The most common cancer in the world doesn't show up on a scan. It shows up in your bathroom mirror — a red dot that won't go away, a spot that bleeds when you shave for no reason at all. And because basal cell carcinoma is usually slow-growing and treatable, the world has learned to wave it off. It's just skin cancer. Nothing to worry about.
Episode 2 of the State of the Patient Podcast, hosted by Patients Rising CEO Terry Wilcox, is about the distance between "treatable" and "easy" — and how differently the same cancer can land in different lives. Titled "The Patch in the Pipeline," the episode follows four people: two patients who caught their own cancers on ordinary mornings, one woman who has had roughly a thousand of them, and a physician-entrepreneur whose investigational patch could change how all of them are treated. What connects them isn't how the disease arrived. It's what each of them decided to do about it.
Kay Frazer, a retired dentist from Texas, has seen a dermatologist every six months for nearly twenty years. Three months after a clean checkup, she noticed a little pinpoint spot on the right side of her nose — "just a little pin dot, a little red spot" — and watched it. Three or four weeks later, it hadn't gone away. So she made the appointment herself.
A prescription cream did nothing. A biopsy gave the spot its real name: basal cell carcinoma. Mohs surgery took care of it — and Kay is quick to say her dermatologist missed nothing, because there was nothing to see three months earlier. That's precisely her point, and the cheapest, most powerful advice in the entire episode: be very diligent about paying attention to your own body. The system didn't find Kay's cancer. Kay did. Twelve years and one more basal cell later, she still goes back every six months — and she still checks the mirror in between.
Mark Smith spent four decades working in telecommunications in Tennessee, much of it outdoors — a fair-skinned kid of the sixties who got sunburned plenty before anyone knew better. His first basal cell announced itself on his left cheek: it bled when he shaved, with no nick to explain it. Mohs surgery handled it, but took more tissue than he expected.
So when a second cancer appeared — this time on the tip of his nose — Mark couldn't stop doing the math on his own face. "If they have to take that much off my nose," he remembers thinking, "it'd be disfiguring." He did his own research and chose a different path, a form of radiation that spared him the scalpel. It worked, and he's glad. But it asked twenty separate visits of him, and it isn't an option for everyone. Either road, as Mark tells it, the system hands you a choice nobody wants: your face or your time. Which is why, when Terry described a patch in development that might someday spare patients both, his answer came without hesitation: "I would not be opposed to trying that before they'd have to lay a knife to me."
For Kay and Mark, basal cell was an event — caught, treated, survived. For Julie Breneiser, Director of Pharmaceutical Relations at the Gorlin Syndrome Alliance, it has never once been an event. It's the weather.
Julie lives with Gorlin syndrome, a rare genetic condition whose most burdensome feature is basal cell carcinomas that arrive again and again, often starting in childhood. By her own count, she has had around a thousand. Both of her adult children inherited the condition; her daughter was formally diagnosed at seven. And unlike nearly every other cancer, there is no finish line. "We can never ring the bell like people do at the end of chemo," she says. "As one doctor told me — you will never be cancer free."
Her community has twice watched a promising topical treatment clear patients' skin in trials, then vanish when the results fell short of the FDA's usual fifty-percent endpoint. "It's like reaching for the golden apple," Julie says. "You take a bite — and then the apple's taken away from you." Patients went from clear faces back to surgery every three to six months. But Julie's chapter doesn't end at the loss — because in October 2025, she sent a LinkedIn message that may change her community's future. We tell that story, and the rest of Julie's, in a companion piece: [A Thousand Cancers, and No Bell to Ring].
The man on the other end of Julie's message is Dr. Raza Bokhari, Executive Chairman and CEO of Medicus Pharma, whose subsidiary SkinJect is developing the episode's namesake: a dissolvable patch about the size of a postage stamp, carrying four hundred microscopic needles tipped with a chemotherapy drug doctors have trusted for decades — delivered only where the cancer is.
The design is built around the calendar. Mohs surgery is often scheduled ten to fourteen weeks out — the system can perform roughly a million procedures a year against five million new cases, and Dr. Bokhari estimates more than seven million patients are waiting in line. The patch is applied in three brief office visits while a patient waits; the lesion is rechecked before the surgery date; and if it has cleared, the surgery may no longer be needed. In Phase 2 results, the company reports roughly three in four treated lesions clearing on visual exam — with complete cellular response at forty percent, against an FDA approval bar of more than fifty.
The patch is investigational and not FDA-approved. No one can ask their dermatologist for it today, and the next, larger study will determine whether it ever gets there. For most patients, the earliest target is 2028–2029. For Julie's community, an orphan drug designation — set in motion by her letter — could move faster. "Chance," as Dr. Bokhari told Terry, "favors the prepared mind."
Across four stories, the same threads emerge. This cancer announces itself to the people paying attention — every patient in this episode found their own, which is why the episode keeps returning to the bathroom mirror. Treatable is not the same as easy — a two-month surgical queue, twenty radiation visits (for those that can take this path), or a lifetime of operations are all hiding inside the phrase "just skin cancer." And patients don't have to wait to be found — the most consequential moment in this episode wasn't a lab result; it was a patient advocate sending a cold message to a CEO, and the CEO writing back.
That's the through line of the episode, and of the show itself: patients first, innovation as the engine, affordability as the standard, and anyone willing to help welcome at the table. As Terry reminds listeners — you have to be the CEO of your own healthcare. But you don't have to be its only employee.
The State of the Patient Podcast is produced by Patients Rising. New episodes every other Tuesday. Follow the show on Apple Podcasts, Spotify, YouTube, and wherever you listen. The SkinJect patch discussed in this episode is investigational and has not been approved by the FDA.