Cottage Cheese and Cancer

I absolutely adore my husband, but he is not necessarily the most observant person in the world.  Patrick loves cottage cheese (which I can't stand unless I'm pregnant) and kept asking me what I did with the container of it in the fridge.  I didn't even know we owned cottage cheese and if I did, I sure wasn't responsible for its disappearance.  After he asked me about it for the fiftieth time, I opened the fridge to see if I could find it.  I kid you not, it was the first thing I saw when I opened the door.  It couldn't have been in a more prominent place.  It was on the highest shelf, at eye-level, right smack in the center.

So you can imagine my reaction when I was brushing my teeth sometime at the end of June and Patrick noticed that a mole on my neck looked a little bigger and darker than he remembered it.  Ooookay.  I looked at it and it did seem a little different but I figured it was fine and eventually forgot about it.  I had a questionable looking mole removed after I had Camden and although it turned out to be pre-cancerous (something called a dysplastic nevus), it wasn't cancerous.  I figured this one was just like that one and who gets skin cancer in their twenties anyway? Patrick kept bugging me to get it checked so I finally made an appointment with my dermatologist.  I went in, my doctor did a quick check of all my other moles and freckles, and said he would biopsy the mole in question but he didn't think it would turn out to be anything.  He left the room, the nurse came in and gave me a shot with the local anesthetic, and the doctor came back in and took off the mole.  It took about 5 minutes and we were out of there.

My mom came to visit for a few days and help me make some pillows for Fin's room.  She was cutting fabric when my phone rang.  I answered and when I heard my doctor's voice, my heart sank.  I had completely forgotten about my biopsy and when I realized it was him calling instead of one of his nurses, I knew it was bad news.  He told me that I had melanoma and then I freaked out.  I am so glad my mom was there.  He told me that he wanted me to come in that afternoon so he could talk to me about what we needed to do.

An hour later, Patrick met me at my doctor's office.  It's amazing how fast things can change.  One minute, your biggest worry is what size pillows to make for your daughter's room and the next minute, you're sitting in a cold little exam room waiting on a doctor to talk about what needs to be done about the cancer on your neck.  My dermatologist is also a plastic surgeon and has had whole bunch a bit of work done himself.  Let's just say it was hard to read his expression when he walked in the room.  He always looks a little surprised.  In his defense, he is probably one of the sweetest men I have ever met and is a fabulous doctor.  Anyway, my doctor came in and after my futile attempt to evaluate the situation by reading his expression, he sat down to talk about my mole.

He told me that what I had is called "Superficial Spreading Melanoma."  I breathed a little sigh of relief when he told me that.  Superficial?  Doesn't that mean that it's just on the surface? That can't be too bad.  And then he told me that this type of melanoma is the leading cause of cancer deaths in my age group .  WHAT?!  I must have given him a look because he immediately followed that statement up by saying that since we caught mine early, it shouldn't be that hard to treat.  Whew.  Way to scare the crap out of me.

Because my melanoma was less than a millimeter thick, more than likely it hadn't had time to spread to my lymph nodes or any other parts of my body.  If it had been closer to or over a millimeter thick, I would have had to have something called a "sentinel lymph node biopsy" to see if the melanoma cells had spread.  They inject a dye into the mole to see what lymph nodes the melanoma drains into.  Then they take out those lymph nodes and examine them to see if there are melanoma cells present.  Luckily, my doctor was pretty confident that this surgery wasn't necessary and that my melanoma could be taken care of by a different type of surgery.  I am so grateful that my sweet husband was so persistent in bugging me to get this mole checked.  If I had waited a few more months, my melanoma could have spread and this would have been a completely different ball game.

My doctor explained that the type of surgery I would have to have is called a "wide local excision."  In other words, I needed to have the mole and a big chunk of skin taken out to make sure the melanoma didn't spread or come back.  He drew a picture on the back of my file to show me what the surgery would look like.  Basically, there was a little dot about the diameter of a pencil eraser (my mole) and a bigger circle around it about the size of a quarter (the area he needed to take out to get a clear margin around the mole).  Then he showed me that in order to stitch the area up without having it pucker on the ends, he needed to remove a triangular area above and below the quarter-sized circle.  What he ended up with was a football shaped excision that was about 3 inches long.  Eek.  I had NO idea that such a tiny little mole would leave such a big scar.  Luckily this was something that could be done in their office the next day and I wouldn't have to be put under for it.

This is a really crappy picture of my mole after it had been biopsied (I had a shave biopsy for this mole). My actual mole was a little bit smaller, but I wanted you to have a reference for size.

Before I could go home, my doctor sent me for a full lab work-up and a chest x-ray to see if there was any sign of cancer in my lungs.  Luckily, everything came back clear.  I went home to freak out some more get myself together.  All night long, the only thing I could think of was getting that thing--that cancer--off of my neck.  I don't remember much about that morning but I do remember going back to my doctor's office that afternoon, going back into that little room where my life changed, and having the sweetest nurse in the world administer my local anesthetic.  My doctor came in a few minutes later, cranked up his iPod, and got to work.  I think it only took him about forty-five minutes to do the actual surgery but it felt like forever.  The worst part about it (other than when he hit a spot where the local anesthetic didn't quite numb--and the sweetest nurse ever quickly came to the rescue with her little needle) was the fact that I could actually hear him cutting my skin.  I'm sorry.  I know that's gross, but nothing about skin cancer is pretty.

This is what my neck looked like about an hour after my surgery.  The scar goes behind my ear as well.  See, not pretty.  All of that from a tiny mole.

After he got everything stitched up, they let Patrick come back to see me and we talked about the next step in my treatment.  Although my melanoma wasn't alarmingly deep, my doctor still wanted me to go to an oncologist for a second opinion.  He referred me to an amazing melanoma specialist at the Blumenthal Cancer Center in Charlotte who I went to see about two weeks later.  He confirmed what my doctor had told me about not needing a sentinel lymph node biopsy and explained that my cancer was classified as Stage 1B (here is an explanation of melanoma staging from melanoma.org) and that the chances of this particular melanoma spreading to other parts of my body were less than 2%.  I am at high risk of developing other melanomas, so I have to have my skin checked frequently by my dermatologist.  I recently had two more moles biopsied that both came back clear and I go again in March for my next check.

I never in my wildest dreams thought that I would be dealing with cancer in my twenties.  I tanned in tanning beds, laid in the sun without sunblock, and didn't take care of my skin.  I knew it could cause skin cancer, but it was "just" skin cancer (please read this post by my friend Chelsea).  It never occurred to me that "just" skin cancer could threaten to take me away from my babies and my husband.  It never occurred to me that it could leave me with a 3 inch scar on my neck for the rest of my life and worry in my heart.  Please, please, please take care of your skin.  Wear sunscreen everyday (even in the winter!!), be careful in the sun, check your skin for changes, and if you find a mole that looks a little different--get it checked out.