My sister made me an appointment to see a dermatologist as she was concerned about my acne. The doctor had a brief look at my face, and as he was leaving the room he asked off-hand if I had anything else I wanted him to look at, suspicious moles, yadda yadda. I said actually, yes - one mole that I kind of had my eye on for the last year or so, on my upper right thigh, that was small but two colors, black and tan. He took a look and said, yep, let's remove this, and before I knew it the nurse was back to prep me for a biopsy. Funnily enough I ended up fainting for the first time ever as he was cutting it off, falling into the doctor and spilling my glass of water all over the floor. I woke up still in my underwear after what felt like a nice nap, and quickly realized "oh wow, I'm still at the doctor's office" - weirdest feeling ever! As I left the office I hoped that that would be the end of it, not wanting to have to face the staff again as "that girl who passed out".
Unfortunately, as would be evidenced by my joining this forum, that wasn't the end of it. I got that horrible call that we've all had last Friday. "Beginning stages of melanoma, we're scheduling you for a wide local excision, asap. Can you come Monday?" I took notes, said thanks, and called my husband. Then began the internet research. Oooooh boy. Having had no family history of melanoma and not really knowing much about it, all of a sudden the true nature of my diagnosis hit me like a sack of bricks. Since the nurse hadn't sent along the pathology report and the office had since closed for the weekend, all I had to go on was that I was in the "beginning stages" - did that mean stage I? II? How deep was it? I quickly became versed in Breslow's depth, Clarke level, 5-year survival rates, recurrence, metastasis, and the melanoma's favorite spots in the lungs, liver and brain.
Despite my best efforts to remain sane and rational, everything I felt or saw became a death sentence. I'd been feeling light-headed and had more headaches since the fainting - it's spread to my brain. I felt a small bit of pain around my left armpit - spread to the lymph nodes. Pain in my chest - it's spread to my lungs. I had a mild sunburn earlier in the spring - oh god, I am such an idiot. I sobbed into my husbands shoulder, "all I want is to grow old with you". Suddenly our happily-planned life of remodeling our home, traveling, enjoying nature, being together, starting a family - began to unravel. "I am 31 years old, why me, why now?"
On Monday I received the report. I will paste it below - and would appreciate any feedback from those more familiar with some of the terms. The doctor cut out a chunk of my leg and sewed me back up, and thus begins the waiting game for the next pathology report. I live in Mammoth Lakes, CA - aka, high-altitude (oops) middle-of-nowhere mountains, so will have to find an oncologist nearby, likely in the Carson City/Reno area. If anyone has an recommendations for doctors in this area please let me know.
So, here I am. I'm 31 years old, fair-skinned (Scandinavian ancestry), dark blonde hair and brown eyes, no family history of melanoma, or cancer for that matter, save my paternal grandmother who died of ovarian cancer. I grew up in northern Illinois, and spent summers swimming and playing soccer, but always with sunscreen. I did use tanning beds occasionally in my late teens and early 20s - a few times to prepare for a vacation to Mexico, a few times as it helped clear the acne on my face. Holy hell, if I'd only known...
I moved to Mammoth Lakes in 2009, elevation 8,000', and when going on hikes or planning on being outside for any period of time would always wear sunscreen - but if walking to the grocery store or poking around in my garden for awhile, would not. Of course I wish I could kick myself now, but I didn't burn and wasn't out for "long", so thought it was okay. I had a friend randomly stop over early spring, and as it was one of the first nice days of the season, we sat outside to chat. As it happens, we chatted for longer than expected, and I burned mildly on my right shin. Idiot, idiot, idiot...!
Here are some of the questions that I still have:
- Should we consider moving to a lower elevation? We love living here, but it's not worth my life.
- Does anyone have a recommended oncologist/hospital in the Carson City or Reno area?
- Besides staying inside or in the shade between 10-4, covering up, wearing sunscreen, exercising and eating healthily, does anyone have any further recommendations for lifestyle changes?
- My husband and I are going to create a full body map of my moles and spots, complete with pictures and measurements, to augment checkups to the derm/oncologiest. Is there anything else we should be doing?
- Should I find a counselor/therapist? I am still terrified, and don't want to lean on my husband too much.
- Will I be able to become pregnant if I have to go through any further treatment? Does pregnancy increase the likelihood of the cancer recurring?
- Will I ever feel normal again?
Thanks and much love to you all.
Pathology report (original biopsy):
Microscopic diagnosis: Melanoma
Microscopic description: The biopsy shows an asymmetric and irregular proliferation of single and nested atypical melanocytes at the dermal-epidermal junction. The single and occasional nested atypical melanocytes are present above the basal layer of the epidermis. The underlying papillary dermis shows mild dermal fibrosis and chronic inflammation.
Gross description: Received in formalin is a fragment of tan tissue measuring 1cm. Entirely submitted.
Comment: The melanoma is mostly in-situ with occasional atypical nests are noted in the papillary dermis with an approximate depth of 0.12-mm. These atypical nests appear connected to the overlaying epidermis in some sections. The neoplasm extends to the margins. A definitive re-excision is recommended.