Melanomania: THE Trip That Almost Wasn't

©2013 by LeeZard

Some of you may have noticed I’ve been quiet for the last week or two. Some of you may have appreciated that. No apologies for returning but I will explain where I’ve been.

There was a little hiccup last week as I continued preparing for THE Road Trip. The Physician’s Assistant (PA) at my favorite dermatological clinic spied something she called “worrisome.”

I have reason to worry; my oldest brother died at the age of 64 with cancer throughout his body, spurred in part by Melanoma. That’s the skin cancer that gets on what I call The Highway to Hell and spreads via your lymph system. If it is fast spreading and aggressive, it is deadly.

As a result, I go in every six months for a checkup, including photo comparisons with previous exams. It’d been seven months since my last checkup and, with THE trip imminent; I thought I’d stop in before hitting the road.

PA Catherine del Secco conducted the examination, primarily on my upper torso where my Adonis-like body is peppered with moles. “Hmmm,” she murmured as she checked my lower back, “I’m worried about this one.”

“Uhhh, what do you mean by worried?” I asked.

“Well, it looks like a Melanoma,” she replied. She didn’t say, “Might be;” she was pretty clear.

Needless to say, I was shocked and frankly, it dulled my response because I never once asked for an M.D. to take a look.  Del Secco immediately carved a good-sized chunk out of my back for biopsy and scheduled me two days later (a Friday) for a follow-up. “The lab results might be in by then, in fact I’ll call them now and ask them to pick up the sample.”

In the meantime, she’d taken a new picture of the spot and compared it to a photo from last January. Pointing to the new pic she said, “This is new, just above a similar spot in the old photo.”

I peppered her with questions. She offered nothing conclusive other than to “reassure” me by saying, “it could be new and not aggressive. In that case, we cut it all out and you’re good to go. The flip side is it could be fast growing and aggressive. Then, we check your entire lymph system to see if it’s spread and how far. Treatment is far more extensive”

My little neurotic mind heard nothing positive in her statements and I went immediately to doom. For the next 36-hours I walked around in a fog and that horrible netherworld of uncertainty. I told nobody except two or three of my closest peeps.

Late Friday afternoon, Catherine let me know as soon as I walked in that the lab work hadn’t returned. Crap.

In the meantime, she checked me top to bottom, looking for any other worrisome spots. She found none but I was in for a long weekend of wait. Right before I walked out, del Secco called me back with a glimmer of sunshine.

“I put both pix up on a big screen and it looks like the suspicious spot is NOT new; it appears to be the same spot we saw in January but the two pix were lined up differently and the one from January is blurred so we can’t tell if it’s changed.”

“Does that increase the chances that it’s a nothing?” I said grasping the straw.

“I’m a little more hopeful,” she replied, “but it’s the only other photo we have of that spot and it could’ve just appeared then.”  Nonetheless, I was encouraged enough to cut the neurotic quotient considerably over the weekend.

With no news by noon Monday and neurosis climbing I called the clinic and learned del Secco was off that day. Crap. I couldn’t hook up with her assistant until 4pm. No lab work.

(Note to self: interesting that a physician’s assistant has an assistant. What do they call her, the assistant assistant? How far does it go? Do they have a junior under assistant to the assistant assistant? How does this affect our health care costs?)

Del Secco called mid-morning Tuesday with the good news. “It’s not a cancer,” she declared, “but it is an abnormality and it is changing. We should still cut it all out but that can wait a couple of months until you return from your trip.”

“Not a Noma!” I yelled to nobody. “What a fucking relief!”

But it had been six hellish days and I’d stopped all prep and shopping for THE Trip. That was remedied yesterday as I completed all shopping for THE Trip and bolted my storage bin to the Jeep’s roof. I have one week and counting until liftoff.

Life is good again. Sometimes the powers that be have to kick us in the ass to remind us.

Skin Melanoma

Skin melanomas often look dark in color and asymmetrical, with a ragged or irregular border. Many are wider than a pencil eraser, but doctors have advanced tools to detect even smaller melanomas. Although melanomas rarely lack pigment, they can sometimes appear as pink spots or bumps on the skin.

The two main classifications of primary skin melanoma are in situ melanoma and invasive melanoma. In situ melanoma is confined to the upper layer of the skin, called the epidermis, and does not spread to other parts of the body after it is removed. Invasive melanoma enters the second layer of skin, called the dermis. This type of melanoma can spread to the lymph nodes and beyond, particularly if it is more than 1 millimeter thick. The deeper the disease penetrates the skin, the more likely it is to spread to other parts of the body, including nearby and distant lymph nodes, as well as the lungs, liver, brain, bones, and gastrointestinal tract.

Melanoma appears more often in adults, although this disease can affect children and adolescents as well. Extensive exposure to any level of UV radiation, intermittent exposure to high levels of UV radiation, or severe sunburns can increase your risk of developing melanoma. Other risk factors for melanoma include:

Atypical moles — People with many moles or abnormal moles, called dysplastic nevi, are more likely to develop melanoma. Dysplastic nevi are often large and raised, with poorly defined borders and uneven colors that range from pink to dark brown. Irregular moles tend to run in families.

Personal or family history of skin cancer — If you have already been diagnosed with melanoma or another form of skin cancer, you are at a significant risk of developing a second skin cancer. You are also at a higher-than-average risk for melanoma if you have two or more relatives who have been diagnosed.

Light complexion or fair skin — People with any color skin can develop melanoma, though those who have light complexions are at a higher risk — especially if you have had excessive exposure to UV radiation.

Weakened immune system — If your immune system has been weakened by AIDS, immunosuppressive drugs, or certain cancers, you have a higher-than-average risk of developing melanoma.

Other skin conditions — If you have xeroderma pigmentosum, a rare inherited condition in which the body cannot repair the DNA of skin cells damaged by UV radiation, you are at greater risk for melanoma.

The best way to prevent melanoma is to protect your skin from the sun and avoid extended periods of sun exposure. If you are a parent, you can reduce your children's risk of skin cancer by protecting their skin and teaching them sun-safe behavior. Everyone should avoid sunlamps, tanning beds, and tanning booths, which are potentially dangerous sources of harmful UV radiation. When outdoors, wear clothing and hats that cover exposed skin, wear glasses with UV protection, and apply a broad-spectrum sunscreen that blocks the two main types of radiation: UVA and UVB.