the Malignant Melanoma
patients go through, I tell others who ask about some of what can happen if taking care of their largest organ isn’t important. Enjoy life, but wear sunscreen.