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Natural Perspectives: Battling skin cancer — and my HMO

February 08, 2012|By Vic Leipzig and Lou Murray

I've been battling skin cancer for the past two months. More accurately, I've been battling my HMO to get my cancer removed.

The good news is that surgery offered a complete cure for this type of cancer, and it is now gone. The bad news is that the surgery left a two-inch-long scar on my face.

When Vic and I were in New Mexico in late December, it became obvious to me that the little "pimple" that I had developed in early December was no pimple. It was growing larger every day, had a crusty, scaly surface, and a pit of dead tissue in the middle. It looked to me like a squamous cell carcinoma, which I have had before.

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But this one was amazingly aggressive. In three weeks, it went from being barely visible to being as big as a pencil eraser.

I decided that an aggressive cancer needed aggressive action. I called my primary care physician the day after Christmas. Since I was pretty sure it was a squamous cell carcinoma, I asked for an immediate referral to a dermatologist without visiting my primary care physician.

My doctor knows that I know what skin cancer looks like, and she granted me that referral. That shaved a week off the HMO process, but it took another week to get an appointment with the dermatologist.

The dermatologist did what is called a shave biopsy. Why do that instead of actually removing it? Because my stupid HMO won't pay for a full removal without a biopsy verifying that it is indeed cancer.

The dermatologist said to come back in a month. At first, it looked like the shave biopsy actually got the cancer. But it came back with a vengeance. The wound didn't heal, and I was faced with twice daily wound care with hydrogen peroxide, antibiotic ointment and bandages.

I soon had a lesion the size of a thumbnail on my face. I wasn't about to wait a month. I called the dermatologist and asked for an immediate referral to a Mohs surgeon, and got it.

Mohs surgery is a cryogenic technique whereby frozen and stained sections of the tissue are examined after each cut to be sure that all the margins of the tumor are gone and that the surgeon cut deeply enough to remove all of the cancer's "fingers" or "roots" under the tissue. My HMO doesn't have a Mohs surgeon in their system, so they contract out for this type of surgery.

Here is where it gets complicated.

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