The Big 'C'

I have cancer.

Skin cancer.

A large, infiltrative morpheaform basal cell carcinoma, to be exact.

I've had a lesion on my forehead for at least two years, which my GP had assured me was a sebaceous cyst and nothing to worry about. However, in the last six months or so it has developed into a non-healing ulcer, and particularly in the last few months of my pregnancy, has started to spread rapidly.

I was waiting until after Lucinda was born before undergoing a biopsy and finding out my treatment options. Now we have more information.

A basal cell carcinoma (BCC) is the best sort of cancer to have. It very rarely metastasizes, and surgery is curative in most cases if enough tissue is removed. However, most information I've read mentions "cosmetic disfigurement" somewhere early on in the piece. I don't think I'm going to end up looking very good, especially in the first couple of months after surgery. It's lucky I'm not having a big birthday party after all!

Yesterday Neil and I met with my plastic surgeon, who is a pleasant man and very competent and knowledgeable. He explained that my tumour is large and deep (he needs to take all the tissue down to the bone), and has difficult to define margins. The cancer itself is about the size of a 20 cent piece, but then he needs to take a margin of up to 6 mm around it in order to make sure it is all removed.

In 95% of cases where the tumour is not adhered to the bone, the surgeon is able to remove it all in the first attempt. That means I am unlikely to need a temporary skin graft. Instead, he will use a rotational flap from the side of my scalp to cover the hole. But he warned me it would involve a very large incision (right around towards my ear, apparently) and I will have a lot of stitches and staples. Because my hair is quite fine, the scar may be visible long term but that remains to be seen.

Because of the extensive nature of the surgery, I will be having a general anaesthetic and stay overnight in hospital with a drain in the wound (it is likely to bleed a lot, apparently). This will all be happening on Thursday, 12th July (the earliest surgery date he had available).

We're still working out the logistics in terms of child care, and in particular the care of Lucinda, who will be four weeks old and is breastfeeding. But I've got a couple of weeks to express and store plenty of milk so that shouldn't be a problem.

In the meantime, my message is ... wear a hat! Even if it makes you feel hot and uncomfortable, or doesn't fit properly. I haven't always been good at that. And if you have fine hair, wear sunscreen on your scalp as well as your face. Even if it makes your hair look greasy and untidy.

Finally, if you have a spot you are concerned about, go straight to a dermatologist rather than trusting your GP! From now on I'll be having annual check-ups with the dermatologist. The chances are more of these tumours will appear on my head and neck. But I'll do my best to make sure they don't get as big as this one has.