Monday, January 30, 2017

My Melanoma

Melanoma is the #1 Cause of Cancer Deaths for Young Americans

This article was written in 2005 and is regularly updated.

The largest mole on the left shoulder blade was my melanoma in situ which is the very earliest Stage 0. It looked like a normal mole to me. If my nurse practitioner hadn’t suspected it, I’d be walking around with invasive cancer now, oblivious until it settled into my lungs, liver or brain. Notice how white I am. I’ve never had a suntan and always use sunscreen. I apologize for not having a close up of the mole. This photograph was taken so I could see the back of my hair at the Love & Hope Ball. I didn’t take a before and after picture of the malignancy because I never in a billion years dreamed it would be cancerous. I’m still in shock that I have Melanoma, I didn’t think I was at risk.

That’s correct. My dermatologist advised me Melanoma is the leading cause of cancer deaths for Americans between the ages of twenty and forty. Everyone fears breast cancer and prostate cancer. Why isn’t the media getting the message out?

Most of us think skin cancer is preventable. We limit our sun exposure between ten in the morning until four in the afternoon. We apply sunscreen. We use cosmetic tanning creams, go to tanning spray salons or lay in UV-free tanning beds.

I’ve never been a sun goddess. I do my gardening early in the morning or late in the evening. I take the kids to the pool after four p.m. and liberally slather on the sunscreen. I’ve never sported a suntan. I don’t smoke, drink, drug or fool around on my hunky husband. I have skin cancer.

My risk factors were strawberry blonde hair, blue/green eyes and two bad sunburns during my sixth summer, when our wonderful neighbors took me to the beach in Ocean City, Maryland with their kids.

How many of you have blue, green or hazel eyes? Blonde or red hair? Get yourselves and your loved ones to see a medical professional ASAP. Skin cancer can creep up on anyone at any age. Even you tall dark and handsome types. All ages, races, skin tones, eye and hair colors are at risk. Human? Get checked.

Like many of you, I thought Melanoma was the curable, no big deal cancer. They remove the mole and it’s gone. No problem. Wrong! Melanoma begins in the surface of the skin, travels down through the layers to the lymph nodes, where it hops on and is transported to the lungs, liver and brain. Cancer that originated in the skin is still Melanoma in the other organs, and it is just as deadly as if the cancers originated in them. This is how people die of Melanoma. Yes, non-smokers, non-drinkers and non-thinkers do contract lung, liver and brain cancer.

At my annual well-woman check-up, I asked my nurse practitioner to take a look at some itchy raised ugly lesions on my back that were bugging me. I thought they were Seborrheic Keratsois, which are benign lesions most people eventually get. She confirmed this. I asked her to recommend a dermatologist. She did, and said, “While you’re there, have him look at this mole on your shoulder blade…”

The initial biopsy showed a severely irregular nevus. The dermatologist explained this could turn into Melanoma, so he wanted to remove it ASAP. The total excision a week later confirmed Melanoma in Situ in the epidermis, the top layer of skin.

Yep, that mole which I took no notice of was Melanoma. It didn’t look like any Melanoma photo I’d seen. It wasn’t black and blue and red and crusty and bleeding. Those photos are what the advanced stages look like. The early stage looks like a normal mole, but has a slight irregular shape to it or a subtle color difference of hues within. I can’t even guess how many seemingly healthy people are walking around with early Melanoma and they have no clue.
I was stunned. How could I have Melanoma? What about all of the little-black-bikini-moms sautéing themselves poolside all day? They were bronzed beauties and just fine. I was a pasty white frump and I had skin cancer.

I endured three operations at the primary site. All layers of skin and some fat were removed, along with a margin of healthy tissue. Stitches in my shoulder blade prohibited me from doing so many activities. Tying my shoe. Yanking clothes in and out of the washer & dryer. Unloading the dishwasher. Pulling weeds. Typing! Oh that hurt so much. Two pathologists agreed all cancer cells have now been excised. I was very fortunate the cancer was only in the very top layer of skin and hadn’t begun to penetrate. I won’t need to undergo radiation, chemo or immuno therapies. God bless my gynecologist nurse practitioner, Brenda Hagan, for suspecting this mole.

My dermatologist tossed me onto a surgery-go-round. Every two weeks I had one or two suspicious moles excised or re-excised. The sutures were removed in seven to fourteen days, and then I had another round. This dragged on for six months in 2005.

I joined a Melanoma Yahoo Group. The other sufferers and their loved ones basically told me that Melanoma always comes back. They remove it all, and then in a few years, or maybe even a decade or more, it comes back. This time in the lymph nodes, or worse. I eventually had to unsubscribe, it was too sad.

The local news didn’t help my mood. A 27 year old pregnant woman who had Melanoma removed as a teen, wasn’t feeling well. She went to the emergency room, and they found Melanoma in her brain. She lapsed into a coma that night. Her husband quit his job and stayed at her side. They kept her on life support until her fetus grew large enough for a premature delivery. She died when her baby girl was born. The baby died five weeks later.
According to the National Cancer Society, the average person with Melanoma has a reduced life expectancy of 18 years. Factoring in my parents’ and grandparents’ long lives, that takes me to around 62, just when I will be eligible to receive my deferred pension. I might not live long enough to receive the first check. It’s doubtful I’ll ever draw Social Security, since I’ll have to be 67 to receive full benefits. But then again, that’s the statistical median. Half the people live longer. Half die sooner.

Once the shock of the cancer diagnosis sank in, I didn’t cry and freak out. I educated myself, and looked back at the lifestyle changes I’d made over the years. I’m going back to brewing a pitcher of iced tea daily. It’s rich in antioxidants. I’m tired of diet soda anyhow.

I did get grouchy and annoyed at the inconvenience, pain and limitations suddenly imposed on my daily life.

I never did the Why me? drill. I’ve had other devastations to endure, and I learned early in life there is no answer to the riddle Why do horrendous things happen to good people? I’ve accepted my disease and that I have a little less time to go. I have chosen to spend the rest of my life on the sunny side of my dreams. I want to take a great big bite out of life with my blue-eyed blonde family.

I am having a hard time swallowing the two bad childhood sunburns caused my Melanoma. Yes, I have been lightly sunburned and peeled a few other times in my life, but never a severe blistering burn. I have kept my sun exposure to a minimum and applied sunscreen. Yet I know many people who sunburn every year before tanning to a dark brown and they don’t develop this in the prime of their lives. Are UV rays really the sun cancer villain? Could something in the sunscreen cause it?

Every house I’ve ever lived in has tested positive for radon gas in the basement. We tested our current home. A normal radon reading is below 4. Two tests indicated our radon level was 20! We stopped spending time in the basement until my husband and son installed a fan to vent the radon out from under the house up through the roof. The next test came back at a reading of 1.2, which is comparable to what the radon concentration is outdoors. I’m very proud of their hard work and proper installation. The fan runs continuously, I hear the hum in our master bathroom as it is adjacent to the attic where the pipe vents through the roof.

Could radon gas exposure have been the culprit or catalyst that triggered my Melanoma? Do any of you with Melanoma have radon exposure?

My husband has his peanut butter theory. Everyone who has ever contracted cancer has eaten peanut butter. His point being we are probably poisoning ourselves and are clueless.

I have skin cancer.

I want to get the word out to everyone. I’M TALKING TO YOU! Each time you see a doctor or nurse, for any reason, ask them to look at your moles. Don’t insist “Oh, mine are fine. I won’t get skin cancer.”

Everyone is at risk…
Update March 15, 2007
I had another follow-up full-body-check today. My dermatologist wants to biopsy a mole on the right side of my neck, near my jaw line. He’s concerned it could be basal cell carcinoma. I had one on the opposite side, same location removed in 2005. That one was a severely irregular nevus, which was on its way to turning into melanoma.

Basal cell carcinoma is not usually deadly like melanoma is. Basal cell carcinoma can be disfiguring if left untreated.

I’ve had a lot of benign seborrheic keratosis popping up and I don’t like the ones on my face. He froze three today.

I also have benign skin tags on my neck which I want snipped. My doctor will remove them when he does the biopsy. Then I’ll be all set for ponytails and up-doos this Summer.

Please, please, please! Even if you have always slathered on sunscreen and stayed in the shade, like I did, have your moles checked. Anyone of any race can develop melanoma. Its a silent epidemic.

Yesterday I was contacted by a textbook author who had visited my website. I granted her permission to publish my above photo in two medical terminology textbooks. One for high school, the other for community college. I feel like Lucy Ricardo in the I Love Lucy episode where she writes a novel and they want to use it in a book about how not to write a novel. Nobody wants to be in a medical textbook. I’m giggling inappropriately and I don’t know why.

Update March 25, 2013
My father was diagnosed with Melanoma at age 91. It didn't kill him, he died of heart failure after a long life in the sun as a farmer, cowboy, Marine and police officer.

As I wrote in 2005, I'm still suspicious that environmental factors in addition to the sun contributed to my early Melanoma. Now there is a lot of talk of the chemical BPA in plastics and lining food and drink metal cans. I rid our home of all plastic that didn't say 'BPA free', the vehement protest of my Disney daughter who loved all of her cups she'd collected from the theme parks. Good news. I did save them and they have a "5" recycling symbol. I just learned that "7" is the one that might contain BPA, so the cups are back in use. Now to use up all the canned food and soft drinks then start buying only frozen or in glass or plastic containers.

Nobody has said BPA causes cancer. There have been studies that show is a hormone disruptor, and in small doses is not dangerous. Still, I don't want it in my body.
I just had another six month full body check. For the first time in eight years, there were no suspicious moles to be biopsied. Usually I have three done:  one mole the doctor is concerned about, one I'm concerned about and one that spooks us both. This is my second visit to this dermatologist and I really like her. I have lots of seborrheic keratosis, which are wart like benign lesions on my trunk and a few on my face and elsewhere. It was always a bother for the male docs/physician's assistant to freeze a few off with liquid nitrogen.
At my first visit to her last year, this lady doc froze sixty from my back. She allowed her nurse to freeze eighty-five yesterday! Pretty much all that we could find. You'd think liquid nitrogen would feel cold. It actually stings like a bee with a blow torch as she zaps each spot for x amount of seconds which seems like a minute but I know it isn't. I flinched and curled my toes and made fists and scrunched up my face but kept a stiff upper lip. She apologized continuously for the pain, but I wanted them gone. The immediate reaction was redness and swelling, I looked like I had hives. And it burned for several hours, I felt as though I was on fire. I took one dose of Aspirin when I arrived home. The pain subsided and now I'm just left with the brown and red spots (some of which bled, probably due to the Aspirin). They will dry out and flake off during the next thirty days. Then I'll look so much better in my summer clothes this year with all of them gone. And it will be easier to keep an eye on changes to my moles and freckles since there won't be so much to look at. Yippee!

Update Thanksgiving 2013
My beautiful non-smoker sister, Beth, died of lung cancer two days ago. She hid it from me, wanting to beat it before she told me. Her husband contacted me one week before we lost her. Beth's voice was long gone. I don't know what type of lung cancer it was. I instantly assumed it was caused by second-hand smoke as she had lived with smokers since college. Her husband still smokes. But now, in May 2015, it's occurred to me it could have been Melanoma that caused the lung and brain cancer. She may have never even found the mole, if like mine, there was no tell-tale pigment in it. Bless you sister, I miss you every day.

Update November 2014
My latest full body skin exam revealed a change in a mole on the back of my upper inner thigh that my dermatologist found troubling. The biopsy came back benign. This wound is a challenge to care for. I have to place a mirror on the ledge of my bathtub and hoist my leg over it to see what I'm doing. The Vaseline is leaking through the band-aids and staining my pants. Sigh.

On an up-note, my doctor let me in on a secret:  Silicone Scar Sheets. They're like band-aids and they flatten and lighten keloid scars. I'm like why didn't anybody tell me about these 9 years ago? I've been tortured this year with so many steroid injections into my scars and stinging laser scorches. Which did nothing but irritate the big raised ugly purple scars on my chest and back. These expensive scar sheets really do work and I am using them diligently. They are available at drug stores and Walmart. $18 a box.

Update April 2015
Had my 6 month full-body skin exam by my dermatologist. She found a worrisome mole on the center of my lower back which she immediately removed. The biopsy showed it was a mildly atypical nevus. Benign, but morphing into badness. The margins were clear, so she got it all before it did evolve into Melanoma. I've been cancer-free for ten years. Unfortunately, since I have an open wound on my back now, I'll have to temporarily discontinue the Brazil Butt Lift workouts, yoga et al. I'll try to run tomorrow and see how I do. Might need to be content walking. Walking is better than dying :)

My 22-year-old daughter also had a worrisome mole biopsied this week. I'd been concerned about it for two years. The doctor she went to back then said it was beautiful, just to watch it. The physicians assistant at my dermatologist last week didn't think it was anything, but did a shave biopsy because my daughter insisted. Guess what? It was a mildly atypical nevus, and now she has an appointment with my doctor to have more skin removed. Momma knows best.

Moles don't have to have all of the signs and symptoms to be cancerous. My melanoma had no pigment in it whatsoever. It was just larger than a pencil eraser and had an irregular border. It surprised the physicians assistant, he wasn't expecting a malignancy.

I've told my 25-year-old blonde haired, blue eyed, fair skinned son to have a skin check as soon as his new job insurance kicks in, and then every year thereafter. He takes after me and my father, who didn't have melanoma until age 91 and it didn't kill him. Something in my generation has accelerated the skin cancer's arrival.

Update May 2015
The margins were clear on my 22-year-old daughter's subsequent biopsy. My doctor took enough extra skin around the atypical nevus to create a 4" scar on her shoulder blade which I am dressing with Vaseline and gauze after every shower. She is just fine.

Please have your skin checked every year by a dermatology professional (doctor, nurse practitioner or physician's assistant). And make appointments for your whole family. Melanoma and other skin cancers are quiet killers. All races and ages can be afflicted, whether you are a sun worshiper or vampire.

Anecdotal Update June 2015
This blog post has begun a dialogue on Twitter. I've been told:

More Australian men die from Melanoma than automobile accidents.

Melanoma is detected at a later stage if covered by a tattoo. Please if you have tattoos, get a full body skin exam by a dermatologist as soon as you can schedule it. Please!

Update April 2016
At my six month full body check, my dermatologist biopsied a mole on my leg she said had a white ring around it. I couldn't see it, but she did with her magnifying light. It came back as a dysplastic nevus, which means it is morphing into cancer, but isn't there yet. Two weeks after this biopsy, I went back today to have the skin reshaved. The doctor determined the wound is too irritated to do that now. It had gotten infected and I finished up a course of Keflex antibiotics this morning. She wrote another script in case it gets really red but told me to hold off on another course of antibiotics. She gave me instructions to create a vinegar rinse, which she feels will clean out the goop and heal it better than antibiotics. I have just done the first soak. It stung a little. My next appointment is in 3 months.

Update February 2017
I continue to have full skin exams every six months. My dermatologist has my polka dots memorized. One of us always finds something new or changed and it gets biopsied and depending on the results, I either wait another six months or she has me back in two months to make sure no pigment is returning. In the meantime, I'm on pigment watch, and if I find any, she will re-excise the scar immediately. Since my initial Melanoma in 2005, no more has been found. We're staying on top of my skin, and anything suspicious is removed before it can evolve into malignancy.

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My Melanoma

Melanoma is the #1 Cause of Cancer Deaths for Young Americans By SHERRY MORRIS This article was written in 2005 and is regularly ...