Living with Skin Cancer

I was diagnosed with nodular melanoma in March, 2007. I was busy with nursing classes and my mother-in-law was dying. It was the day after she died that I could no longer ignore this persistent pimple on the back of my neck. It wasn’t a pimple, of course. I knew it wasn’t normal when I finally took time to look at it in the mirror.

Called and scheduled an appointment right away. I started my research regarding melanoma, because I had a pretty good idea what it was, and I had an aunt die of melanoma. While I waited for the next scheduled appointment to have the lesion removed, it took off in a radical growth phase which even shocked me.

The waiting for pathology reports was always the hardest. It came back as atypical melanocytic proliferation on the first report and then was forwarded to a melanoma specialty lab. The wait continued and was confirmed as malignant melanoma. I was scheduled for a lymphoscintigraphy and reexision of the area.

I think my main reason for sharing my story is that I want others to know that you have to be your own advocate when it comes to your health. I was not satisfied with the first MD’s attitude and her lack of concern. She did perform the first surgery, but I requested another MD from the same practice that I had heard positive things about regarding his overall approach to caring for his patients. With the first MD, I had to learn all my pertinent information from my pathology reports. She never discussed with me the serious nature of melanoma. In fact, she told my husband that she thought I had a less than 5% chance that it would be in a regional lymph node. Now, my lesion was 1.7mm Breslow thickness, a Clark’s level IV (in the reticular dermis or vascular space), the mitotic rate was high (looking for 0), and the tumor infiltrating lymphocytes were sparse (should have many), and what bothered me most about her attitude was that I had asked her if the more in-depth pathology results were back and she responded with, “It basically concurs with the original report (which offered only basic info). This she said to me in pre-op, prior to removing a 3.7cm width x 9.8cm length flap of skin, subcutaneous tissue, a lymph node in my neck, and 4 nodes in the axillary area.

The <5% chance of it spreading to a regional node was the only info that my husband heard. I knew that wasn’t accurate. She even knew that it was nodular melanoma, a more aggressive type and she never once shared that information with me…the patient. I solely relied on my pathology reports and my own research. The second surgery was scheduled with another MD, and the remainder of nodes in the posterior cervical triangle were removed and one of the lymph nodes had micrometastatic melanoma.

Now the wait begins. I have full-body skin checkups every 3 months. I’ve already had 6 lesions removed, with 2 being atypical. I will have an annual brain MRI and full-body PET scan. Hopefully, I will beat melanoma. I know the odds and I know that being my own advocate will give me the chance I deserve. I know I didn’t deserve to be treated as if I had little or no intelligence. I was straight forward with the first MD and told her that I was a nursing student, so when I asked the first question, “1.7mm, so would that be in the reticular dermis?” and her response was, “It doesn’t matter. I’m going to follow protocol.” Really, I didn’t deserve that treatment.

I am still in nursing school. Plan to graduate this May. I just kept going. Although some rest and time to recuperate would’ve been nice, I believed that I needed to keep living my life on the track I was on until I graduated. Being the patient has taught me some valuable lessons. I know how I want to be treated and I shall treat my patients the same way that I want to be treated.