In honor of the start of the Summer season and my recent clean bill of health at the Dermatologists office I thought I would do a little public service work for you fine folks.
It starts and ends with this- Wear sunscreen, all the time.
I am extremely lucky in some ways. While I’ll never win the lottery, so it seems, I did by chance, happen to enjoy a dry walk to the bus stop in the morning and another on the way home from it last week on a day when there really was only about two 20 minute periods of no rain. I’ll take that kind of luck any time, as a matter of fact I’ve sort of come to expect it as evidenced by my not carrying an umbrella that day.
About 10 years ago I had a similar stroke of luck, although this time the stakes were much higher. And, I had no idea. I had a mole on my back that was a little bit odd, I think that’s about the best way to describe it. Wasn’t particularly large I’d say it was about the size of a zero on a page in 12 point font. It was weird in that it was especially dark, matter of fact it was quite black and had a bit of brown on one side and it was raised a little bit.
At my annual physical I mentioned it do my GP, he took a look, shrugged and said “I don’t think it’s anything but if you’re worried I’ll send you the Dermatology clinic.” He was BTW, the second GP to tell me “it’s nothing”. Now Mrs S would be all over me if I didn’t go, so the appointment was made. Dermatologists are notoriously hard to get an appointment, but I did and I went. The Derm looked at the mole, commented that it’s “not too impressive, I’m pretty sure it’s nothing but we can take it off just in case it’s a precancer kind of thing. But I doubt it” and just to be sure he took it off with a hole punch looking deal.
Three days later I got the call that the mole was a malignant melanoma and I needed come back in for more surgery that day or anytime tomorrow.
It was a serious “gulp” moment for me, one that I’m still dealing with.
I was quite lucky in this, the first removal had taken the entire mole, but current protocol is to take an additional centimeter or more of skin from around the spot. The result was a 6 inch scar and clear margins. Because it was caught so early there was no need for any other treatment, which was good because the last thing a guy with melanoma should do is get on the internet and look up melanoma. You’ll be getting your affairs in order pretty quick I assure you. The problem with the disease it that once it breaks through the dermis layer it metastasizes pretty fast around the body and once that happens, response to treatment is in the low single digit percentages in terms of success.
Since that time I’ve had three more moles removed that were judged atypical stage 3, or as my doctor would say pre-cancerous. When they would “turn”, who knows. But, I’ve been going to the derm every year and I’m almost guaranteed some stitches and the most hated part of the deal, the biopsy result.
Since the surgery I’ve learned enough about moles and what to look for; the ABCD’s of skin cancer and I’ll admit I do spend some time worrying about stuff.
For those of you at home the ABCD’s are as follows, the below are indicative of possible issues:
A= Asymmetrical Moles that aren’t round or oval, one side is different from the other.
B= Borders are jagged or blurry, they aren’t sharp.
C= Color, moles that aren’t uniform in color are suspicious.
D= Diameter- if it’s bigger than a pencil eraser get it checked out.
E= Elevation- raised above the skin.
To this I would add a couple more-
Changes= moles that seem to be changing shape or size
And the obvious one, any mole that bleeds needs checking that afternoon.
So after my experience and the ensuing paranoia that it brought I happened to talking with a friend of mine at work. Glancing at her arm I noticed a mole that met three of the criteria above. Not that it was any of my business, and I didn’t really know this woman all that well, but I commented to her that she should go get that thing looked at.
She wasn’t open to my suggestion. All professional talk aside, I was pretty serious when I said; I don’t want to alarm but based on my experience I would get that thing looked at. In addition I learned that women for some reason are more likely to get melanomas on their arms and legs, men on their torsos. I told her that she really needed to have that evaluated but I would say nothing more about it.
About a month later she came by office, her arm in a bandage. “I just wanted to let you know that the mole scared me into having checked out.. it turned out to be melanoma, stage 2.” Stage two requires additional screening including a lymph node or two to be biopsied. It means the tumor as gone through the dermis and is in danger of reaching the lymphatic system and blood stream. The outlook isn’t as great.
She was lucky as well. The doctors could find no evidence of involvement beyond the initial site and she was in the clear. But only after two surgeries and several different scans and biopsies.
I’m quite certain my cancer was a direct result of years of playing in the sun, I grew up swimming in the neighbors pool almost every afternoon. Not to mention sailing and fishing and I don’t thing I wore sunscreen once that entire time. I remember some extensive sunburns, like more than one a summer and you know, I never thought twice about it.
I do now. And so, should you.
My experience was pretty mild. The initial biopsy, a skin harvest that turned into a nice coin purse for my parents and trips to the derm every 6 months for several years, once a year these days. Since then I’ve had many more moles removed. My back is has many white lines and stitch marks across it, as does my leg and foot, and so far I’ve been fortunate. As a matter of fact the best thing to come out of this are two things 1) I don’t really have to worry about melanoma anymore. The number of screenings and frequency means I’m well monitored and while statistically I may get another one, I’m pretty sure it’ll be caught early and I can get it removed before it does harm. 2) I move to the A List of appointments for the Dermatologist. Where most people get a 8 week out appointment at best, I call and ask for an appointment, play the “M” card and I’m in that afternoon.
The bad news is I will never be able to get health insurance on my own again.
I have type O- blood. Very popular in the blood giving community, it’s the one blood type that makes me the universal donor and it’s the type of choice for newborns. I have my last pint a few weeks before my diagnosis. I’m now in the thanks, but no thanks community.
Life insurance is pretty expensive. I just recently was able to get it again, but only at significantly higher costs.
So, moral of the story- wear your sunscreen, and STAY OUT OF THE TANNING BOOTH. No one looks good with a tan in my opinion.