Melanoma Surgery

I spent yesterday morning working furiously on a series of posts on going bald (these aren't up yet), and then showered and dressed just in time to make it to my dermatologist's office for my melanoma procedure.

Calling it "surgery" sounds a bit dramatic, but that's what is was, of course. An office procedure called a "wide excision."

My dermatologist, Dr. Richard Grabowski, gave me a copy of the pathologist's report and explained everything to me carefully.

I was right in my recollection of what he had said on the phone. My melanoma was only 0.2 millimeters thick, which is good. But the melanoma had gone into the second level of my skin, making it invasive. Not so good.

The report says I had a "difficult and challenging melanocytic neoplasm with a differential diagnosis of a malignant melanoma..." "Difficult and challenging"? I don't think I want to know.

Dr. G said it was Clark's level II. I looked that up on Oncolink this morning, and this is what it says: "Clark's Level II involves the epidermis and the layer of skin immediately below, the papillary dermis." Which is, of course, what my doctor had said.

The surgery itself involved a larger incision than I had expected, and this is why:

The protocol for a melanoma like mine calls for cutting away 1 centimeter in all directions from the melanoma. So Dr. G drew a circle with a 1 centimeter radius around the original incision from when he had removed the mole for biopsy. But he can't close an incision that is a circle, so then he drew lines outward in two directions until the drawing on my arm resembled an elongated Egyptian eye. The eye is about 2 inches long.

Then he cut along those lines, after numbing my arm (I stopped watching after that point), sewed me up with internal stitches and some on the outside skin, and I was good to go. His nurse made me an ice pack out of a glove to put on my arm as I was driving home.

I felt a little queasy afterward, but well enough to stop by Taco del Mar for a burrito for dinner and a quick trip to the drug store for a few things.

I was in bed by 7:30, asleep by 8:30, and slept till almost 9 this morning. Now, my arm hurts. The incision bled a fair amount into the gauze that's taped onto my arm, but I'm not supposed to remove it for 24 hours.

Also not supposed to exercise or use my arm to lift anything for 48 hours, so I canceled my workout today. But I will walk my dog and work in the garden for a bit (with the other hand) if the rain stops.

Dr. G and I also discussed how careful I need to be about sun exposure in the future. I've been following the debate about vitamin D and moderate sun exposure, and since I live in far-north Seattle where the sun is weak anyway, my practice is not to put on sunscreen or wear protective clothing unless I am going to be out long enough that I might burn. Or on the water. And of course when I am in Hawaii I do the full-meal-deal: hat, sunscreen, and protective clothing.

He agreed that this level of caution was appropriate, so I'll just carry on.

The only thing that's new is that I need checkups every three months to watch for another melanoma and also for the other types of skin cancer, since I am apparently at greater risk for skin cancer generally, now that I've had melanoma.

@ Jeanne Sather 2007.

Comments

[Cory]

Hi Jeanne,

Whoah...fast response!! I was looking through your other posts and popped back on and there you had already replied...thanks.

I think a therepist would be good, maybe even a support group...trouble fighting that here in my area.

I think what I want is facts...or a reassurance that people that have had a melanoma go on to live life without a repeat.

Recently a doctor was telling me at an appointment that melanoma does not just show up in a mole but it can be internal too....how do you detect that? All this "stuff" that swims around in my head...the what-ifs and could it be...makes me want to throw up. I get tired of punch biopsies, sore body parts, removing stitches...sometimes when I get a mole removed...I do actually feel happy...like "Gotcha you little sucker!" I can't remove them all but irrationally I want too.

A person blogged on here that you never hear of people that have survived a melanoma and lived a long life talk about it...those are the people I want to find. Where are you?!?!? Step up and tell your story to others that still struggle.

Thanks for your response....I have enjoyed reading your blog...best of luck to you and your continued journey with cancer.

Cory

[jeanne]

Cory--let's see who we can find. Jeanne