I promised when I first began my Cancer Journal three years ago that I would be honest about what I was facing, and report any new developments - good or bad. But I was reluctant to bring up my latest setback, until I saw Elizabeth Edwards and her incredibly brave press conference with John. Compared with her revelation that her breast cancer had metastasized, my latest glitch was tiny.
I found out recently that I had melanoma on my shoulder, and it required immediate surgery. Melanoma is the most serious form of skin cancer, with the most potential for deadly metastasis. And, according to cancer experts at Johns Hopkins Breast Center, "there is a genetic link between melanoma and breast cancer."
Perhaps most disturbing is the way I found out I had it. It "presented" as they say, as a dark red freckle, smaller than a dime, on my shoulder, which is covered with freckles already. It felt no different from the other freckles, but it was larger and darker. So I asked my primary physician what he thought, and he dismissed it, because it lacked some of the distinctive melanoma traits. I also asked him about a sore on my neck, which I was always nicking with my razor. I thought it might be an ingrown whisker, but it wouldn't heal. He suggested antibiotics, but when that failed, he suggested I see a Dermatologist.
It was while examining my neck that Dermatologist Dr. Eric Gilbertson noticed the odd "freckle." He was going to biopsy the "nick" anyway, so he took a bit of the "freckle," too. Four days later, the report came back: The nick was a "basal cell carcinoma." Serious, but not necessarily fatal. The freckle was worse. It was melanoma. But it was the earliest stage of melanoma, called Melanoma in situ. That meant it hadn't proceeded further than the surface of my skin. And that meant they could get rid of it with surgery - no chemo, no radiation necessary.
But I still had to share the news with Jenny. She was pacing a hospital floor waiting for the birth of our third grandchild! (If that sounds familiar, our first grandchild was born the month I started chemo for the breast cancer. My son and his wife have since promised not to have any more children!)
As you might expect, Jenny did not take the melanoma news well. Back came the memories from three years ago -- the mastectomies, the hospital stay, the fluid drains, the chemo. But we knew two things: She and I were in this together, and God was still in it with us. That, and some crack doctors and nurses, virtually guaranteed a good outcome.
I had surgery on March 7th at Scripps Clinic in La Jolla by Dr. Hugh Greenway, head of the Mohs Surgical Center. And here again is why you want to catch cancer *early.* Before the surgery, they circled the two cancers with a pen. The picture shows what they looked like: small, but not as small as they were six months or a year ago when I first noticed them.
Dr. Greenways excision was larger than a silver dollar - just to make sure he got all of the melanoma the first time around. The open wound has a "patch" stitched over it to protect it until the lab results came back 24 hours later.
The following day Dr. Steven Krant (of the famous SK Sanctuary in La Jolla) removed the carcinoma on my neck, and repaired the wound on my shoulder. I wanted the best plastic surgeon in the business to ensure that not only would *all* of the cancer be removed, but that it would have the least impact on my appearance. I will include a picture of both repairs when they finish healing, and the swelling goes down. Since my shoulder wound was too large to just "pinch together and sew up," Dr. Krant had to use an ingenious method of loosening a flap of skin from the back of my shoulder, which he pulled up to cover the excision site. The affected area measured five inches in diameter! Remember, this started as a freckle smaller than a key on your computer keyboard. Now its as big as the palm of your hand! Imagine if the melanoma had spread to a nearby lymph node or covered more of my shoulder! I know a man who lost his entire ear lobe because of one tiny spot of melanoma at the bottom.
So, please, believe me when I tell you how important it is to a) wear sunscreen, b) avoid sunburn, and c) if you have a history of sunburn or light skin, or if you have had breast cancer, get checked by a Dermatologist regularly.
That's it for today. But I'll be back soon with more on the melanoma, and some words about what Elizabeth and John Edwards are facing now.