Pardon my gushiness.
With fair skin and some moles, I get annual checks or go if things look weird to me. I esp. like that:
* Dr. Dotz is very knowledgeable, and passionate about explaining things;
* he uses one of those hand-held lights (Optical Coherence Tomography?) to help tell when something is just a routine cherry mole and reduce unnecessary biopsies;
* all the staff members are highly capable/professional and have been there a good while.
I had a small (1/8 of pencil eraser?) thing that looked like a pimple with a bit of a scab on it. I didn't remember well, but thought it was there for a while, not healing at the rate I expected and possibly rescabbing. It didn't look like the scary "what to look for" photos, but I decided it was best to get it checked.
Dr. Dotz said the pattern of blood vessels he saw through his device looked suspicious. Since I wasn't sure how long it was there, we reserved a biopsy date in case it didn't go away quickly. I went back for biopsy and later for the results.
When it turned out to be cancerous, Dr. Dotz went well above the excellent level of care I would have even thought to expect. As usual, at every step, he thoroughly explained the possibilities, my options, his recommendations and his reasoning.
The following all happened on the day I went back for the biopsy results::
* I had basal cell carcinoma on my forehead, infiltrative type with possible perineural involvement indicating that it might be growing along a nerve (hopefully not reaching body parts I may someday have use for, such as my brain or eyes).
* He recommended Mohs type surgery (helps minimize how much extra skin has to be removed, and I think also better checks borders to hopefully get it all). He described the process so I'd have an idea of what to expect.
* He and his staff checked insurance possibilities for me (SFSU vs. Alta Bates). Dr. Dotz provided recommendations for a specific surgeon at each organization. He seems like a "tough grader" about what labs he sends to and who he recommends, so I highly value a recommendation from Dr. Dotz.
* He also gave recommendations about how quickly I should get the surgery in case one was scheduling too far out. Although the SFSU scheduling machinery was outside his control, he said he'd reach out to the non-SFSU doc about expediting a consultation (Dr. Dotz called me personally, I believe that same evening or possibly the next day, to confirm that the doc he called could expedite a consult as early as the following weekday, and Dr. Dotz again checked in and asked if I have any questions).
Getting a skin cancer diagnosis is, um, stressful. Esp. not knowing how far the "roots" branch out underneath. But getting all this helpful information right away, and the quick consult with the surgeon, helped a lot.
I liked both surgeons after doing a consultation with each and getting their opinion. I opted for SFSU due primarily to insurance considerations and was happy with the decision (I suspect I would have been happy with either surgeon).
Dr. Dotz suggested I schedule a visit several weeks after. The stitch line/scar runs vertically down the middle of my forehead, about 2 inches long, from hairline near widow's peak to the space between the top of my eyebrows (they couldn't give me a lightning bolt; I asked). I had asked the SFSU resident who removed my stitches (the doctor in charge of the surgery was out during Xmas week) about whether there is anything I could do to minimize scarring; the resident said no most confidently. When I visited Dr. Dotz, he summarized some research on silicone scar sheets and ointment (I believe vitaminE-based)--he had a file folder of articles. I opted to try a silicone scar sheet (mostly at night) and occasionally used coconut oil. You can only see the scar if you look for it, and Dr. Dotz mentioned that the healing turned out better than he would have expected given my type of skin. I would have been fine if the scar was more visible, but it's great that it healed so well.
My experience further highlighted that Dr. Dotz is committed to providing great care for his patients and puts in effort he really doesn't have to. I appreciate his expertise in catching this early, his helpful recommendations and his thorough follow-up.
I was also reminded that skin cancer on the face, aside from the cosmetic aspects, is especially bad because it's close to brain and eyes and can travel (I was lucky that it hadn't traveled further, given the complications if it reaches eyes or brain and the scary chemo/radiation words I heard while we didn't know how far it extended under the surface).
My takeaways:
* check out anything odd early--search on basal cell carcinoma pics and you'll see that some really look like nothing
* sun protection is esp. important for the face
* I feel very lucky to have had help from Dr. Dotz and the folks at his office. read more