Thanks very much for getting back to me. I was examined by an intern and then a Dermatologist. I brought the lesion to their attention as it was a new spot on my arm (6 weeks at that time). The intern suggested it looked like a type of psoriasis or an early "AK". The Dermatologist looked at it more closely and said "I am almost positive this is an early AK" with white spots beginning to form on top" . It was the white spots that made the dermatologist most confident about the "diagnosis". I was just told that I was fortunate that I came in for the screening as these "pre-cancerous lesions have an approximate risk of 5 to 10% of eventually becoming malignant". The doctor said that the lesion could be frozen off easily either at my own dermatologist's office (I dont have one, no health ins)  or even done there; a major university hospital in the NYC area. The intern told me that this dermatologist had over 20 yrs. experience and was incredibly accurate in her diagnoses. I was a little stunned but not overly alarmed as there was no mention of any cancerous suspicion. Upon leaving, (15 minutes later), I was handed a standard form by another (clerical) staff member with a human body diagram pinpointing the location of the spot on my arm. It stated "Diagnosis:Actinic Keratosis" with an additional note "biopsy recommended" (which I didn't notice at that time) and it was signed by the doctor. No mention of the biopsy had been made during our conversations and thus no reason given for the handwritten recommendation. I do remember, however, the intern stating that this specific dermatologist is more cautious than most. I guess my fear or major concern is that if there was a need for the biopsy could I have hindered a proper pathological diagnosis by removing the lesion on my own? (As for contacting the doctor, this was a free public screening at a major hospital and many people showed up. I have serious doubts as to whether the doctor would remember my case specifically. However, I will follow your instructions as that does seem to be the logical place to start).

Hello Merely Me,

Okay; I do have an update for you.  I contacted the hospital directly as per your advice.  I did not actually speak to the physician who saw me originally but corresponded online with the Chairman of the Dermatology Department instead! He was extremely helpful and told me that their clinic offers a sliding scale for treatment and is therefore quite affordable and that this even includes the biopsy.  I will be seeing a doctor there to look at the lesion again next week and most likely have that biopsy afterall. As for the original recommendation for the biopsy, another physician that I was referred to in their clinic told me that if there is any suspicion at all of a malignancy (in this case a possible, but not probable, early squamous cell skin cancer), they will recommend a biopsy.  I was advised not to be alarmed and that "self treatment is not usually a good idea".  I think I will heed that advice.

Thanks again for your reply and very helpful advice.  I will give you another update when I am "properly" diagnosed. I must say that I admire you tremendously for all you do to help people with your posts, especially in light of your own very busy life and the personal issues that you have to confront on a daily basis.  I thank you again and sincerely wish you the best.

Regards,

Jack 

Hello Merely Me et al:

Thanks again. Well;you certainly made my weekend.  I will definitely keep you posted. I will know more after I go back to the clinic on Wednesday.

Regards,

Jack

Hello again; I promised you an update and here it is. I have excellent news, though it might not be the news you expected! Since we last communicated, I have started a new job with a decent salary (after 3 years of exhaustive search). With the great financial news, which is an amazing relief, comes the added bonus of REAL medical benefits (among numerous other perks). As a result I decided to hold off on my appointment with the dermatology clinic until the benefits officially kicked in, which they already have. So, I have an appointment next Wednesday.

I guess this just goes to prove that "keeping the faith" is almost always worth it (and you don't have to be religious to experience this). 

Let me say once more, Merely Me, that I truly do appreciate the marvelous work that you do. Rest assured that your efforts are noticed and I am sure that you have helped countless others besides me, even if you haven't been made aware.

Oh and as promised, I will give you an update after my appoinment at the clinic next week when I should have finally gotten that "recommended biopsy"!!

Hello. It's been a while since I posted, but I did promise an update and so here it is. I finally went to the hospital about a month ago, where I had the original cancer screening after making an appointment for a follow up biopsy. Now I would have gone earlier which had been my original plan, but after the unexpected good news of a job offer, I delayed for a few weeks until my new health insurance benefits kicked in.  Upon examination, the dermatologist decided that a biopsy was no longer feasible, as I had treated the spot where the lesion was so aggressiively that there seemed to be no trace of it left behind, and therefor no reliable tissue samples would be present to test reliably!   But, while I was there, he did spot another lesion on my back (a completely different type), called an "inkspot lentigo", and because of the relative isolation compared to other freckles or sunspots on my back, a biopsy was performed afterall. 

This time the news was definitely good as the "inkspot" turned out to be benign, and for now I have no other suspicious looking spots or lesions to lose sleep over. But my story is still a cautionary tale, I will probably never know if I had a squamous cell cancer where my original lesion was found. And, while I am certainly grateful that I appear to have removed all traces of it, I don't know for sure. And skin cancer is not something to treat lightly, as many alternative internet sites might have you believe. Moral of the story, don't self treat...squamous cell cancers can spread and even kill. Go to the doctor for any suspicious lesion and leave the guesswork to them.  Peace of mind is priceless!

Jack