20 Mar Angela Canavan
I am normally a very private person, but after a lot of thought I have decided that I want to share my story. My hope is that I might bring this real disease to light and maybe help just one person make better decisions and stay on top of their health. As most of you know, I have been working on living a healthier lifestyle. I have been running races and half marathons for about two years. I have tried to make healthier decisions in all aspects of my life. With this, I also vowed to get back to my regular routine of visiting the dermatologist annually, since it had been about two years since I had last gotten checked.
At the end of May 2013, I visited my dermatologist for a routine skin exam. With my fair skin tone and hair color, and several freckles/moles, I am supposed to go once a year for a full body scan. It is normally very easy, I take everything off, put on a gown, and he looks everything over with and those unusual spots with the dermatoscope to make sure they haven’t changed. My doctor usually takes a few notes and tells me everything looks good and he’ll see me next year.
Occasionally he biopsies one or two to be cautious, and the results always come back benign and all continues to be well. At this visit he spotted a mole on my leg that looked suspicious, but he told me it was still round and wasn’t very big so he didn’t think I should be overly concerned. His suspicion was that it was either a spitz nevous (which are benign) or a type of non life threatening pre-skin cancer that could be treated with a follow-up visit. I had a biopsy that day, like I have had a handful of times in the past, and figured I would get the results like I always did in about a week – hopefully saying everything came back fine just keep a close watch on my skin and see you in a year. This time was different. I waited, and waited, and waited and waited. I went on a work trip weeks later expecting the call with the results, and it never came. The reason, the pathologist was concerned with the sample, and wanted to send it to the leaders in skin pathology, the University of San Francisco, to get a second opinion to confirm the results. They knew it was a type of cancer, but needed to figure out what kind by doing extensive DNA testing. What? Why couldn’t they tell? I hear I have something wrong and have to wait longer? I called the doctor’s office several more times after that, and was told they were still waiting on the report. A preliminary report should come soon, just hold tight. I called again and started getting frustrated and angry that I was in this holding pattern with very little information.
Then, in July 2013, 8 weeks after my original biopsy, my world came to a complete hault. My doctor called the house after hours and told my husband to have me call him when I got home from work. I knew something was really wrong. This man was very hard to get ahold of and he was calling me after hours and waiting for my return phone call. I had a knot in the pit of my stomach the whole ride home. I couldn’t drive fast enough. I raced home shaking and nervous and my husband had the phone ready for me. I called the doctor promptly when I walked in, and put the phone on speaker so he and I could both listen to what the doctor had to say. He called to tell me they had done extensive testing extracting DNA and running special stains on my lab sample, and unfortunately I had malignant melanoma. I didn’t hear much of what he said after that, I held it in as best I could until I hung up, and then I couldn’t stop crying. I tried to catch my breath because I was hysterical. I couldn’t tell my family that night because I couldn’t even comprehend what was happening yet. This was my worst fear since I learned about skin cancer and my risk factors and prior history in the sun.
Melanoma is the most dangerous type of skin cancer. It is the leading cause of death from skin disease. I found out the next day there are four stages, with each stage the mortality rate drastically increases. The percentages of people in stages two through four that lived beyond 5-10 years made me cry. I had melanoma stage 1B, at 33 years old. For those that don’t know, melanoma is not just “skin cancer”, if it’s not caught early it can’t be treated because it doesn’t respond well to radiation or chemotherapy. It causes 75% of all skin cancer deaths. There are pre-cancers and basal cell and squamous cell skin cancers that are awful and can be extremely disfiguring, but are fairly common and usually slow moving and can be cut out completely with a very great outlook.
The worst part about melanoma skin cancer is, if it is not caught in its early stages, there is no cure. In most cases, it has to be surgically removed completely with the hope that it hasn’t spread to the lymph nodes. The destruction and statistics for all of the stages of this disease are terrifying, but II-IV are horrifying. Even stage 1 can spread to the lymph nodes. Mine was found on my right medial knee and was a stage IB, meaning it was less than 1.00 MM thick, but the cells were growing and dividing rapidly (the mitotic rate was very high). This means the tumor was moving and ready to spread…fast. It had already penetrated through the first layer of my skin called the epidermis and invaded into the second layer (dermis). I am extremely grateful I went to the dermatologist when I did. That office visit saved my life.
The next step for me was surgery where I had the original biopsy taken. I was referred to a surgeon who had done many melanoma surgeries in the past, and had experience in cases like mine. I had wide local excision (WLE) surgery on July 19, 2013. That Friday my husband took me in and the surgeon told me he was going to take out more tissue around where the mole was originally removed, in order get ensure control has been established by testing for clear margins, making sure none ha “wandered off” or moved towards the lymph nodes around the area. This would also reduce the chance that the melanoma would come back in that same area. Although I was very frightened, the surgery went pretty quick. I am proud to say I didn’t faint or get too light headed. The part that almost got me was when he put the shots in all around the area before he did the surgery (those were not fun), and the pulling and tugging I felt as he removed the tissue. Nope, they don’t knock you out for this surgery, you get to be awake for the whole thing! He tried to talk about vacations and work to take my mind off of what he was doing, but I still thought about it. My husband watched for about 10 seconds and then couldn’t stand anymore. The surgical site is actually larger than the margins they need, because they need to make a football shaped area so they can pull the wound close into a straight line. I got nine stitches and a large gauzed bandage and was told they would call me with the results of this tissue sample, and to come back in two weeks to get the sutures removed.
Very luckily for me, the pathology report came back quickly with no traces of residual melanoma in the sample. It appears they got it all out of the area. I had the option of doing what’s called a sentinel lymph node biopsy to see if there are any traces of cancer in my groin, the closest lymph node to the site. They would inject a radioactive chemical in the site and trace it to the nearest lymph node and take that first one out to test for cancer cells. I decided against that procedure since it doesn’t prolong life expectancy and can cause other serious problems down the line.
Since my surgery I have had eight additional biopsies done on other spots/moles, and have had stitches in and out for several weeks at a time. I have scars all over my body. I feel like a human pin cushion, but I have peace of mind knowing I am being cautious, and having everything that could potentially be cancer checked and removed. Does that mean I’m done with this for good? No, it can come back at any time. Once you get a melanoma, you are more likely to get another one. It can come back in your eyes, mouth, even where the “sun doesn’t shine.” It can be internal. I had and continue to see the dentist an OB-Gyn frequently to make sure all areas look clear. I am to get checked by my dermatologist every three months for the next five years. Five years is the supposed beacon point, when you can go back to annual exams. My most recent excision surgery was for a large spot that I’ve had for years, and I was very relieved to hear that the pathology report came back clean. This will have been 8 biopsies/skin excision surgeries and numerous stitches in four months. I have a follow-up appointment tomorrow where they plan on doing 2 more. Thankfully every biopsy after my melanoma surgery has come back clear. I know this is great news and I’m very happy, but also cautious as I know I could get another bad report at any time. I’m cautiously optimistic because I am now on top of my health, and if anything comes I will catch it early and stop the monster in it’s tracks!
Why am I telling you this? I am light skinned and have moles and freckles all over my body. I always have. I know a lot of my family and friends do too. I knew I was at a higher risk than average for developing skin cancer because of these traits, but like most people I thought “it won’t happen to me.” I am healthy, I feel great! Also, I’m too young for that. I tanned occasionally in tanning beds as a teenager, and laid out by the pool and river intermitantly growing up. I went on vacations and tanned on the beach. I wanted a “healthy” glow, and I thought I looked better and felt better with a little color in the summer.
When I see friends post pictures of them laying out by the pool or of their recent sunburn I cringe. When they talk down about feeling pale I get sad. You don’t have to be light skinned to get skin cancer. You don’t have to have a family history. You don’t have to even have moles. I know three people personally who have been diagnosed with malignant melanoma. None of these people are related to me and none have the same skin or hair type. One the same age as me (I am 33 years old). I know several other friends or family members who have carcinomas or pre skin cancers that they’ve had burned off or removed. Of the few people that I have shared my story with, some responses I have gotten are “Oh, my Uncle died from melanoma,” or “Yeah, my friend’s mom had that and passed away,”and “I just went to a funeral from a young man in my home town who was just diagnosed but it was too late and he already lost his fight.” Too many people are affected by this either personally or through someone close to them. THE TAN IS NOT WORTH IT…EITHER OUTSIDE OR ARTIFICIALLY….Please stay out of the sun! I would be happy to show pictures of my surgeries and scars to anyone who is thinking otherwise, or anyone who has a teenager that wants to be tan or is upset with their pale skin.
My advice to everyone is to check yourself every month…..with a mirror for those hard to see areas, or have your spouse help you. If you have never been get to the dermatologist and go regularly. This appointment saved my life. I waited two years and if I had waited three it might have been too late. If you have anything that concerns you, see a professional. The warning signs that I can share are (and I’m not a doctor but have spoken to my doctors and read many articles) asymetrical spots, spots with irregular borders, spots with more than one color (usually black, brown, tan or red), spots that are larger than a pencil eraser, spots that are changing or evolving, or anything that looks different than your normal freckle/mole pattern (the ugly duckling). ANY of these should be concerning and should be taken seriously. I am sharing this because I don’t want ANY of my friends or family to have to go through what I went through. I am willing to help and fight for this cause it in any way I can. I want to spread awareness and raise money for this cause. This was eye opening for me. Cancer sucks!! Thank you for reading my story and I hope it helps you take better care of yourself as I want to be around and want you to be around for a very long time. Life is precious!
In closing, below are some very scary statistics about melanoma:
A person’s risk for melanoma doubles if he or she has had more than five sunburns at any age.
One sunburn damages the skins DNA. DNA mutations are a primary factor in skin cancer.
If caught in the earliest stage, melanoma is entirely treatable with a survival rate of nearly 100%. If untreated and allowed to spread, there is no known treatment or cure.
While family history, genetics and the environment undoubtedly contribute to developing melanoma and other skin cancers, the largest melanoma risk factor is exposure to ultraviolet rays (UV) from natural or artificial sources, such as sunlight and indoor tanning beds.
The National Cancer Institute recently released a special report that found overall death rates from most cancers declined from 2000 through 2009. But NOT melanoma! Melanoma is increasing in incidence and mortality – with the exception of women’s mortality which neither increased nor decreased.
- 1 person dies every 57 minutes from Melanoma
- Exposure to tanning beds before age 30 increases a person’s risk of developing melanoma by 75%, and younger people who regularly use tanning beds are eight times more likely to develop melanoma than people who have never used them.
- The incidence of people under 30 developing melanoma is increasing faster than any other demographic group, soaring by 50 percent in young women since 1980.
- Legendary musician Bob Marley died, at age 36, from melanoma on May 11, 1981. This proves you don’t have to be light skinned to get this cancer.