Johns Hopkins Bayview News - Melanoma and Me
Melanoma and Me
Date: October 7, 2013
It was an unraveling hem on my skirt that first alerted me. When I turned to look in my full-length mirror, I saw the offending blue thread from my skirt brushing the back of my calf. And that’s when I also saw “it.” It was something I had never seen before. There on the back of my pale, slightly freckled calf was a spot—round, purplish black in color and about the size of a pencil eraser.
I thought to myself, “This wasn’t there the last time I looked at my calf.” But, when was the last time I really saw the back of my leg? I decided to put “it” out of my mind.
As a journalist, I had even written about “it”—skin cancer: telling others how to recognize the signs, take the proper precautions in the sun, get regular skin checks and have suspicious moles or freckles examined by a dermatologist. I couldn’t possibly have skin cancer. Or could I? A nagging feeling (and my husband), encouraged me to see a dermatologist a few days later to have it biopsied. Even then, I was convinced it was just a strange mole. It wasn’t until I actually heard the word “melanoma” that it hit me. I had melanoma skin cancer!
I was scared. I knew that melanoma was the most dangerous type of skin cancer, and was the leading cause of death from skin disease. I also would come to find out that there was a lot I didn’t know about melanoma (see below). I learned that surgery was needed to treat my melanoma.
The skin cancer and some surrounding tissue on the back of my calf were removed during a 50-minute procedure. Because of the location, there were obstacles in closing the incision easily, and a skin graft was even considered. Luckily, I didn’t have to have a skin graft. Even more fortunate was that my melanoma was caught early, before it could spread. Although I was a little surprised by how large my incision was, I was thankful that the initial procedure was able to remove all of the cancer.
My advice: if you see a spot on your body that doesn’t look quite right, don’t try to put “it” out of your mind. The key to successfully treating melanoma is recognizing symptoms early. You might not notice a small spot if you don't look carefully. Have yearly body checks by a dermatologist, and examine your skin once a month. Use a hand mirror to check hard-to-see places. Call your doctor if you notice anything unusual.
There are four types of melanoma. I had superficial spreading melanoma, which is the most common type. It is usually flat and irregular in shape and color, with different shades of black and brown. It is most common in Caucasians. Other types include:
Nodular melanoma, which usually starts as a raised area that is dark blackish-blue or bluish-red. However, some do not have any color.
Lentigo maligna melanoma, which usually occurs in the elderly. It is most common in sun-damaged skin on the face, neck and arms. The abnormal skin areas are usually large, flat and tan with areas of brown.
- Acral lentiginous melanoma, which is the least common form. It usually occurs on the palms, soles, or under the nails and is more common in African Americans.
The risk of developing melanoma increases with age (I was 50 at diagnosis). However, it also is frequently seen in young people. Only about half of melanomas develop from preexisting moles. Melanomas are just as likely to develop on mole-free -skin (like in my case, on the back of my leg).
You are more likely to develop melanoma if you:
- Have fair skin, blue or green eyes, or red or blond hair (that’s me)
- Live in sunny climates or at high altitudes
- Spent a lot of time in high levels of strong sunlight, because of a job or other activities (I was a sun worshipper in my teenage years)
- Have had one or more blistering sunburns during childhood
- Use tanning devices (I confess, tanning beds used to be an essential part of my pre-vacation ritual)
Other risk factors include:
- Close relatives with a history of melanoma
- Certain types of moles (atypical or dysplastic) or multiple birthmarks
- Weakened immune system due to disease or medication