MPIP: Melanoma Patients Information Page

The MPIP is the oldest and largest community of people affected by melanoma hosted through the Melanoma Research Foundation. It is designed to provide support and information to caregivers, patients, family and friends. Once you have been touched by melanoma—either as a patient or as a family member or friend of a patient—you become part of a community. It is not a community anyone joins willingly. But if you must be part of this group, you will find no better place to find the tools you need in your journey with this cancer, and the friends who can make that journey more bearable.

The information on the bulletin board is open and accessible to everyone. To add a new topic or to post a reply, you must be a registered user. Please note that you will be able to post both topics and replies anonymously even though you are logged in. All posts must abide by MRF posting policies.

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Rita and Charles's picture
Replies 1
Last reply 12/13/2015 - 8:09am
Replies by: Momofjake

I visit often and don't post a lot, i constantly look for topics that might answer a question or set my mind at ease.  Afterall, my husband was only diagnosed in May......only one tumor in his lung, lymph nodes affected...but not the tumor burdon of some. 

Early on I picked up on Arties journey, I followed his posts and felt so touched by the sheer hard work he put into his battle. With humor he described his journey, his ups and downs even his pain. He kept fighting. Selfishly I felt solace in thinking that my husbands was caught early, he is responding to the BRAF combo...we wouldn' have to walk in Artie's shoes.

I have been working like mad for months now, keep moving, supporting Charles ....keep moving so I can't stop to think what If? After I read about Artie, I cried harder than I have in 5 months. I never knew him, but I feel I knew him.  I cried for him, I cried for us - for the fear that we might be just at the tip of an ice berg of what our next 3 years might unravel to be.  I am positive......but the fear came with Artie's passing, how will we handle choices he was faced with.....will we ever have to make those choices.

This is just temporarty sadness insanity, tomorrow is a new day and we will decoraate for the holiday...plan for years to come.  With hope.........but I will not forget Artie, Life has forever changed, measured by blood tests and scans, spots and derm visits....but we have life, now we just need to hang onto Artie's courage and humor.

Take care everyone, all stages - with all the new medicines maybe the melanoma beast can be tamed.

 

Rita

Rita

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Maureen038's picture
Replies 8
Last reply 12/14/2015 - 3:56pm

Hi all,

    It's been so long since I've posted because my husband has been in a battle with this awful disease. I haven't wanted to post it for a long time, but because of Artie's  incredibly brave postings about all of his struggles, I feel I must share what my husband has been dealing with in the hopes it can help someone else. After being on the Ipi/opdivo trial for over a year where he was just taking opdivo for at least nine months he progressed. We were SO close to NED. It was devastating!!! He had two lung nodules that were in the lung, but one was very close to the heart. He continued the opdivo for a month while we consulted with three melanoma specialists. The next scan both nodules doubled in size and the one by the heart, he had to have a heart MRI to make sure they could operate. We decided for him to have his third VATS surgery on the right lung because of how fast the growth was and how close it was to the heart. The surgery was successful, but he still had two nodules in the chest cavity. Each of the specialists had different opinions, but because Bill has had interferon(waste of time), TIL at NIH and then the Ipi/opdivo,there weren't many options. He didn't qualify for some new promising trials because he had hemolytic anemia due to the Ipi. When we went to Sloan Kettering they did a blood test to look and see if he had any common cancer mutations. We found out only about 2-3 percent of melanoma patients have the Her-2 mutation and Bill has an over abundance of it. They asked Bill to do the pill form of DTIC while they were waiting for the trial to start. He was supposed to take five days of pills and then wait three weeks and do it again. Unfortunately Bill's blood counts went so dangerously low he was in the hospital for nine days. Luckily he got out of the hospital the Friday before thanksgiving. Apparently Sloan Kettering is in the process of writing a paper about patients that have been on the Ipi/opdivo trial and progressed and then did the DTIC. They had five patients there that had very similar responses as Bill and they also had very good scan results. All of the patients were neutropenic.

Bill lost about ten pounds too. His blood levels are almost normal and his scans showed very good shrinkage on the two nodules. The trial at Sloan Kettering has been delayed until February so we are paying for TDM1 ( a form of Herceptin- breast cancer drug)every three weeks because we think it's risky to wait. We are hoping that insurance will pick up some of the cost. Bill has gained back about four pounds and still has an amazingly upbeat attitude. I feel very blessed we have options and hopefully the drug will work.

May all of you have the best holiday possible!

Love,

Maureen

 

PS This post is in honor of Artie!!! May we always remember his courage and honesty!!! He will be deeply missed on this board!!

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SABKLYN's picture
Replies 3
Last reply 12/12/2015 - 8:04pm

Found this his and thought I would share

 

http://www.wrul.com/2015/12/10/glen-a-artie-vangampler/

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Momofjake's picture
Replies 11
Last reply 12/11/2015 - 9:28pm

Scans were not good. And dec 5 Artie wrote to me here. Now he is gone. Not my best day. I hate "cancery" days. I feel faced again with the reality Jake may not have the time I want....6 months of Keytruda. 2 new tumors. Throat and rectum!!! He is 18! For 6 months he has had 20 in his liver, 20 in his lungs, many in his spine, all over his bones...now this. He takes it great. Feels fine. Looks good. 

I go to bed devastated. Not Artie. At least he is free of this beast. I will wake up okay. I can't waste the good days crying about the bad ones. 

I loved you Artie. You were the first to help me. You were smart, kind, and empowered me in a fight I didn't want with melanoma! I will keep you in my heart! Please watch over Jake. 

Kerri

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Janner's picture
Replies 3
Last reply 12/10/2015 - 11:17pm
Replies by: kylez, Anonymous, Bubbles

I liked this article - gives a good analogy on how the body works and how cancer metabolizes sugar (layman terms).

 

http://www.cancerdietitian.com/2015/08/why-you-should-stop-saying-sugar-...

http://www.MelanomaResources.info

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BrianP's picture
Replies 12
Last reply 12/29/2015 - 11:23am

I know several of you are Facebook friends with Artie or maybe had other channels of communication.  I would like to request if any of you see information regarding obituary or memorial services if you could please post here.  I would very much like to know if and when his family has made any "in lieu of flowers" request and I'd also like to know his parents' address so I might make a donation to MRF in his memory.  I'm hesitate to post someones personal address on this site but if you could message it to me that would be great.  I'm not sure if his parents knew how much he was loved by this site but I think it would be a wonderful gesture if there was a fundraising effort in his honor.  Right now on the MRF donation page I don't see a way to let the family know the donation would be from Artie's MPIP family but maybe someone on the MRF staff can help us with that. 

Thanks,

Brian

 

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micheley's picture
Replies 6
Last reply 12/11/2015 - 10:23pm

Hello everyone,

 I went to Penn today for my 2nd Yervoy (10 mg) treatment and it was pushed back to next Thursday, 12/17. Dr. Schuchter felt it was a good idea to get the rash under good control before giving me the next treatment -- which my husband and I both agreed with.

 As many of you know, the past 10 days I have been fighting a pretty good rash. At first it was located solely on/in my ears, neck, upper chest and upper back, and underarms. It was mostly diffused red bumps and not concentrated. They initially treated me with Hydracortisone .1% cream but that did nothing. In fact, the rash moved on to all other parts of my body (including tiny blisters around my mouth with small, red, itchy bumps around my left eye, anus, labia, and a llitte bit in the entrance to my left nostril, basically targeting the mucosal tissue, peripherally) with the most intensely irritating and sore rash in my armpits. It was (and is) angry, red, burning, and stinging. Then I received a prescription for Fluticasone .5% -- which still did nothing. As of yesterday, I started with a low dose (10mg/daily) oral steroid that bumped up to 20 mg/daily as of today's visit.

 The good news is they took my blood work for today's treatment and it all looked good. So, when I get through this rash portion of the effects, the first treatment was ok. Of course, as I've been told, the effects can become more increased with each subsequent treatment so the next one brings additional apprehension. Dr. Schuchter indicated she could/would drop my dosing to 3mg for the next treatment if I wanted her to but, at this point now, I'm committed to taking the 10mg dosing -- if or until I experience more serious side effects -- as there is no hard data yet to support the benefit at the 3mg dosing for Stage 3.

 By the way, I wanted to mention I found a lump on my neck behind my left ear last Sunday -- the opposite side of my neck dissection. Of course, it freaked me out. I called Dr. Schuchter's office and her associate indicated it could be an enlarged lymph node due to the treatment. Then, another lump presented on the same side of neck surgery on the back part of my neck. My ENT, who I was seeing as a follow up to surgery, wasn't concerned either -- also indicating it was more than likely the treatment not a recurrence. No one was worried and they told me it is likely more nodes will become enlarged. Good to know.

 I am mentioning it in case anyone else has the same effect after their treatment. Yes, of course, get it checked out but it's more than likely the treatment as they are tweaking our immune systems -- hopefully, to a a good end!

 That's all for now. I will continue to update you.

 Wishing everyone healing, comfort, and peace.

Best,
Michele

 

Michele C Yerger

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Lindsayblueyes's picture
Replies 3
Last reply 12/14/2015 - 7:37am

Hello everyone. I've been lurking here since Sept but haven't posted until now. I'm a 35 yr old female and was diagnosed with an insitu melanoma on Sept 23rd. Margins were found to be clear after WLE. I've since had 4 more biopsies. I have atypical mole syndrome and have had several biopsies over the years. I also have a paternal uncle as well as first cousin on my mother's side who have had melanomas removed (not sure if this qualifies me for FAMMM)...

My derm put a "rush" on my latest two biopsies. I've been calling each day for results as it has been nearly two weeks. Today, finally, my derm got on the phone with me and told me they only have a preliminary report. The slides from one of my biopsies has been sent to Boston for a second opinion as they cannot rule out invasive melanoma. He said the 1st dermapathologist (sp?) believes it is a severely abnormal nevus but they want another opinion.

My question is this...how could a severely atypical mole actually be invasive melanoma. Wouldn't it be an insitu? I thought insitu was the next "step" after severely atypical. I'm trying not to be anxious but I'm definitely concerned. Any explanation would be appreciated.

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jessicaerin02's picture
Replies 15
Last reply 12/26/2015 - 4:54pm

Hi everyone,

I am 33 yrs old newly diagnosed stage 3a. I've been struggling with many decisions and finding my path through the "mad rush" phase of this diagnosis and would appreciate any input from this supportive community.

late August 2015 - mole (left buttock) excised by derm. Mole was not new, but had seemed to change during pregnancy, kept putting off getting it checked (busy with new baby and assumed (and also was told) it was normal to have some moles change while pregnant) and finally went in August. 

Sep 2015 - confirmed melanoma. Superficial spreading. 0.92mm non ulcerated, mitosis 5. Referred to major cancer centre melanoma oncologist.

Oct 2015 - WLE and SNB left groin. Margins clear. 1/1 nodes positive for micromets 0.34mm. Surg onc saw no other clinically suspicious nodes or concerns. 

Nov/Dec 2015 - Baseline CTs head/chest abdo pelvis all clear. Stage 3a. Recommended to be followed by ultrasound q3-4months. Offered interferon, or Trial available: randomized interferon vs keytruda but requires full completion node dissection, (and it's unclear if requires >2 nodes involved???). 

For peace of mind we are in the process of getting a second opinion from Johns Hopkins and have access to Memorial Sloan Kettering if we want an additional opinion. The other major cancer centre in our city would likely push for surgery but they are a bit more conservative than our centre which was part of the MSLTII trial. I trust and respect my doctors and feel safe in their care, but I can't help but wonder what the other side of this argument might be. I have a medical background and a good understanding of the research that exists. I understand the recent German paper which found no difference in overall survival, yet the question of local disease control is raised.

It's a very tough decision, wondering if you're at the forefront of a big practice change, or if there is truly is value in doing the CLND in the case of 3a (despite the quality of life challenges which influence my decision). I also wonder if down the road, what role the lymphatic system will play for the newer immunotherapy drugs, and in that case, would retaining the nodes be the right way to go. 

On top of this we are in the midst of trying to preserve my fertility via egg retrieval given the chance I may choose interferon (or additional therapies in the future, in that case it would be a peace of mind thing  as well, as we would like to have additional children down the road). On that note as well, our medical oncologist has assured me that there is no evidence to link pregnancy with melanoma, but I have read some anecdotal cases that might contradict that. Is it advised to be NED before trying to conceive again? 

I've been advised by loved ones (and my heart tells me as well) that there is no right or wrong decision, just the decision that is right for you... I trust medicine, I trust research but I do know that it has to feel right. I have a beautiful baby girl and loving family and I just do not want to leave this life early. I am so scared.

Looking for advice/input or if anyone is currently going the ultrasound route and what your experience has been. My apologies for the long post. And thank you for listening...

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Becky's picture
Replies 31
Last reply 12/12/2015 - 5:53pm

I see on FB that Artie lost his battle. This makes me so sad. I rarely post but have been reading along for 6 years...everytime there is a loss it breaks my heart. There are a few over the years ( Himynameiskevin, Dian, Jerry) that break my heart even more. Artie is one of those. He has been in so much pain, but never complained. Always here to give advice.

 

keep fighting everyone

Becky

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Azcaddyman's picture
Replies 6
Last reply 12/15/2015 - 5:57pm

Let's start out by saying I don't mean to ramble on but here's my story.

A couple years ago I first saw it. A large bruise/birthmark looking thing on the back of my neck. I asked my gf if she ever noticed it. She assured me i always had it. We had been together 5 years at that time. I asked my ex wife if she ever saw it. She said she didn't know what I was talking about. I asked my mother. She said I was born with a birthmark. I thought how strange I could go 40 years and never know. So I just stopped worrying.

I've had battles with my health. In 2013 I started having problems breathing. I've had asthma my whole life but I had never had serious issues like this. I had a cough so severe that it would make me faint. Off to the Dr I go. Get referrals to cardiologist and pulmonologist. Heart was fine. Lung Dr thinks I have copd. Starts me on a full prescription regime. I have now been on prednisone among many other drugs for 2 years. However in the duration my health was so bad it cost me my job and career.

Now unemployed I decided to take time off to recover and be a daddy again. My youngest daughter was born in 2014. I was feeling more like myself. I decided it's time to get back to work. Ok in all fairness the local court also demanded I work on my growing child support from my first 2 kids.. But that's a whole other story

I started applying and interviewing but just as soon as I did, I started to feel just off somehow. I felt sick but not in a cold or flu way, just not well. At first it started mildly. Eventually I started getting a persistent headache that never goes away completely. It's at the base of my skull on the left side (right above my skin lesion). Then my legs started feeling heavy. Like I was pulling a few hundred extra pounds. Next came burning numbness and tingling in my feet. So bad that I'm even writing this at 3 am cause sleep is impossible.

In October 2015, while battling my now mystery illness I had the chance to interview for a job back "home" in Phoenix az. My parents paid for my trip home. When I arrived I actually felt good. Almost no symptoms of anything except one scary thing. The skin lesion had started itching a few weeks prior. After not looking at it for years I noticed changes. It had grown "eyes". 2 spots that had lost color. On a visit to my parents home I again asked my mother about my birthmark. She again told me I was born with it. However upon questioning her my heart sank. I was born with a "stork bite". My children all had it. It's a strawberry colored mark at the base of the scalp. It's common and it fades quickly. It's also not where my lesion is located. I'm now convinced I have melanoma. I've done my research. I know what I'm looking at.

Upon my return home, again I quickly started with my other symptoms. Now add in extreme fatigue. Getting out of bed is a chore. The headache and ringing in my ears is more than I can tolerate. Off to the Dr I go. I get a referral to an ear nose and throat Dr. I didn't mention my skin lesion (yet) cause I sat in disbelief. Years of treatment for copd/asthma means I had dozens of Dr visits. Every one of those visits involved in a Dr using a stethoscope on me. I had a Dr inches away from my cancer and no one saw it. Oh I'll add it's amoeba shaped almost 2 inches long! Now this time after describing my headache again I pulled down my shirt and said " do you think this thing could explain anything " now I get a referral to the dermatologist..

Stay with me folks, I'm getting there.

I chose fox chase cancer center for my treatment. Partly cause they accept the Medicade I'm on and partly cause they have a good reputation. After the month wait to get in I met with my Dr. Upon quick examination he told me he thinks I have a pigmented basal cell carcinoma. Tells me he wants to do a shave biopsy to confirm. I'm so confused. He didn't use a dermascope. He didn't even get close. He just ran his finger across it. I asked him how he could tell the difference between what I have and for instance a simple melanoma in situ. He looked at me. Paused. Gave me a look I could only assume meant "stop reading things on the internet". He corrected the way I said in situ. Told me he could tell it's basal cell by the feel. Now I felt stupid. My hours on you tube and hours on Google are no match for his 12 years of training. I felt dumb. I stopped asking questions. He assured me he was confident it couldn't be melanoma. Now only in my head I'm saying your wrong. There's no waxy or pearlescent feature. there's no raised or rolled border. The color is wrong. It's in a place you'd expect melanoma as well. However he proceeded with the shave biopsy. Only taking a small portion (maybe 30% of the surface).

Now I'm confused. I'm sick. I have no answers. Basal cell carcinoma isn't serious. Ok cancer is always serious but come on, it's not going to explain my symptoms. I'm relieved though. I figure perhaps my headache/fatigue/pain is something related to my copd meds. Perhaps I'm anemic. I don't know. Now at this point my car broke down. Being unemployed for 2 years has taken its toll. I have nothing. Not a penny to my name. My gf supports me and our daughter on a very meager salary. I can't get to my dr. Again I'm playing Dr Google and thinking I'm either anemic or have diabetes. All I knew was it can't be cancer. Right?

A week after my Dr visit I get the call. I'm working on my car at the time and miss the call. He actually left his cell phone number and said to call any time. That's never good. When I finally spoke to him he told me it is confirmed melanoma. He said he's confident it's only stage 1. That it only shows at .77mm deep. Yeah, I'm thinking, it's only .77mm deep cause that's all he shaved off! How can the genius that was confident it wasn't melanoma be so sure it's stage 1 (no a or b stated)? Mind you, I've had this tumor growing now for over 5 years. He then set me up for a consult with a surgical oncologist.

Finally folks here's the questions

1. Is it concerning that an alleged cancer specialist dermatologist performed a shave biopsy on only a small portion of a malignant melanoma?

2. Will this give my surgeon enough information to know if a sentinel node biopsy is called for

3. What are the chances my headache/fatigue/tenitis/peripheral neuropathy are related to my cancer?

4. Which Dr do I spill my guts to about all my problems? My primary? The surgeon? Who's most likely to help?

Ok that's it. If your read this far into my story you deserve a medal :) thank you.

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ChristianDude1990's picture
Replies 1
Last reply 12/10/2015 - 10:05am
Replies by: Janner

Hi I had 2 moles removed, one behind my ear and one on my leg. Please can someone explain in lamens terms what these results mean?

 

MACROSCOPY

A hairy excision of skin, 0.4cn.

An excision of skin, 0.9 x 0.7cm. The epidermis contained a pigmented lesion, O . 6cm.

MACROSCOPIC EXAMINATION PERFORMED BY DR E RAAN MICROSCOPY

SPSCIMZN 1 :

The excisional biopsy displays skin with pigmented intradermal naevus. The epidermis displays irregular acanthosis. The dermis contains nests of pigmented naevus cells and single naevus cells descending the underlying dermis with

maturation. No dysplasia or neoplastic changes are present.

SP3CIMSN 2 :

The excisional biopsy displays skin with architecture distorted pigmented compound naevus

The epidermis displays irregular acanthosis. Located at the epidermal/ dermal junction are single pigmented naevas cells and nests of naevus cells

representing junctional activity. The papillary dermis displays lamellar and

eosinophilic fibroplasia. The dermis contains pigmented naevus cells arranged in nests and single lying. Free lying melanophages are present in the dermis.

No atypical mitoses or pagetoid infiltration of the epidermis is identified.

The features are consistent with architecture distorted pigmented compound

naevus .

DIAGNOSIS

SKIN FROM RIGHT SKIN ?ROM LET LOWER LEG

PIGMENTED NAEVUS.

ARCHIECTURE DISTORTED COMPOUND PIGWNED NABV3S .

 

My doctor just said the one on my leg was "weird" but there is no cancer on either mole. What does he mean by weird and what does this report actually say?

 

Thanks in advance!

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-f7-forlife's picture
Replies 2
Last reply 12/10/2015 - 10:16am
Replies by: Janner, -f7-forlife

Hey everyone. First-time poster. I won't lie, I feel a little guilty, albeit selfish, for making my first post a call for help. I also feel very uncomfortable about this because I have never spoken about it with anyone. It has remained a secretive issue, one that has always dented my self-image.

I've always had more moles than the average person. They're all over me. They range in size, but none have ever been very concerning. They've typically followed the ABCDE's.

More recently, however, in the past few years, more have been popping up all over me. There are a bunch of small red ones in every location of my body. There are enough now to where it has become a serious concern. I won't take my shirt off around anyone- it has damaged my social life and I don't feel comfortable discussing it with anyone close.

The one time I made mention of it was when one of my friends asked me why I always had bandages on my arms and legs. I told him I was using ACV to eat away some pesky moles and he told me I was insane. He did not react supportingly at all to my insecurities and was kind of freaked out by it. I know this isn't a good idea because it can hide malignant melanoma, but when you're so down in the dumps about it and don't have the money for professional care, what else are you going to do?

It's so bad, I haven't had a lay in over three years. Any time a lass comes along, I push her away out of fear that she'll be disgusted once I take my shirt off. It's that bad. Be as it may, however, I can live with a poor sight of a body because I can still be ambitious and try accomplishing things in life. What I can't live with is a hidden melanoma, because I know melanoma is a swift killer.

I am 25 years old, and unfortunately, the unlucky one of the family to be born with a fair complexion. On summer outings, the focus was always on me to wear sunscreen, and a whole lot of it, too. I always believed if I just tanned up enough, that I could do away with the sunscreen and join my peers without fear on the beach.

Sadly, life doesn't work this way. I've endured several extreme burns that have left me in agonizing, itching pain. When I thought I was some beach-hunk, I ended up paying for it for the next week by keeling up next to a fan to keep my burning skin cool so the itch wasn't so intense.

I believe I am now paying the price for my ignorance toward proper skin care in the sun.

Maybe all of this introduction could have been skipped. I'll now explain why I'm here.

Three years ago, a mole developed on my chest, one that isn't like the rest. It is not symmetrical. There is a light shade on one side, but the other side is darker. Here is a picture of it. I know that I will be told to see a dermatologist if I'm concerned (working on that), but I would like to see what you guys think.

This mole hasn't changed, at least from what I can remember, but after reading more about melanoma and seeing sample malignant images, some have come across looking exactly like the one I have.

Here it is: http://i67.tinypic.com/2zznhq1.jpg

This is located on my left pectoral, slightly below my collar bone. At the bottom center of the image (or center of my chest) is one of those red moles I was telling you about. They are all over my body and have been rapidly appearing over the past few years.

It doesn't ever itch or bleed or any of that, but when I saw sample assymetrical images, I started to panick. I know that melanoma can spread rapidly, and if this is malignant, I may already be screwed because of how long it's been there (which may explain the rapid formations everywhere else. Who knows, I'm no doc).

I was just curious to see what someone else thought before I start collecting my things to see a dermatologist. Life is short enough already, I would rather have some extra time to go out and do things I love, instead of living in constant fear. Who wouldn't, though?

 

Thank you for bearing with me through this introduction. I am so sorry for being selfish and making my first post a call for help. I really didn't know what else to do, though. Any opinions or advice is graciously welcomed.

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Kare83's picture
Replies 7
Last reply 12/11/2015 - 9:29pm
Replies by: mjanssentx, Anonymous, Kare83, Janner, Patina

HI there,

With a lot of help from some others here on the board, we worked out that my melanoma removed last week was a Stage 1a (Clark Level II, 0.4mm).

I am feeling great and the amount of information and support I have received from MRF and other Melanoma organisations in my city has been amazing!!

I was just wondering how everyone here keeps on track of their moles and tracks changes?

I have a lot of moles, freckles and age spots turning up all of the time. I downloaded one of those body mapping apps earlier today and took a few photos of some moles, before realizing that it is absolutely hopeless as I more moles than what I can even count.. 

My doctor tells me I have nearly every kind of mole imaginable.. I feel like a walking canvas!

It's really frustrating and I know I can ask my husband to help keep an eye on my back but I can't help but stress over everything I can't see. I have new moles appearing all of the time and I just don't know how I'm supposed to stay on top of this. Any tips or advice would be greatly appreciated!

I'm 32 with a history of melanoma in the family (grandfather & brother).

Is there any way of telling when will the moles might stop appearing? How do you all monitor everything?

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jodaro's picture
Replies 2
Last reply 1/13/2016 - 6:37pm
Replies by: jodaro, AshleyS

Hi All,

Quick backstory, I'm a 42 year old male, no family or personal history of cancer. I have dark hair but blue eyes so I'm probably considered fair skinned. I'm definitely someone who enjoys being outside, and while I wouldn't consider myself a sun worshipper in the typical terms, I'm out enough that I, admittedly, should be better about covering up and wearing sunscreen. I have taken it more seriously recently, but I've definitely had my share of sunburns.  

This past summer whilst on vacation my wife and kids said there was a mole on my back that looked strange. I didn't take it that seriously, and said I'd go in and have it looked at but always had some excuse as to why I hadn't yet called the doctor. I hadn't been to see my primary care physician in a few years as for the most part I'm healthy, active, don't have any major health issues (aside from asthma which is very well controlled). I'm also a fantastic procrastinator and someone who is good at minimizing the severity of things.

Eventually I got around to calling my doctor and scheduling an appointment (last month, November 2015). I figured I'd bundle in a cholesterol and blood pressure check, flu shot, etc. I could also ask him what the current suggestions were for a 42 year old in terms of prostate and colon screening.

I showed the doc the mole and he said "dysplastic nevus", wasn't terribly concerned but absolutely agreed that a trip to the dermo (to which I have never been, incidentally) was totally worth it for peace of mind. He recommended a practice that was a bit more of a drive but that he had good experiences with. I called and made the appointment immediately, assuming that if I didn't do it now while it was on my mind, it might not happen.

I believe they saw me the next week. I showed the doctor the mole, and she looked around a little bit more at my back. "Yeah, we could biopsy that ... but I'm actually more concerned about this one." She pointed to a much smaller mole further up near my shoulder/neck. "Which?" It had never really stood out to me (probably in part because I couldn't really see it). She took a picture and showed me. That one? That's nothing. Nonethless, she did a shave biopsy of the two of them, and I was on my way.

Over the next couple of weeks, I read up briefly on the types of skin cancer, but didn't take it seriously as I figured I had nothing to worry about. Of course interspliced within the waiting period was the Thanksgiving break, which added to the delay of the results. Every couple days it would pop into my head "Huh, I wonder if those lab results have come in ... ", and then about as quickly I'd forget. There was probably nothing to report. Eventually I'd call them and they'd say "oh, yeah, nothing there, carry on!" On the Monday after Thanksgiving, I thought "I'll call them this week." I didn't. They called me on Friday.

It was the doctor. "That mole you came in for is nothing. But the one further up came back positive for melanoma. The initial lab sent it on to another lab for a closer look, and they verified it. You should have it removed completely for a more in depth diagnosis." (OK, thats not an exact quote, but that's what they said). I was in shock, but I didn't panic really. I scheduled the procedure for the following Tuesday, which was yesterday. I should have asked more questions, but I wasn't really prepared.

Between last Friday and yesterday, I read up on as much as I could about melanoma, trying to stay on the clinical/factual side and not too much on the anecdotal/personal story side. It obviously isn't that the latter information isn't important, but I really just wanted to know the facts for now. I had more questions about the labs findings but given the timing, I wasn't able to reach the doctor and figured everything would be available when I got there. The best thing for me at the time was education.

When I got to the doctor's office  yesterday, armed with the knowledge of diagnoses, stages, procedures, etc. I asked for the pathology report. Here are the specs:

Nevoid melanoma, Breslow thickness of 0.75mm (at least), no ulceration detected, mitotic rate of 1/mm2, vascular invasion not detected. The stage is pT1bNxMx ... I'm guessing those x simply mean that they can't determine the spread to lymph nodes/distant sites because the biopsy is only the raised layer from the shave.

The doctor did a wide excision with a 1cm margin, the whole thing is about 2 inches long (and still bandaged). Fortunately, I think it went fine, and now, a day after, I don't have much pain. The doctor said that she didn't think a sentinel node biopsy was required a this time, and to see what the full diagnosis from the sample was before proceeding. She did order an LDH test and a chest x-ray in the meantime. She checked lymph nodes in my neck and groin and said everything felt fine there.

That's where it all stands. From my searching and reading, it sounds entirely likely that, aside from yearly trips to the dermo, I could be done with this. I hope that's the case. I don't think I have any major questions right now, but any insight or things this community thinks are worth looking into further would be greatly appreciated. I think I'm doing ok emotionally, and trying to just hang in there until I know the full extent. It will most likely be a couple weeks until I have the next results. 

Thanks for reading.

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