Monday, June 30, 2014

"Did you catch it early?"

Melanoma friends, is this the hardest question to answer, or what?!

"Did you catch it early?"
"The good news is melanoma is very treatable if you catch it early!"

Here's the problem...melanoma is a tricky beast. Somehow it has convinced the American public that it's really not a big deal. No worries, we'll just catch it early. Why would we catch it late if we can catch it early instead? Easy breezy. Nothing to worry about here!


It's true, melanoma is pretty "treatable" if you catch it when it's tiny, but I'm not exactly sure how that's done. My own melanoma was tiny by any reasonable standard. Smaller than a pencil eraser, for sure.  Yeah, it was a dark color, but lots of moles are dark colors. It was small. There is no chance that anybody without melanoma experience would have thought that spot was dangerous in the way it turned out to be. We're looking for big "scary" moles that say "Hey! You should get me checked out! Now!", but the reality is that melanoma really speaks to you in the back of your mind. "Nah, that's just a little spot. Don't overreact. Doctors' visits are expensive. Why are you making such a big deal?" and all the while it's digging deeper and deeper into your flesh, in a place you can't see. It's a pretty nasty little beast, actually. Tricky.

Also, it's not so easy to find out if you "caught it early". Sure, some melanomas are what's called "in situ", which means they are just sitting nicely on top of your skin, but you've gotta be pretty quick to catch one of those before it takes root. If your melanoma has taken root at all, you're going to need surgery, and it's not going to be pretty. Yes, if you're in this boat, melanoma might not kill you...but it's going to take a chunk of your flesh, leaving you with a pretty messy scar.

In my case, it APPEARS that we've "caught it early". The doctors hold out very strong hope that this beast hasn't invaded my lymph nodes or other organs, but we won't know until they've had a look-see at those nodes.  So, here's what "catching it early" means in my own individual case:

1. A probable 8 inch incision that by all accounts will look like a shark bite, stretching from my thigh to below my knee. This is where the doctor will scoop out the spot where the melanoma used to be, and will cut out an additional 2cm of flesh in all directions, making sure (or trying to make sure) that the remaining flesh is free of cancer. Goodbye bathing suits! Goodbye shorts! Goodbye cute skirts! Well, if I'm being honest, I've never been a fan of bathing suits and the sun, but goodbye (and good riddance!) anyway, bathing suits!

2. A 4-6 inch incision in my groin where the good doctor will remove one or more nodes to determine if they've been invaded by melanoma. If not, good! If so, that will mean we didn't "catch it early" and I'll enter an entirely different ballgame. Still, you can't tell just by looking at the tiny mole on my have to dig deep to find out.

3. A skin graft donor site. If the doctors can't close that 8 inch incision, they're going to need a skin graft, and the skin graft will have to come from somewhere.  Maybe my thigh, or my hip...I won't know until June 7th when I meet the plastic surgery and he can decide for himself.

In my case, "catching it early" means two, maybe three surgical sites and a potentially hellish recovery. I'm ready for what's ahead, but it won't be a walk in the park, and it doesn't seem reasonable for the removal of what really was a tiny little spot.

Don't underestimate this beast!

What can you do?

-You can see your dermatologist. You can point out any spots you think look a little weird, and you can let that dermatologist have a look at your skin and see if there are any spots the two of you should keep an eye on together.

-Use your sunscreen! I have research that I still need to do about sunscreen, but I can tell you that before this melanoma scare, I wasn't using enough of it.  It takes a whole shot glass full of sunscreen to do the job. At least!

Here's a video that might help convince you about the dangers of melanoma.  It made me cry, but I guess that may be a reflection of what I'm going through right now. I chose the one with French subtitles, because I'm a French teacher and I think the subtitles make it better...but that's how I am.

Sunday, June 29, 2014

It was just a little spot...

I have decided to go ahead and start a blog, because that's what many people do when they receive a cancer diagnosis, right? I am hopeful that this blog will help me process some of the things that are coming my way, and might help some other newly diagnosed melanoma patients / warriors / survivors (when am I EVER going to feel comfortable with these terms?!) get the information they need as they begin their journeys.

First of all, this melanoma is one of the strangest things that has ever happened to me. I still just can't believe it's real and happening to me. I guess that's a normal reaction to learning that your life has changed, but it surely is uncomfortable. At this point, I feel like I've read the entire internet (seriously!) and it seems that most people feel more comfortable with their situation after a year has passed.  Let's get that year started then!

I have spent quite a bit of time reading melanoma blogs. If someone has posted a picture of their incision / stitches / skin graft / recovery...I've seen it.  I feel like I could perform my own surgery at this point, that's how much I've read.

Let me start by showing you what my "spot" looked like at the beginning of this whole process.
See? It's tiny. This spot is located on my inner thigh, just above my knee.  Even posting this rather inconsequential photograph makes me realize I'm going to have to work on some issues with being self-conscious about pictures of my body parts.  Ha! The next pictures are going to be really different, aren't they?

I had shown this spot to my doctor at my annual appointment last year, but I FAILED to say the words "It's new."  I just said, "Will you look at this spot?"  Why didn't I didn't point out that it was new? Why?! I have beaten myself up pretty significantly about that fact over the past month and I guess I'm just going to have to let myself be.  He looked at it and said, "I think that looks fine."  At this year's appointment, I said "Can you please take this off...I'm concerned about it."  He did not argue. I knew I was in trouble when he said "Well, maybe this isn't a melanoma.  Let's hope it's not."  He normally tells me when he believes something is fine, but this time he didn't.  I knew that was bad.

Sure enough, I got "The Call" one week later.  By that time I had done my research, because I knew in my heart it was melanoma.  In that respect, I'm grateful for my doctor's choice to say "maybe it's not a melanoma" instead of sugar-coating it.  I had done my homework, and I knew everything I might hear in that call. That made it possible for me to take the call calmly and really hear the words my doctor said. These are the highlights:

-Breslow depth .96 mm means I'm shy of that all important 1mm cut-off, but the doctors are going to behave as if it was a 1mm lesion
-Clark's level IV, but Clark's level doesn't mean much anymore
-Mitotic rate 2
-Superficial Spreading Melanoma
-Referred to the Loyola Medical Center
-If my dermatologist had a family member with melanoma, he'd choose this surgeon
-My current stage is 1B based on depth and mitotic rate.
-I'll need a sentinal node biopsy, which will help determine if I move to stage 3
-My prognosis is very good

Prognosis? Did you say prognosis? Oncologist? Surgery? Wait...prognosis?  But this was only a tiny spot...

For those of you who have just been diagnosed, I know you have questions about timeline.  I had my biopsy on June 3rd, I received the results on June 10th, I met with the surgical oncologist on June 24th, and I will have surgery on July 10th.  Results to surgery will be exactly one month.

More about those details later.