Middle left: Two weeks post-op Atypical Melanocytic Proliferation
Middle right: Four months post-op Atypical Melanocytic Proliferation
Bottom left: Four months post-op Basal Cell Carcinoma
Bottom right: Two days post-op Dysplastic nevus with atypical borders/precancerous mole
Skin Cancer. As I lie here creating a blog that I have wanted to write for months, the pain from a fresh scar across my shoulder blade reminds me that this battle is not over, and it will never be over. I am only twenty four years old and have just had my fifth surgery to remove skin cancer. With each diagnosis comes a higher risk for reoccurrence, and I am your textbook patient.
You may be thinking to yourself "It's JUST skin cancer" "They cut it out and you move on" "It's not a big deal"
These are the painful half-truths I believed as an 'invincible' teenager. I truly believed it could never happen to me. And if it ever did? Well that's easy, I would just get the mole removed and continue with my life. I had an answer for everything.
At 18, I found a spot on my abdomen that hadn't been there before. Nothing too suspicious. It certainly didn't look like the scary pictures you see in books and online, but given the family history, my mom set me up to see a dermatologist. A little numbing lidocaine and a shave biopsy left me with an eraser size red mark and a bandaid. Easy. No big deal. I think I went home and got in a tanning bed the next day. Graduation was only a few weeks away and I needed to make sure my legs looked good in my dress. After all, the mole was gone and I was in the clear. A week later, I received a phone call regarding the biopsy results.
"We need you to come back to the office for a wide excision surgery."
The borders of the mole were unclear and melanoma cells appeared on the outside edges.
Melanoma? Isn't that the bad one?
I was scared and unprepared for what was about to happen. After numbing the area, the doctor cut an oval about an inch long and an inch wide into my skin and snipped away at it until it was no longer a part of me. He stitched me up and sent me home with pain meds. The pain was horrible. I could hardly move without pulling the stitches and ripping open the new skin trying to grow. A few weeks later, the office called back. The section of skin they had removed still had unclear borders and what they believed to be melanoma cells. This meant another wide excision surgery in the same painful site that had not even had the stitches out yet. But this time much bigger, and deeper. I cried at the thought of having them cut me up again. I don't remember much about the second surgery, but I do know that a few weeks later I slapped some gauze and an extra large band-aid over it and went to lay out by the pool with my girlfriends. See the light rectangle on my upper abdomen? Invincible.
I started my undergraduate degree at Texas A&M and completely immersed myself in "college life". I was busy having the time of my life and figuring out how to be an adult- naturally my skin was the last thing on my mind. The apartment complex we lived at had free tanning beds and a resort-style pool. I used the tanning beds 3-4 times during the week and spent 7 hours a day poolside with friends on the weekends. I would throw some SPF 15 on my face and chest most of the time, but I tanned easily so I didn't worry too much about the rest of my body. I had that golden glow and felt beautiful and comfortable in my darkened skin. Invincible.
Did you know that indoor tanning beds are proven to cause cancer and have been classified into the highest cancer risk category by the World Health Organization's International Agency for Cancer Research? And that exposure to tanning beds before age 30 increases a person's risk of developing melanoma by 75%?
My senior year of college, a strange looking mole appeared on my right thigh. I figured it was nothing serious, but that I should at least have a dermatologist look at it. A few weeks later a biopsy was done. A week after that I recieved the phone call.
The biopsy showed unclear margins with melanoma cells. We are scheduling you for MOHS surgery.
MOHS surgery is a type of skin cancer removal surgery where they find their margins and go deeper and deeper until all of the cancer cells have been excised. I think this is the moment where I finally said "no more". No more artificial tanning, no more skipping suncreen. It may have been that I was 22 and slightly more mature, but I think part of me realized that this was really happening to me. I caught both early, but they could have killed me. This surgery was much harder than the first. The recovery was long, painful, and an absolute nightmare. I was left with a hole in my leg, sewn up into a "Y" to allow the skin to grow back together the best it could. No longer invincible.
I moved back to Abilene after graduation to start nursing school at Texas Tech. After seeing a couple dermatologists in town, I decided that I needed someone with more expertise, more passion, and a plan for prevention and treatment.
Enter Dr. Wisniewski in Lubbock, TX.
This guy. I drive two and a half hours to see him each time and it is worth every second. At my first appointment with him I told him my personal history and my family history, did a full body check, and removed a few spots. Surprise, surprise, guess who got a phone call a week later.
The spot we removed from your back is an Atypical Melanocytic Proliferation. And the spot we removed from your chest is Basal Cell Carcinoma.
So we scheduled two surgeries. One for Tuesday and one for Saturday. First up for removal was the Basal Cell Carcinoma. This stupid thing was a small pink/white bump that I barely noticed was a brand new spot. Once again, no "textbook signs" of skin cancer besides the fact that it was new. Even Dr. Wisniewski said "I don't think we will get anything cancerous back on these results but let's play it safe and biopsy anyway." And BAM- Basal Cell Carcinoma. A wide excision surgery was done this time, taking out around 2 inches in length and an inch across. This one sucked in particular because it was right on my bra-line. Great excuse to wear baggy sweatshirts and no bra for a few months, but a real pain in the ass to let heal. Any stretch or movement of my chest hurt like crazy and I eventually ripped open the scar (accidentally) once the stitches were out.
Saturday I was back in the office for the next surgery; my left hip the victim this time. Because the biopsy showed an Atypical Melanocytic Proliferation, it was important to remove a large area. AMP is essentially the closest your cells can get to melanoma before they turn cancerous and begin spreading further. The wide excision was nearly six inches in length and three inches across. This surgery takes the cake for being the absolute worst, most painful, horrific recovery I have had. Do you know how often you have to bend at the waist every day? How often you turn the top half of your body to look at something? How often you SIT? Any movement, any position, any pressure was torture. Even four months later, this scar still hurts when I am not careful in how I move.
Three months after these two surgeries, I was back in the office for three more biopsies. One on my face, one on my shoulder blade, and one on my calf. Another anxious week passed and.. you guessed it... the phone call.
The one on my face- benign. Thank god.
The one on my calf- atypical cells but caught early enough and the biopsy showed clear margins. Again, phew.
The one on my shoulder blade- atypical cells without clear borders, meaning whatever it was about to turn into had already started to spread through the layers of my skin.
Another wide excision surgery scheduled. It's almost routine now. Skin check, appointment, biopsy, phone call, surgery. Rinse and repeat.
So I see my dermatologist every three months for a full body check, I perform skin checks on myself every few weeks, we take pictures at each appointment and measure each mole and freckle on my body and monitor for changes, I wear high SPF sunscreen every day and I avoid being in the sun as much as possible. It has been a difficult transition- this girl LOVES the sun and being outdoors.
I would be lying if I said this hasn't been an emotional roller coaster of fear, anger, and sadness. I have had to do some serious soul-searching and sorting through my emotions. This is such an exciting time in my life- I am in my mid 20's, I'm looking forward to my career as a nurse, marrying my best friend, and beginning a new chapter. The fear of missing something or not catching it in time petrifies me. I'm not ready to die, and certainly not from something that I could have prevented years ago.
I have had time to reflect on my teenage/college years and I wish so badly I could tell myself what I know now. The information was out there, the shocking and emotional videos of people missing huge chunks of skin and saying 'I wish I could change this', the people I knew personally and my family members who have had battles with skin cancer telling me to stay out of tanning beds.... to wear sunscreen.... I had every resource available and potential motivation to prevent this. I felt invincible and too young to worry about cancer. At the age of 24, I have had countless biopsies, multiple diagnoses of skin cancer, large scars across different parts of my body, a hole in my leg that will never be the same again... and for what? A tan? Being too cool for sunscreen? I am now living in fear of my future.. and regret of the past.
I don't expect my story or this blog to make a huge difference, but I do hope that it might encourage even one person to take care of their skin, to wear sunscreen, to stop using tanning beds, to get that weird spot checked out.
This is real. Its happening to young people. And it is scary as hell.
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