December 21, 2011

Spitz Nevus/Melanoma

In case you missed the note, when I'm pregnant, I get skin cancer.

Last time around, M noticed the new weird thing on my skin when I was about seven months pregnant.  It took about a month before I saw a dermatologist, and it was that same day that he biopsied it and discovered it was cancerous.  It wasn't really a big deal- just a basal cell carcinoma.  As soon as I delivered the girls, they cut off all the surrounding tissue, and declared me "cured."  I have kept going back for skin checks a few times a year, though.  And twice they've removed moles that looked pre-cancerous.

Having my temple anesthetized let me raise one eyebrow!
Well, as I've mentioned, this time around the pregnancy trail my very first symptom was that a mole started getting odd.  I was scheduled for one of my regular skin checks less than a month later, so I just brought it up then.

When I say odd, I mean that this very small mole had started changing colors to an orange shade from its previous light brown, and its borders had become a little fuzzy.  By the time I got to the skin check, it had also become raised, and a dark spot had appeared in the middle.   It was probably less than 2 millimeters in diameter.

The intern doing the skin check thought it looked strange.  Something about "globules."  They scheduled me to come in and have it excised once I was out of my first trimester. That appointment was Friday.  In the time between my first appointment and my last, it grew a little more, its borders became a little stranger, and a second- barely visible- dark spot appeared.  It was still probably less than 2 millimeters in diameter.

When the doctor came in to remove the mole, he took one look at it and said, "That little thing?  We're taking that off?  Really?"  And then left to check the notes from my skin check to be sure there was any point.  He seemed to think that it was ridiculous to take off something that, to him, looked so obviously benign.

Today I got the call with the results.  I figured that since I hadn't heard back, no news was good news, and I should forget all about it.  I was wrong.

Turns out that this time around, it's not quite skin cancer.  Turns out it's basically stage 0 melanoma.

Melanoma.  That's a pretty freakin' scary word.

I have to go back right after the holidays and have the area around the mole removed, biopsied, etc.  Instead of my nice, tiny, one-stitch scar, I'll get a much bigger cut.  Not that that's my primary concern,

My primary concern is the cancerous aspect.  My dermatologist is going to be referring me to a specialist- not an oncologist, somebody who specializes in these just-barely-not-cancer situations, does more frequent skin checks, and decides if and when to refer me for chemotherapy.
Googled this pic of "early stage melanoma"- looks like mine.

Because melanoma is, unfortunately, VERY malignant.

The reason they're most concerned is that, of course, pregnancy can make you much more susceptible to things like... well... cancer.  And if this mole was just a few months from being full blown melanoma, from requiring chemotherapy- possible every year for my whole life.  Under most circumstances, they'd consider this incredibly lucky and just keep me going back for regular checks with my dermatologist.  Under most circumstances, they'd cut off all the extra dangerous cells, and that would be that- again.

Instead, because I'm pregnant, it's more dangerous.  And the fact of the matter is, no matter how much they tell me not to worry and that I don't really have a very dangerous form of skin cancer yet, I am not so distracted as to catch all the subtext.  The warning that two cancerous (or just barely not) moles of a variety of strains before I'm thirty doesn't particularly bode well.

I'd just like to say, as obviously freaked out as I am, I am also incredibly relieved.

I am so relieved that I found the mole right away.  I am so relieved it was somewhere so visible that I could notice its minor changes.  I am so relieved I was able to have it looked at and removed quickly.

If I had waited until after the baby was born, I would have melanoma.  I would be facing a newborn baby AND chemotherapy, I would be in a much much much more frightening situation.

I am so relieved to have had an intern who was really looking for something interesting in my mole.  If it had been that doctor looking instead of the intern, I'd be in a lot of trouble.

I am so grateful.

More things I'm grateful for.
I am grateful that I probably won't be faced with a choice of breastfeeding or taking chemotherapy.

I am incredibly grateful that it didn't grow more during that first trimester.

I am SO grateful that in a few short weeks I'll be able to put this unpleasantness behind me again.  For the most part.

For now, I just need to focus on eating well, not usetting my gall bladder, and keeping Baby X happy and safe inside my belly box.  (On that front, DD and SI have taken to carrying around ultrasound pictures and telling me how happy the baby in mommy's tummy is.)



Happy Channukah to you and yours!  May your holidays be filled with as much joy and little sadness as ours, and may all of your travels be uneventful.  :)

7 comments:

  1. This is such an important post, supermommy! I'm so glad you caught it and can be ever vigilant now about your skin and checking for signs. Thanks for sharing, it's a great reminder to visit the dermatologist and do regular skin checks all over! Happy Channukah, peace to you and yours this holiday season!!!

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  2. Happy Hanukkah and here's to many more, thanks to interns who care! And I'm definitely keeping a closer eye on a funky little mole of my own.

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  3. I've been thinking about you all week because ALL of my moles are growing, especially a couple, and one of them totally grew back after it was removed.....

    I'm making an appointment tomorrow AM.

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  4. After Logan was born, I went to the dermatologist for something that turned out to be nothing. But, while I was there, she took 3 other moles and one of them was pre-melanoma. I go every 6 months now. I totally freaked out when it happened . And truthfully, I don't trust my doctor, she looks so quickly. I need to find someone else. Your lucky you had the intern!! Good Luck with everything. And happy Channukah!

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  5. You are helping others by sharing this information. Thank you!

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  6. Oh that’s a bit alarming but good thing you had it checked as early as possible. I also knew about those moles that looked pre-cancerous. I guess we should not ignore those little things we notice on our skin because those little things we ignore can be big things in the future. Thanks for this informative post!

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  7. Women diagnosed with melanoma and interested in achieving pregnancy require counseling for fertility preservation, fertility treatment and the safety of pregnancy after melanoma treatment. Melanoma is one of the most common cancers in young adults in the United States. In the US and worldwide, there is dramatic increase in the incidence of skin melanomas.

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