Trigger Warning, this article includes images of surgery.
Most people do not realize how serious melanoma skin cancer can be. For one professional, busy mother of two it took her doctor’s call to her husband to get her attention. Like many people in the United States Debbie was delaying treatment because she was concerned about the financial cost. Melanomas account for over 7,000 deaths in the United States per year so getting treatment quickly is a matter of life and death.
There are three main types of cells in the top layer of the skin. They are squamous cells, basal cells and melanocytes. Melanocytes are the cells that cause changes in pigment when exposed to the sun. They are also the cells that can get melanoma. According to the American Cancer Society melanomas more often occur in fair-skinned people.. Melanoma is also the most deadly form of skin cancer because it can spread to other parts of the body quickly. Melanomas typically appear as dark colored moles. However, they can appear pink or look like a normal mole so its best not to wait to get checked by a dermatologist on a regular basis.
Melanoma and Sunshine
It will probably not surprise anyone today that exposure to natural or artificial sunlight is the number one risk factor for skin cancers. Ultraviolet (UV) Rays damage the DNA of skin cells. While commonly known today this was not always the case. Growing up in the Pacific Northwest during the 1980’s Debbie sought that healthy glow during the few days the sun peeked out from behind the clouds. Like most people her age she used tanning oil to increase the pace at which her winter white would turn to a golden bronze.
Later, as a young adult, Debbie worked at a tanning bed salon where she took full advantage of the unlimited tanning bed usage. Salesmen that sold the beds touted the many health benefits of year-round tanning. Some of the benefits listed included increased mood, elevated Vitamin D levels, and reduction in acne. Nobody would have dared to put on sunscreen and limit the potential health benefits of the UV light. Now the FDA requires tanning beds to display a warning about potential cancer risks.
Other Skin Cancer Risk Factors
While anyone can start controlling the amount of sun exposure they get now, most risk factors are outside of any individuals’ control. As with most cancers, family history is a known contributor to increased risk. Once an individual gets a melanoma they have a higher risk for future melanomas. They should get checked more regularly by their doctor. In Debbie’s case, she will be checked every four months for now. Fair skin, freckled blonds are at a higher risk. As we age our risk increases especially past 50 years old. Certain weakened immune systems can also contribute to a higher risk.
Spotting Skin Cancer
The American Academy of Dermatology recommends remembering the ABCD model to know when it is time to see the doctor. Asymmetry: is one side different than the other? Border: is the border as irregular as a lake on a map? Color: does the color vary within the mole? Diameter: is it more than 6mm in any direction? If you answered yes to any of these questions it is time to see your dermatologist.
Once at the dermatologist they will start with a physical exam in which they will visually inspect 100% of your skin. For many people disrobing and balancing the paper sheet over your private areas is the worst part of the appointment. If the idea of this causes anxiety for you,
A biopsy is either completely or relatively painless. A small syringe needle will be used to numb the area first. Then a small scalpel will cut away a piece of the skin tissue. This process usually takes less than a minute. The amount removed is typically about the size of the end of pencil eraser in diameter. It is probably thinner than a slice of shaved garlic. While it could scar, it often does not leave any noticeable mark. The tissue sample will be sent to the lab and you will have to wait to hear back from the doctor. This can take anywhere from a couple days to a couple weeks.
A Serious Diagnosis
For most people melanoma is not the first thing they think of when they hear the word cancer. This may be particularly true when it comes to terminal cancers. This is a mistake. Melanoma can quickly spread making it one of the most deadly cancers if left untreated. Most likely that suspicious mole is not a melanoma, but it is very important that you call your doctor back if they leave a message stating your biopsy revealed skin cancer. If the melanoma is removed quickly there is at least a 90% five-year survival rate for melanoma.
While unpleasant, the process for removing a melanoma is fairly simple. It is an outpatient procedure done in a clinical setting. First, the clinician will have to cut away all of the melanoma. In order to make sure that it is all gone they will test the surrounding tissue while you wait. In some
Once the lab has determined all of the skin cancer has been removed they will stitch up the hole. Debbie felt the physician did a good job and does not feel there is a noticeable difference once she healed. Some people choose to get additional plastic surgery afterwards especially if the area is on the front of their face or are otherwise bothered by it. Debbie’s spot was fairly small yet still took 24 stitches to close.
Recovering and Lesson Learned
A few year’s ago a patient would likely have been prescribed a few narcotic pain pills to help with the post procedure pain. Doctors prefer more conservation treatment options in the post opioid epidemic area. Debbie was prescribed only ibuprofen for the pain. I have known Debbie for over 40 years and can personally attest to her strength. This woman runs marathons. A favorite summer past-time as kids was challenging others to race down the gravel road barefooted to see which was the toughest. So when she said it hurt, I believe her pain was more than most people would have quietly endured. Fortunately, that pain was short lived and within about a week Debbie was back to her happy self.
It has been awhile since Debbie set foot in a tanning bed or used baby oil to bronze her skin. She will now be much more vigilant about wearing hats to protect those delicate ears. As a mother she was already aware of the dangers of the sun and took appropriate steps to protect her children including wearing sunscreen. As an active family that enjoys running, hiking, bike riding, baseball, and other outdoor fun they will be even more vigilant about protecting their skin from UV rays.
The American Cancer Society recommends sunglasses, covering with clothing, wearing a hat and choosing the shade whenever possible. The American Academy of Dermatology has these guidelines for choosing and using sunscreen: most adults will need at least one ounce of a broad spectrum (UVA and UVB) water resistant sunscreen in an SPF of at least 30+. And, it should go without saying: never, ever get in the tanning bed again.
About the Author
Tami Madden wears many different hats as a regular volunteer with The Unchargeables community. She is also a Caregiver for a Chargie with Dysautonomia. She can be found on Instagram sharing her life as a reader, writer, teacher, baker, chicken soup maker, and fighter for all things healthier, stronger, kinder and better than yesterday here.