Tag Archives: melanoma and Parkinson’s

Melanoma #5

Those of you who know me, or have followed this blog, know that my husband and I have had recurring melanomas. I started it, with a melanoma (stage 1, .9mm) on my ankle in June, 2003. That followed with one on my shoulder (stage 1, .8 mm) in 2013.

My husband has Parkinson’s, and astonishing as it may sound, those with Parkinson’s are 4-7 times more likely to have melanoma. His first was on the back of his neck (stage 1, .2mm) in 2015. Another followed in his ear (stage 1, .2mm) in 2018. This year, it was on his face.

WARNING! GRAPHIC SURGICAL PHOTOS FOLLOW!!

I post these photos and these blogs because when I was first diagnosed, I obsessively looked at photos of melanomas on the internet. Turns out, it was a good thing I educated myself like that, because I found the one on my shoulder, and all three of my husband’s.  Well, I didn’t like the look of them, so flagged them for his annual dermatologist visit. It is in that spirit that I post the following pictures of Al’s most recent diagnosis and surgery, because melanoma is a real thing. It is deadly, and you (every one of you) ought to have a thorough, annual skin check by a dermatologist. Just in case. 

jan2019

Melanoma next to right eye

This was the melanoma as of January, 2019. I had seen it, and photographed it the previous year, because I didn’t like the look of it. (Just so I don’t run to the dermatologist every other day, when I see something weird, I photograph it and put it on my calendar to photograph again six weeks later, for comparison. Most things have resolved by then. This got darker and a little larger.) The dermatologist at the VA initially said it was nothing. A year later, I insisted he look at it again, and he scraped it for a biopsy. A scrape should never be done on a suspected melanoma. A punch biopsy is what’s called for, so just in case it is a melanoma, we can get an accurate depth of the tumor. Still, he scraped, so we have no depth. Still, melanoma.

Wisely, the VA declined to do the surgery so close to his eye, so he sent us to a fantastic oncology dermatologist/surgeon. She held a black light to the lesion, and this is the area that glowed.

Eye1

The melanoma, including in-situ

Then she mapped out a 5mm margin. It looks all puffy in the photo below because she had already injected the anesthetic before I snapped the picture. (Interesting detail: When I asked her if it was all right that I took photos, and told her why, she said that most people do.)

Eye2

Surgical lines with 5 mm margins

Then she cut.

She was doing what they call “Slow MOHS.” In normal MOHS surgery (for basal cell and squamous cell carcinomas) they cut with a tiny margin, then examine it right in the office to make sure they got it all. If the margins aren’t clear, they cut a little more, put a bandage on it and have the patient return to the waiting room while they test to see if they got it all this time. When they have clear margins, they stitch it up and send the patient on their way. Melanoma is a little different and they don’t have the capacity to test it in the office. They have to send it out to a pathologist.

Eye4

Melanoma surgery

So they took the skin and sent it to pathology, put a bandage on his open wound and sent him home.

Fortunately, the pathologist said she got clean margins, so we went back the next day to be stitched up. I have to say, she was a master at it.

Eye5

After melanoma surgery

This is how he looked when we left there, but bandaged, of course. A week later, the stitches came out and they put tape on it, which they said would fall off in a week to ten days. Right on schedule the tape fell off in the shower, and this is how it looks, 18 days after surgery.

Eye6

18 days after melanoma surgery

Know your ABCDEs of melanoma:

A: Asymmetric. One half does not match the other half.

B: Border. Melanoma is unorganized. It does not grow in a uniform way. Borders have a “notched” appearance.

C: Color. Al’s melanoma had no particular color, but many times moles turn bad, and they can look pretty colorful. Al’s lesion (not a mole) just got darker. (Interesting point: most people don’t get new moles after they’re 30 years old.  In fact, most moles begin to regress as people get older. If you are middle aged or older and suddenly have a new mole, have it checked.)

D: Diameter. Any mole or suspicious lesion that is larger than a pencil eraser needs to be looked at.

E. Evolution. Melanoma is cancer. Cancer grows, changes. That’s why I take photographs for comparison. I would add to this Elevation. My first melanoma was a standard flat mole that grew tall.

Wear sunscreen and long sleeves in the sun.

Be safe out there. 

 

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