Recurring Vigilance

The physician discussed the current landscape of melanoma research while focusing on trends in targeted therapies for late-stage melanoma. I was busy writing notes on a paper pad. My cell phone buzzed, the ringer was turned off, and I looked at the incoming call. It was my dermatologist. The results of last week’s biopsy were in.

I muted the presenter mid-sentence and answered my phone. My dermatologist said that the biopsy came back melanoma in situ. She said she was sorry, and we scheduled the wide local excision in two days.

My heart sank over another melanoma

Once again, my heart sank. This is not my first rodeo with melanoma. Unfortunately, it likely won’t be the last. Not only do I have a high rate of recurrence, but I’m also a stage IV melanoma patient.

I unmuted my computer’s speakers and continued my virtual attendance at the Melanoma Research Alliance’s Patient & Advocate Forum, which was held in late February in Washington DC. A panel of scientists and doctors had moved on to a new subject: Not all melanomas are created equal. The irony was not lost on me. I tried to pay attention to the presentation, but it was impossible to focus. My heart just wasn't in it.

Melanoma in situ recurrence

After my fifth melanoma diagnosis, one of my dermatologists jokingly called me a 'melanoma factory'. He admitted that he had never seen a patient with more than two or three melanomas. That’s not unusual. Remember, I grew up in Florida in the heyday of sun tanning with little to no skin protection.

Now, I live in the mid-south with plenty of sun, rain, and cold temperatures. It’s understandable that my local doctor had not seen that many skin cancers in one patient. He compared my situation to someone with fair skin who grew up in South Africa or Australia. As that dermatologist put it, I just "grow" a lot of melanomas.

Unlucky number 9

This melanoma in situ, which is on my inner right ankle, puts me at number nine. Yes, that’s nine melanomas. The reality of nine melanomas bounces around in my head like the voice of John Lennon repeating “number nine” at the beginning of the Beatles’ song, Revolution 9.

Yes, I’m a melanoma factory. For anyone diagnosed with skin cancer, recurrence is a major concern. In addition, there’s a heightened risk for those of us with melanoma. Recurrence may happen at the site of the initial, primary tumor or it may happen as a new primary melanoma. Skincancer.net has an informative article on melanoma recurrence. Unfortunately, every one of my skin lesions has been a new primary melanoma.

Remaining vigilant

If there’s a silver lining to my latest diagnosis it’s that we caught the melanoma in its early stages. I say “we” because both my dermatologist and I had been watching that particular spot for the past couple of months. When I came in to have the mole re-checked, my dermatologist agreed that we should take a biopsy. The lab results confirmed our suspicions.

All of us must remain vigilant. Examine your skin regularly and schedule routine skin exams. You may not be able to prevent the start of a new melanoma, but you can certainly prevent an early stage skin cancer from becoming much worse.