Ronél Rabé – Face Value

Ronél Rabé shares the after effects of having two surgeries and radiation to remove basal cell carcinoma (skin cancer) from her left cheek.

Ronél Rabé (58) lives in Krugersdorp, Gauteng with her husband, Frik. They have twin daughters (26).

Dry patch of skin

In September 2018, Ronél noticed a dry patch of skin on her left cheek. “I thought it was caused from the material of my pillow. For months, I would put cream on and it would clear up but then it would flare up again. Then Frik said it’s looking bad as it was becoming a red sore so told me to go to the GP,” Ronél explains.

The GP gave her antibiotics and referred her to a general surgeon. “The surgeon looked at it and suggested cutting it out and sending it for a biopsy.” The day surgery was planned for a week later, Ronél was put under general anaesthesia and 13 x 8 x 5mm of her left cheek was removed. “My face was fine, it was my hand that was sore (where the anaesthetic was inserted), I couldn’t use it for three days,” she says.

A week later she went for her check-up and the first thing the surgeon asked was for her to smile. “He was worried that he had cut muscles. Luckily, he hadn’t, and my smile wasn’t affected. He then casually told me that it’s cancer: basal cell carcinoma (skin cancer) but that the cancer will never come back on the same spot, though it may come on another area. With that, I didn’t think much of it and was told to come back in six months,” Ronél explains.

Unfortunately, Ronél didn’t go back due to her medical aid being depleted. “This was my fault but because of the surgeon’s casual response and saying it won’t come back, I wasn’t too worried.”

Second surgery

In December 2020, Ronél noticed a lump forming on the cut, thinking it was scar tissue. “When I pressed on it, I felt a sting in my ear and thought this doesn’t feel right, and at the bottom of the cut, it started getting red again, the same as the first time.”

Ronél went to her GP in February 2021 and he froze the bottom part, prescribed an antibiotic and referred her back to the same surgeon. The surgeon examined her cheek and then told her another surgery is needed. No other explanation. 

When Ronél was getting authorisation for the second operation, her medical aid informed her that the code she was using was for cancer and she isn’t listed as a cancer patient. 

The first biopsy result wasn’t sent to the medical aid. Thankfully, this was resolved quickly, and the second surgery took place in March. This time 22 x 9 x 10mm was removed, only this time horizontally; the first surgery was vertically. The biopsy report confirmed invasive, aggressive basal cell carcinoma.

Wound complications 

A few days after surgery, Ronél’s face was still swollen and she was still in pain. “I was trying to eat breakfast and suddenly everything was wet. Every time I chewed, water/saliva would run out.” It turned out that one of her parotid glands was cut during surgery. 

Not knowing what was wrong yet, Ronél went to her GP as it was a long weekend and the surgeon wasn’t available. The GP explained he wasn’t going to touch her and told her to go to casualty. The doctor on duty at casualty opened the wound, cleaned it up and sent her home with pain killers. She then went to the surgeon two days later. “He told me that he can’t decide if he must send me to an oncologist or to a plastic surgeon. I then told him, but the wound is seeping every time I eat so I can’t eat. He told me the wound will heal and to come back in a few days.”

By this time, Ronél was walking around with a cloth to soak up the seeping wound. The surgeon finally referred her to a wound specialist. 

“The sister cut the wound open with no anaesthesia or anything and put this black foam in it (for the wound vacuum assisted closure to work), and then connected a drain to it. Frik called it a Kreepy Krauly as it made the same noise,” Ronél says laughing.

That same day the surgeon phoned her and informed her that he had made an appointment for her at an oncologist. So, Ronél had the drain on her wound for the weekend but then had to get it removed for the consult with the oncologist and then go back and get it put on again. 

Radiation

The radiation oncologist sent Ronél for a sonar where a mass in her neck was picked up. A fine needle aspiration (FNA) was scheduled. Ronél had to go to the wound specialist again to get the drain removed to have the FNA done. This time a drainage bag was put on the wound. Thankfully, the mass in her neck was benign. 

“Another doctor then informed me that the cancer is caused from childhood, running around in the sun without sunblock. He ensured me that it isn’t anything I did now and explained it was also part of my genes,” Ronél says.

Ronél can agree with this as she says she is fair-skinned and grew up playing in the sun in a mining area. “In that day and age, there was no sunscreen and when I did have sunburn, it was always red with blisters.”

The radiation oncologist advised the mother of two that 30 sessions of radiation (every day for six weeks) would be needed. “I was shocked! According to the surgeon, this was not going to come back on the same spot and now I needed radiation?”

Ronél couldn’t start radiation until her wound had healed. By this time, she still had the wound bag on and thankfully by the time radiation was needed (six weeks after surgery), the wound had healed. 

In May 2021, Ronél started radiation. “That first day I had anxiety; that machine is so close to the face and it felt like I couldn’t breathe. Thankfully, the sessions were only for two minutes but the set-up took longer. I was given the R1 gel and R2 cream to put on the wound and it worked excellently. 

The 58-year-old was extremely grateful for the hospital transport that was offered to her. “For six weeks, I was picked up and dropped off and since Frik works, this was so needed.”

Check-ups

Unfortunately, Ronél got COVID after radiation so couldn’t go for her check-ups. “But Frik was in constant communication with my radiation oncologist informing her of how 

I was doing and sending photos to her. She sent a prescription through. It was a crazy time but thankfully I recuperated and went for my check-up in mid-August. My oncologist was happy and said in November I need to go for a CT scan.”

The CT scan showed another growth, but it wasn’t known if it was scar tissue or cancer. “I went for another FNA and that was the worst, it was so painful for a needle to go through my cheek area. Giving birth to my daughters wasn’t even as bad as this. Even if I touch it now it’s still sore, and it turned out there wasn’t enough tissue for a biopsy to be done. If I put my tongue against my cheek, I can feel a hole,” Ronél explains.

It was decided to wait for the wound to heal completely and then do a PET scan in June 2022 to check the whole body for cancer. “It was all clear, however, my oncologist asked if I had a stroke as there was a black spot on the left side of my brain that indicates that I had one. But I haven’t?”

Survivorship 

The scar has healed extremely well and isn’t even noticeable. “I massage Bio-Oil Skincare Oil on every night which has helped a lot.” However, Ronél says her left side of her face droops slightly when she is tired and her left eye weeps and at times it looks like she has a blue eye. “I must also be careful when I blow my nose as it can start bleeding and I can’t sleep on the left side of my face anymore as I get a sharp pain in my brain, like brain freeze. The weather (hot or cold) also causes it too tingle. It feels like my face is going to explode. I also had hair loss, but I don’t know if that is from COVID. “

Ronél uses SPF +50 anti-aging sunblock and applies it every day and about four times a day on the left said of her face. “Even though the sun is not my friend, I do have to go out to see to the dogs and do other housework chores.”

Photos by LuciaB Photography | Facebook @luciabphoto | Venue: Silverstar Casino – silverstar.co.za