Thursday, May 05, 2011

Biopsy Results: Melanoma

I've been fiddling with this post for a while now, trying to figure out what to say and how and when to say it. I finally decided to take the doctor's approach and just say it. The biopsy results came back yesterday, and it turns out that mole was actually melanoma. That's pretty much exactly how she told me, and yes, those words are as scary to hear as you might imagine. Melanoma, for anyone who might not know, is skin cancer.

The good news (did I just say that about having cancer?!) is that mine is something called melanoma in situ, which as I understand it basically means "in place", or in layman's terms, "only right here." It is basically Stage 0 cancer, only on the surface of the skin, not penetrating down into the other layers. I've read several websites on it, and I think this one does a good job of explaining things in simple terms, if you want to read more.

Treatment? Excision. Translation: cut out a big chunk of skin. How big? Not sure exactly, but I do know it won't be small. Online estimates vary from margins (clear space around the original melanoma; think perimeter) of 2mm on all sides (highly unlikely it will be that little) to 2cm all around, including depth. I'm hoping for something the 1cm range! Given that the initial biopsy site was nearly 1cm to start with, something with 2cm margins would end up about 2 inches (5cm) across. On my arm/shoulder! Um, ow. I keep trying to explain where it is on my arm, but I think it would be easier to just show you (on someone else! too hard to take a picture of my own shoulder, LOL). Mine is on my left shoulder, but it is roughly here:

Yeah, that will feel great. The little small spot she took last week (7-8mm across and 1-2mm deep) has just now, after a week, stopped stinging and itching every time I move my arm, and it didn't even require stitches. It was essentially just a bad (intentional) scrape. But, I would rather them take enough and only have to do this once than skimp on the margins and have to repeat the exercise. If that means taking a 2 inch divot out of my shoulder, then so be it. While I'm not looking forward to the eventual scar, I don't care much about it either. It's not like I ever wear sleeveless things anyway! It is actually the pain and healing of the excision that I'm dreading. Well, that and being afraid to go outdoors during daylight hours. I'm already pretty much the pastiest white person I know. I've even had complete strangers comment on how white my legs are (happened a few years ago at Stone Mountain; I was not amused). I think the next step is becoming nocturnal! Maybe I should just skip ahead and go straight to vampire....

Anyway, if you're going to have cancer, this is the way to do it. Cut it out, show clear margins (meaning they got it all out), and you're all done. No radiation or chemo or lymph node biopsies or anything like that. The survival rate of people who receive surgical treatment for melanoma in situ is 100% at 5 and 10 years. "That doesn't happen" says my personal private epidemiologist (my Ph.D. brother); 100% survival rates are nearly unheard of. I know plenty of people who would gladly trade some pain and a scar for such a positive prognosis, or to have their loved ones back. Of course having had one means I am statistically more likely to have another, but I was already pretty high on the statistics of having one, so that's not really new. I'll have to be checked every 3-6 months for the next few years, and then we'll see.

PSA warning: Please practice sun safety and go to the dermatologist! Wear high SPF sunscreen, wear a hat (you can get these things on your scalp!), and avoid the sun during prime hours (10AM-4PM) as much as you can. And definitely protect your children! A bad sunburn during your first 20 years increases your melanoma chances significantly. Even if you think you have nothing on your skin to worry about, go see a dermatologist and have an expert tell you there's nothing to worry about. Please, I'm begging you. *This* is why you go, even when you think nothing is wrong, so that if/when there ever is something wrong, it is early in the game and super-simple to treat. I should have gone *long* before now. Between my skin coloring (or lack there of) and my family history of dysplastic nevus (atypical possibly pre-cancerous moles), I should have been going every year, and I didn't. In fact, it had been at least 15 years since I'd been, possibly up to 20. Long enough ago that I genuinely don't remember, and I know not since I got married almost 13 years ago. That was stupid! Don't be like me. GO! /end PSA

So, if y'all could think good thoughts for both the doctor and me on Monday, I would appreciate it. I'll check in Monday or Tuesday to let you know how it went. The report on the excision will take a while to come back, so we won't really know for sure if I'm "cured" for a little bit. When I know, you'll know.

Currently feeling: still trying to adjust to the news


  1. Of course you get the bestest good thoughts for Monday!

    My MIL had one of those excised when she was well into her 60s. It was about a 2-3inch excision on her upper arm, and it took a while (couple years) before it stopped looking like she had part of her arm sliced and serged together (it had that sort of seam looking appearance). You should bounce back much quicker than that, having a little more elasticity to your skin (being much younger than mid-60s!) So EXTREMELY healing thoughts are coming your way, and it's all going to be OK!

  2. Scary news, but you are right, if you are going to have cancer, that's the way to do it. And you are so right about being safe in the sun. I know I'm not as careful as I should be, and I appreciate the reminder.

    You will definitely be in my thoughts. Best wishes for a speedy recovery.

  3. {{{HUGS}}}

    Good healing vibes heading your way - scary, yes of course, but you were sensible and you have an excellent prognosis so focus on that.

  4. You have all the good (and healing) thoughts I can muster!

    My SIL (who lives near you) just had her THIRD one of these puppies removed (in less than three years). Yet, she persists in her outdoor activites - they have a lake house at which they spend a great deal of weekend/summer time. Let's not even talk about how many kinds of stupid that is. I am so glad you are not behaving like her. You will be around to love on your grandchildren!

  5. I'll truly be thinking of you on Monday and wishing you well.

  6. Hugs. Hope all goes well. I've moles removed from both shoulders with incisions of around 2cm in each so I know what you mean about the discomfort of wounds there.


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