The phone call from the dermatologist came as quite a shock three weeks ago. I felt like I was having something of an out of body experience as he explained that the reason for his call was that the mole his staff removed some twelve days prior was a malignant melanoma, and that I needed to get help immediately for a sentinel lymph node biopsy and wide excision.

I knew skin cancer was a bad thing anyhow, but when I mentioned the diagnosis to my wife, Linda, and saw the color drain from her face, I gathered I might not fully comprehend the extent of my problem.

Further research indicated that melanoma is the worst kind of skin cancer there is, and that it has a rather high chance of being symptomatic of cancer in the lymphatic system, especially if not detected soon enough. And once entrenched in the lymphatic system it’s only a matter of time before the cancer invades one’s organs (which is known as metastasis).

I hoped it had been caught soon enough. After all, the mole that I had had removed had only been present for only a short time. Granted, it had grown rapidly – from zero to about 7-8mm in around two months, which is why it originally had me a bit worried – enough so that I wanted it removed. And I only noticed it because it was in a rather obvious location on my right thigh and seemed to be a little different from my other moles, but not in any really obvious way.

My mole one week before it was removed. It later turned out to be an amelanotic malignant melanoma.

My mole one week before it was removed. It later turned out to be an amelanotic malignant melanoma.

If the mole had been on my back or other non-obvious spot on my body, I would still be ignorant of my condition, and thus a step closer to permanence of the truly bad sort.

I was also fortunate in that the dermatologist had the same idea I did – namely to get the mole analyzed in a lab to make sure it wasn’t something bad.

Of course, that wasn’t the result that came back:

Excerpt from the diagnostic report on my mole pathology.

Excerpt from the diagnostic report on my mole pathology.

It’s not obvious from the above text, but the mole was a rare kind of melanoma, an “amelanotic” melanoma, meaning it did not have any pigment, and therefore none of the visual warning signs that the tissue was potentially cancerous. As a result, the statistical survival rates for amelantoic melanoma are not very good because they are usually identified far too late – many months or even years after they have formed. In my case, however, the hope has been, and still is, that two months was early and soon enough. We’ll see, as the lymph node biopsy (which I will discuss in a separate post) came back positive (for cancer), which is actually rather negative from where I sit.

The Moral of This Story

I am only 46 years old, in good health, only mildly overweight, with no known genetic predisposition to cancer.

Granted, I live on a Caribbean island, but the reality is that I’m a bit of a mushroom, spending almost all of my time indoors working, cooking, eating, playing, and sleeping. I average less than an hour or two a week outdoors, so regular sun exposure is not a likely contributor.

I did, however, get a really bad sunburn on my right thigh from a full day of white water rafting in Costa Rica in September 2008. Could this have started then? No way to know, and I’ve been told that there is a body of thought among a small group of cancer specialists that there is no sustainable correlation between sun exposure and melanoma. The fact that melanoma can appear on (or even in) any part of one’s body, even one that never sees sunlight, lends some credence to that possibility.

What I can tell anyone reading this is that you should be on constant vigilance for any new growths on your body, whether odd looking or not. And if your gut suggests something is wrong, run, don’t walk, to your doctor’s office and have it looked at. And insist on a lab analysis on any part of your skin that is removed. Better safe than sorry.