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Wilma is a skin cancer specialist nurse, here to answer your questions about different...
My background is: 29, male, mixed-race (skin type 3/4 Fitzpatrick), brown skin, no FH of skin cancer, don't use tanning booths, don't spend huge amounts of time outside other than summer, but did live in Oz for six months a few years back. I have a few moles over my body and all of them are a deeply pigmented colour, possibly something to do with my ethnicity.
At the end of October, I made an appointment with my GP to look at a small back mole on my back which is very slightly raised. It had become slightly itchy and I just 'felt' something wasn't right with it. The GP didn't think it looked like melanoma but referred me to a dermatologist and I was seen in two weeks.
I went to the dermatology appointment two weeks ago and the dermatologist inspected it. I was very shocked that she told me that it looks atypical and that it had been bleeding as there was a small scab over it. She did seem to be quite reassuring though and said that I would be low risk for melanoma based on my background (she said because of my ethnicity and natural pigmentation) but that the mole needs to be removed as the mole was very dark under the dermascope. She also did a general examination of my body and saw a 7mm flat mole on my thigh and her words were "this is going to worry me" - again, it is a deeply pigmented mole but with irregular borders and her referral letter also referred to irregular colour. Her view was that because of how pigmented the moles are, they need to be excised for biopsy. As far as I'm aware, I've always had these mole but I haven't really been monitoring them for changes. I just assumed I'd had it since childhood. In fact, I looked at some photos from 1.5-2 years ago and the two moles look very similar to when they were removed - same sort of shape and size and the same dark black colour.
I then had the appointment two weeks ago for the double excision with a plastic surgeon. Before the procedure, the surgeon also examined the moles. He said that the one on my thigh was striking and really "pops out" because of the deep pigmentation and 7mm size. He said that he thinks the moles are unlikely to be cancerous mainly because of my age but that lots of young people have atypical moles and that excision is a preventative step. I pressed him further and said if it is cancer, what stage is it and he said that it would probably be early stage. He also said that in his 25 years, he had only seen 4/5 people in my age bracket with melanomas. We then went upstairs to the procedure room and he did a closer examination of the moles under the light before the procedure. It was at this point I sensed a change in atmosphere because he inspected the one on my thigh and said emphatically "Okay, this one must be removed, in fact I am not letting you leave without removing it and would be concerned if you went away and came back in three months about it". He then went on and removed both of them.
These words made me feel sick. As I said, the mole on my thigh I was sure I had for many years and I hadn't seen any changes. Yes, it was deeply pigmentated in colour and irregular but I had always accepted it as just a 'funny looking' mole that is part of who I am. Now I am panicking that it is something very serious that has spread across my body into different parts and it's been caught too late given it was there for so many years. After the procedure was over, I asked the surgeon what he meant by these comments and said are you alarmed by the moles now you've seen them under the light and he said "the one on your leg yes, but the important thing is they've been removed now".
I feel overwhelmed with stress and anxiety by all of this. I didn't even go to the GP about the mole on my thigh, I assumed it was just a strange mole I'd always had and the pictures I've been examining over the last few days seem to show that the mole was there at least 1.5-2 years ago and looked similar. The advice of the doctor feels inconsistent - as in don't worry, it's unlikely, but emphatically these must be removed.
I have the appointment tomorrow to go back in and have the stitches removed two weeks on from the excision. The surgeon told me that the biopsy results would be ready "in a week" (that was 2 weeks ago) and that he would usually call the patient if the results were abnormal. I had reacted pretty negatively to that and I think he understood from my reaction that I wouldn't want to be called. I had all this done at a private hospital (here in the UK) and haven't heard anything from the hospital since the procedure other than an automated text reminder of the appointment.
1. What do I read into all this? That under the light, he actually thinks it's a melanoma? Why was he so firm that they need to be removed?
2. Would the doctors say that they think something is likely to be a melanoma if they thought it was? It feels like they weren't saying it is likely to be but at the same time ordering that they be removed so I'm very confused.
3. Is it likely that you would have other symptoms if you had advanced stage melanoma? I am making peace with the fact that I think I have a form of melanoma especially in the leg but wondered if it was advanced there would be other symptomology.
4. Would they usually call you in earlier if there was something very bad arising from the biopsy results (even if you'd indicated that you didn't want to be called)? Or would they just accept your wishes and wait for the follow up appointment to discuss the results with you?
5. Would they typically call you and advise you to bring someone with you to the appointment if it were bad news? How much notice would they give you? I'm just conscious I haven't (yet) had that communication and I'm nervous they will call on the day of the appointment (i.e. tomorrow) and tell me to bring someone.
I can't stop thinking about moles, about the fact I may have stupidly let something insidious grow on my skin for years of my life and now it's too late.
Sorry for the long rant, upset and really really down and don't know what to expect at tomorrow's appointment.
Hi Concernedlondoner and welcome to the online community
Waiting for results is probably the worst time as you feel completely out of control. You may have already had your appointment and been told that neither of your moles is a melanoma but, if one of them is, there are plenty of people in the group, including myself, who will understand what you're going through and will be able to help with what happens next.
However, in case you haven't seen your consultant yet I'll try and answer your questions based on my own experience. Firstly I'd have to say that I was treated under the NHS so can only comment with what happens there.
Do come back and let us know how you get on today. I'll be keeping my fingers crossed
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Hi Concernedlondoner, how did you get on today? I’d be surprised if you got your results today - it’s usually a nurse that removes stitches, but I don’t know if that’s the same for private appointments.
Try not to read too much into the dermatologist insisting on removing the moles, that is the standard treatment for all kinds of things. When I saw my dermatologist he suspected Bowen’s disease. So although I knew melanoma was the worst of all the options when I got my biopsy results, the treatment was no different from what I’d been expecting previously. However, like you, I also felt the atmosphere change on the day of my biopsy - my lesion has changed rapidly between being seen initially and having the biopsy! I then got a phone call asking me to come in, rather than the results letter I’d been expecting. I think a combination of those things meant I was ready to get bad news, but it was still a lot to deal with. My diagnosis subsequently got worse (and now better again!) but I was never as worried as when I got that very first diagnosis... So - the long rambling point is - you don’t know for sure what is coming, it is very stressful and scary, but you can only deal with the information you have got.
Hopefully there will be good news and this will be the end of it, but please do let us know and come back if you need us.
Hello Katy and Latchbrook
Thanks to both of you for your messages, I really appreciated reading them this morning before I went to the appointment.
I managed to get to the appointment although I was in a complete state by the time I went in. He delivered some really good news to me - both moles were benign 'hyperpigmented compound nevus' - to say I am relieved is an understatement and I feel completely exhausted now. Apparently my moles are just deeply deeply pigmented, perhaps due to my ethnicity, but from what I understand they were not even atypical. So no further surgery is required at all. I am still trying to process the news after being in a state of high alert for about a month. The surgeon said that he had been very worried about my results because of the appearance of the moles and that had he shown images of the moles to medical students they would all have said cancer. So I guess I read the room correctly at the surgery when he performed the removals when I said the atmosphere changed, albeit it there were good, unexpected results.
He has told me that my risk hasn't changed and that I should just, like everyone else, keep an eye on any changes for the rest of my life through self-checks. I may still go for annual checks though for peace of mind.
I feel a bit of a fraud having made such an issue of this when there are many people posting on here with their deepest darkest worries and diagnosed with serious conditions. This experience took me to a very dark place at times but also made me feel hopeful about humanity and the kindness of strangers.
I am so thankful to you for the time you took to reply to my message, which I typed when I was feeling scared and low. I hope you are well yourself and wish you all the best.
Hurray - that’s fantastic news! And breathe.
Really pleased that’s the outcome, thanks for letting us know. I hope you’ve done some serious celebrating! Best wishes,
That's great news Concernedlondoner!
Thanks for coming back and letting us know. We like to hear good news!
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