Tuesday, September 22, 2009

Poster boy for early detection

My friend D. is the poster boy for early detection of melanoma. He had a mole on his neck that made his wife suspicious, even though his GP had looked at it earlier this summer and pronounced it harmless. D. went ahead and made an appointment with a dermatologist anyway, who once he saw the mole indicated that a biopsy was in order. The lab report came back positive for in situ melanoma, so D. had the mole and a small margin of skin removed this week. The excised tissue has been sent to a path lab at OHSU just to make sure this was indeed stage 0 melanoma. Assuming this staging is correct, D. has nothing more to worry about. The cancerous melanocytes lurking in the mole are now gone and can do no harm.

There are three lessons to be taken away from this little medical drama:

1. Don’t assume your GP is there to assure your health. They’re too busy and disinterested to take the time you deserve. I saw my GP a few weeks before my melanoma was diagnosed in 2006, when the mole on my knee was clearly out of control, and he said nothing about it (sadly, I ignored it as well). Oversights of this magnitude are not uncommon, and typically not legally actionable, as negligent as they may seem.
2. There is nothing so wonderful as a loving, nagging wife. Listen to her. It’s sometimes hard to notice incremental changes in your own body, especially in places you can’t easily see yourself. Let her be your medical tech.
3. A diagnosis of melanoma need not cause panic. Melanoma should never be considered harmless, but caught early the odds of it killing you are very slim. D. appears to have kept his cool, but I’m sure he’ll breathe easier when he gets final results back from OHSU.

There’s a lot of melanoma going around, in case you haven’t noticed. If you’re reading this, you’re already ahead of the curve in understanding the risks of skin cancer. Inspect your skin once a month and don’t hesitate to have anything suspicious examined by a skilled dermatologist. There's nothing so sinister as a good mole gone bad.


Tad said...

Hi Peter,

I had to laugh at your "lessons," particularly #2. Two months ago, my wife pestered me to get see a dermatologist about a mole, and I finally caved in. About one week later, we found out it was melanoma.

I just had the surgery (WLE/SLNB) last week, and it looks like we caught it before it spread. While Stage IIA isn't ideal, I'm not complaining one bit. I'm very grateful for my wife's insistence and persistence to get me to the doctor.

I've learned much reading your blog since I found it a few weeks back. Good luck with the marathon next week.

dls said...

D. here. Thanks for the posting Peter and for the follow up Tad. We do have an advantage for those of us who have wives who pay attention to changing marks on our bodies. The mole on the back of my neck is not even one I was remotely aware of. But fortunately, Michelle watched it with her artist's eye.

In defense of my GP, he did ask if I wanted a dermatologist to look at it during my summer visit, but since an appointment was already scheduled for September with a dermatologist that I highly regard, I declined.

The final result came in on the 30th of September and confirmed the original in situ diagnosis, which the dermatologist made before the original biopsy was taken and sent to OHSU in Portland. He bet me a nickel that his call was right on and I gladly paid up the day he cut the mole and surrounding tissue out and sent the final sample in for analysis.

To be honest, I didn't think about the result during that 10-day span as the Dr. was convinced and with 35 years experience I believed him. He's a straight-shooting Dr. so if he had suspected something more he would have told me.

He also made the statement that melanoma is 100% curable if caught early. And that once diagnosed with a melanoma that family members are 16% more likely to have a mole go 'wacky' on him/her.