Janner's Profile

http://www.MelanomaResources.info

Dx:

4/92 WLE of MM, Clark's Level II, Breslow .58, lower left front leg
2/00 WLE of MM, In-situ, lower right front leg
8/01 WLE of MM, Clark's Level III, Breslow .88, Right upper back
8/02 Squamous cell carcinoma shave, followed by scraping.

First melanoma:
I was 29 years old and shaving my leg one day. Finally convinced myself that this dark, multi-color, irregular-shaped mole on my shin was probably melanoma. I had watched it for a while and didn't think it was changing but decided I should not be stupid. Made an appointment with a new derm and he immediately removed it. He took wide margins but the path report wanted a bit more. WLE followed. Followed up for about a year but then stopped. Too much hassle to get a referral to my doc. Prior to the internet, guess I didn't realize how lucky I really was. Continued to watch my body myself.

Second melanoma:
Eight years since my last melanoma....feeling pretty good. I had a new mole pop up on my other shin. Nothing suspicious about it except it seemed a teeny bit "oranger" than my other moles. Made it stand out a bit more to me. Perfectly round, 6-7mm. About 2 years after this mole appeared, I noticed a tiny small dot in the very center of it. Had it removed immediately. MM in-situ.

Third melanoma:
Changed docs from just a local derm to a melanoma specialist at a Cancer Center. Started regular checkups with him. Had body checks but he found nothing suspicious. 2nd visit, I told this doc I wanted this dark mole removed from my shoulder blade. It was hard to watch. Doc consented. This melanoma was 4mm round, regular borders, solid dark color, no asymmetry. It looked nothing like my other melanomas. Now even my "regular-looking moles" are more suspicious. Checkups every 4 months. No additional treatment at this time.

1/02 Severely atypical nevi removed via punch. WLE 2 weeks later as a lateral margin from the biopsy was questionable. Developed an allergic reaction to the steri-strip adhesive as well as all other adhesives. Off to another derm 3/02 for patch testing to see what type of adhesives may be used in the future.

4/02 Patch testing shows I'm allergic to Mastisol and Benzoin - the adhesives they use to attach steri-strips. Also sensitive to all tapes. Had another punch biopsy done by the dermatologist on a new abnormal looking lesion on my back that just popped up within the last 2 months. Turned out to be mildly atypical but margins were not clear. This derm suggested watching it. Returned to my normal derm for mole mapping. I only have about 15 questionable moles (many freckles, though). Derm saw the pathology report on the mildly atypical mole and wanted to do a WLE. Didn't want any atypical cells left. I agreed. WLE done. Tolerated adhesive tape for 5 days. Opted to tape a pad into an undershirt and leave all adhesives off my skin. This is the best solution I can come up with for the skin irritation I get from the adhesives.

4/02 Mole mapping pictures taken. I don't have many moles, but don't trust the ones I do have. This definitely helps with the anxiety levels.

7/02 Happened to run into my derm and had him check a new little bump on my forehead. I'd had it for about a month. He didn't think it looked too bad but with my history, he opted to remove it. Squamous cell carcinoma. Had to go back and have it scraped again. Aparently, it was growing more on the surface than deep.

8/02 Regular derm appointment with updated mole mapping pictures. Showed him a new lesion on my arm. We both looked at it through his scope. I agreed it looked very superficial. He decided to remove it. He wanted to see a "NORMAL" biopsy report. Mildly atypical. Still trying for normal.

01/03 Two moles showed changes from my previous Mole Mapping pictures. One I had been concerned about. It was small and dark. I just felt it had nowhere to go but worse. The other looked worse, but felt less threatening. First one: moderate atypia. WLE because the dermatopathologist wouldn't guarantee the margins with a punch. Scar is 2 1/2 inches long on my calf and VERY tight. Bad place for a WLE. Second biopsy: congenital nevus with mild atypia. No WLE. ;o)

6/03 Participated in a Familial High Risk Melanoma study being done at my cancer center. I am adopted and never pursued this. But I happened to be talking to the lead study doctor one day and she suggested I join. Multiple primaries is apparently a good indicator of a genetic defect. So I participated in a one day clinic which included a detailed history, educational material and a blood draw. I never heard anything from this so assumed I had no genetic defect.

10/05 Received a certified letter from my cancer center telling me that they may have important health information for me. Did I want to know about it? So I scheduled an appointment to find out the results. I had to answer a questionnaire about melanoma before I talked to the genetic counselor. When I finally talked to her, she told me I had the p16 (CDKN2A) genetic defect. This is a tumor suppressing gene. They have known the results of my genetic testing for two years but was not able to assign a risk because they did not have enough data. So, in their high risk families, this defect presents a lifetime risk of 76% for developing melanoma. Moot point as I've already had 3 primaries. I also have an 11-17% lifetime risk of pancreatic cancer. Normal risk is <1%. Higher cancer risks for other types as well but not enough information on them to assign a risk. I then had to take another questionnaire upon leaving that discussed everything the genetic counselor told me.

12/05 Had an appointment with a GI doc who specializes in genetic pancreatic cancer and is the crossover doc to the melanoma family study. They suggest scanning starting at age 50 or 10 years earlier than the earliest pancreatic cancer in your family. I went to talk to him because I am adopted and have no history. I needed more input. We discussed that it was unlikely I would have pancreatic cancer, but I shouldn't ignore the possibility. So an MRI/MRCP as well as an endoscopic ultrasound was scheduled.

01/06 MRI/MRCP was done and showed no abnormalities of the pancreas. Endoscopic ultrasound (image pancreas through the stomach) was done and showed a slight enlargement of the bile duct. This is a prime spot for cancer to show up. For now, the enlargement is considered on the high end of the normal range. They will scan again in 1 to 2 years. I am now also involved in the Familial High Risk Pancreatic Cancer study as well. Oh joy.

April, 2009. Nothing new or exciting, just 17 years since I was first diagnosed with stage I melanoma. I don't really even remember what it was like to live without melanoma in my life!