With the warmer weather on its way and Memorial Day weekend kicking off the beach/lake/pool season comes the threat of melanoma, a potentially deadly form of skin cancer. Helga, a mom of two daughters, ages 6 1/2 and 9, shares her story on finding out she had melanoma and what happened next. Plus, advice from Breezy Mama go-to dermatologist, Dr. Vi on treatment, prevention and more.
How was your melanoma discovered? A routine check? A suspicious looking mole you discovered and had a dermatologist look at?
I was diagnosed with melanoma in December 2008. It was a mole I had for several years and I had been going to a dermatologist every six months for skin checks. It had been noted during my last visit with the dermatologist I was seeing at the time, however we decided to leave it and not do a biopsy, just watch it. It was on my lower leg and during a personal conversation with my friend Dr. Gigler [a.k.a. Breezy Mama’s Go-To dermatologist Dr. Vi] she asked if I had checked that particular mole — I was wearing shorts and it was summer at the time so she could see it clearly. I told her we were watching it; she said to definitely have them consider a biopsy next time. Luckily I listened to my friend (and now dermatologist) because it turned out to be early melanoma.
What prompted you originally to make an appointment with a dermatologist?
My husband has been working on the business side of dermatology for many years. Because of this, I’ve met many dermatologists and they always commented to me how fair my skin is, light eyes, better watch the sun, wear a hat and so on. After the birth of my eldest daughter I made my first appointment with a dermatologist and got a skin check. I was in my early thirties at the time and after having my first child I thought I better make sure everything was in order. Thank goodness I made the appointment!! I had several severely atypical moles which were removed and after that visit my dermatologist recommended I get a full skin check every six months. Luckily for me I continued to be very diligent — I’m so thankful for that decision.
Were you shocked to get the melanoma diagnosis?
When I got the melanoma diagnosis, I was shocked and upset. I felt guilty and irresponsible for all the sun exposure and worried about the future–was there another one lurking somewhere and we were missing it? I had been told by my doctor that with the severely atypical moles we needed to be on the look out for basal cell cancers as well as scarier things. I did not expect that I would really end up with a melanoma.
Is melanoma hereditary in your family or was this a direct result of the sun?
Melanoma does seem to be hereditary in my family but I have also had more than my share of sun exposure. My younger sister has also had an early melanoma and she is very diligent as well with her doctor visits. My family comes from Germany originally and my coloring is very fair. I’ve spent quite a bit of time in the sun, I’ve always loved the beach, swimming and sun bathing. I remember getting sunburns growing up, because I was not diligent with sunscreen. I attended the University of Arizona and lived in Arizona for four years, during that time I always had a tan — it was the 80’s after all!
Once diagnosed, what did you have to do next to be cancer free?
Once I was diagnosed, I made an appointment to have the melanoma removed. It was a relatively simple surgery but in an area on my lower leg, near my ankle which made it very uncomfortable. I had fifteen stitches and it took a while to heal. The good news was that the edges were clear and the melanoma was completely removed.
Was the melanoma an immediate threat to your life, or was it caught in time?
Luckily the melanoma was not an immediate threat to my life — it was early. I will forever be grateful to my dear friend and doctor who noticed the mole and took the time to point it out.
After you have had it once, how often do you then go into a dermatologist to make sure it doesn’t return?
Since the melanoma diagnosis I get a skin check every three months. I never miss an appointment. It’s been over a year, but there is a chance that there could be another one. I have had several basal cell cancers removed and continue to have them. Although less likely, these cells can also migrate and cause major problems. I have also had a full blood panel done to check for any signs of cancer in the blood stream.
What is your advice for women so they can hopefully prevent melanoma?
My advice to any person is to get checked by a dermatologist at least once a year. This does not mean by your general doctor but a reputable dermatologist who looks at skin all day. I don’t think enough people are aware that they need to be doing a skin check yearly — this is especially true for fair people and people with a lot of sun exposure. Since my diagnosis I tell anyone who will listen to wear sunscreen, protect their children from the sun and get a skin check. I have referred many friends to my dermatologist and several of them have had serious moles removed which undetected could have been a real danger in the future.
QUESTIONS FOR DR. VI
How common is melanoma?
Approximately 50,000 diagnosed each year in the US; approximately 7,500 die each year in the US from melanoma.
Do you get many patients that didn’t even realize a mole might be suspect?
Yes- many patients are not aware of their melanomas… we catch them on routine skin exams. I would say more than 50% of the melanomas I find are in patients who were not aware that they had a suspicious lesion.
If melanoma is not caught in time, at what point does it become deadly?
I do not really want to give a timeline since the rate depends on the type of melanoma and depth at time of diagnosis… but if a melanoma is caught early, it has a much higher rate of survival (close to 100%)… late melanomas can kill patients in a matter of days. I do not say that to scare patients, but to emphasize the importance of skin checks and early diagnosis.
What is the treatment if it is caught in time?
If it is caught early, all that is needed is an in-office procedure to excise the skin around the tumor. The procedure takes about 30 minutes and is done in the doctor’s office with local anesthetic. If the lesion is more advanced, a lymph node biopsy and or chemotherapy may be needed.
If a patient has melanoma, how often do they have check-ups afterward?
Every 3 months for a couple of years, every 6 months for the next 3 years, and then every year for the rest of their lives.
If a patient had never had melanoma, how often should they have their skin checked by a dermatologist to be safe?
Every year at the minimum, but I often have patients come in every 6 months if they have risk factors such as family history of melanoma or sunburn.
Is the best defense against melanoma protecting yourself from the sun?
This is the best defense for prevention, but I will say that melanoma is complicated. You can get melanoma even in areas that do not have sun exposure. The best defense for survival of a melanoma is early detection- that being routine skin checks by your dermatologist and biopsies of any suspicious lesions. Biopsies can be quick and easy, and relatively painless. I also recommend that patients check their own skin monthly and look for any new or changing lesions. We ask patients to look for the the ABCDE’s of melanoma- asymmetry, abnormal borders, variations in color, and diameter bigger than a pencil eraser. And most importantly–evolution, any new or changing lesion. Melanomas can even be pink–so we ask patients to come in if they see any new or changing lesion. In addition, any lesion that is itching or bleeding should be shown to the doctor.
Any other advice?
Be aware of your skin… know your moles and other spots. Establish care with a dermatologist or primary care doctor and get routine skin checks. Discuss with your doctor which lesions should be biopsied and which should be monitored. Follow up with your doctor. Ask your doctor when you should follow up and make sure you do that… do not wait for them to call you.
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About Dr. Vi
Vishakha Gigler, M.D. is a board certified dermatologist. She enjoys practicing medical, cosmetic, and surgical dermatology, including Mohs micrographic surgery. Dr. Gigler was recognized as a “top doctor” by her colleagues in 2007 in San Diego Magazine. She prides herself in delivering the highest level of medical care. For more information, visit www.comprehensivederm.com