Susan’s (almost) skin cancer chronicle, part 3

When is a mole (not) a beauty mark?

August 2008: I have this mole, right above my right breast. I like it a lot: It’s sexy.
About six months ago it started getting darker. The edges blurred. It grew, slightly larger, slightly thicker. I knew it had to come off. But I really liked the mole. So I watched and waited.

Mole-roulette, I was playing with fire.

I walked into my doctor’s office. “This mole has to come off.” She glanced, nodded, then her eyes flew up to my face. She pushed back my hair, touched my left cheek, above the jaw. “This one, too,” she said. A few minutes later, I felt her cool hand, touching the back of my left leg, the meat of my calf. “And this.”

Lidocaine, bandages. This time a rash, a fierce itch on my chest, swelling. “It’s very deep,” the nurse said when I called, “Doctor had to dig deep to get the whole thing.”

Third time down this road, I’m waiting for a phone call that doesn’t come.

I wait, denial leaves me content. The itching stopped, the swelling eased. I don’t call – silence is good news.

The phone rings while I am on deadline. “We need to schedule surgery…”

There are only two details worth sharing:

1.  I was ‘as close to’ melanoma as one could get…without actually being diagnosed. In other words, one screaming close call.

2.  This time, no white sheet blocked my view. Instead, I kept my eyes closed the whole time – except for this one moment: I peeked, and saw the surgeon transporting a large blob of flesh, blood dripping, fat globules dangling, from my chest to a large vial.

The mole is gone. I have a jagged scar I’m told will fade in time. I’m trying to believe it’s sexy, but all my necklines are higher now.

I’m glad, grateful, that this cut – so deep, so wide, so long – was enough. The margins are clear. That’s what the lab report says, it gives no other explanation, no recommendations for self-care. But I don’t need them: I wear sunscreen. I invest in Coolibar clothing. I see my doctor annually. Between visits, I study my front. My husband’s got my back.

I don’t want to see another mole go bad. I don’t want another scraping, another surgery. I’m taking care, but at the same time there’s nothing more that I can do. The initial damage – years of unprotected sun worship – is done. What lies beneath each and every one of my moles is an active volcano: It can erupt at anytime.

Next up: Susan meets melanoma survivor.

Susan’s (almost) skin cancer chronicle, part 2

The phone call came while we were driving to Seattle.

“Is this Susan Rich? We need to schedule you for surgery, immediately.”

“What? Why?” I was baffled, sure I’d misheard the voice on the line.

“You need to have some moles removed.”

That’s how I found out (again) that my moles were on the march, taking their first unwelcome steps towards melanoma. This was December 2005, a few days after I’d had four moles scraped off my body.

Less than a week later I was on an operating table, a white sheet dividing me in half. I stared into the bright overhead light, at the surgeon, his assistant. I couldn’t see my abdomen, the lower right quadrant where two errant moles had been scraped away.

Scraping is a biopsy, removal means surgery: Stitches, a scar.

“How big?” I asked.

The surgeon shrugged. Until there’s a clear margin, he said.

And then he explained: Even though the visible mark is gone, moles are not surface blemishes. A certain amount of skin – so deep, so wide, so long – has to be removed to make sure the entire mole is gone.

“And then I’m ok,” I said. A statement. Relief. Another small scar. No big deal.

He shook his head. “No. Then we do another biopsy. If there’s still a trace of pre-cancerous cells, we cut some more.”

I raised my head, tried to stare down the table. The white sheet blocked my view.

“Again?” My voice faltered.

“And again. Sometimes we have to cut so deep we need to do a skin graft to cover the wound.”

“Is it.” I couldn’t say cancer.

“Melanoma? No. But we still have to make sure we get it all.”

Then he explained: There is no cure for melanoma. No cancer drugs have proven effective. The only treatment is to cut: So deep, so wide, so long. A series of deep cuts, mathematically precise, with no guarantee that the first cut will be the last.

I put my head down. Stared up at the lamp. “It was a tiny mole. Both of them. Smaller than the scrape you can see.”

He swabbed my abdomen. Injected a local anesthetic. The scalpel glinted. “You’ll feel pressure, not pain.”

He was right – there was no pain. Instead, I felt warmth: My blood welling, then spilling down my side, pooling below my back.

“I grew up in Arizona, Phoenix. Before I knew about sunscreen – I used to put on baby oil and bake in the sun. Now…I’m better about it. Not lying in the sun.”
But I was lying.

He nodded, pursed his lips. Yes, it was my fault. Yes, I was paying for my past – my passionate love affair with bronze skin.

“You had a mole removed once before. I can see the scar.”

“Yes…”

He looked up, his eyes met mine for the first time since the surgery started.

“Statistics show – once moles start to turn, they keep turning. That doesn’t mean you’ll get melanoma, but your risk goes up with every biopsy. Now will you take this seriously? Start wearing sunscreen. I don’t want to see you in here again.”

Next up: When is a mole a beauty mark?

Susan’s (almost) skin cancer chronicle, part 1

Yesterday I had four moles scraped off my abdomen.

December, 2005: Four small black marks with irregular edges and dense centers. These spots have been a part of my anatomy since my late teens, along with dozens of others sprinkled across my arms and legs and back. A precise row comets across my face, the one in the middle looks just like Cindy Crawford’s.

When I was 12, I used to cry when I looked in the mirror. In the words of a sixth grader, my face was spotted, like a bug. All that year and next I shied away from meeting people, convinced their instant judgment had them comparing me to a less-than-glamorous ladybug. I refused to look at myself in a mirror, and if I did, I focused on my eyes or my nose or the center of my chin, mole-free venues, safety zones.

My mother proffered makeup: I daubed on foundation and cover up. The dark spots faded, my skin tone was smooth. I studied the results and reached for a washcloth. I realized, suddenly, that hiding my branding was the same as hiding me.

More moles appeared as puberty progressed, like a permanent form of chicken pox. Spots and spots and more spots.
It took years to adjust to the moles, the imagined stares.

I laughed when I learned that fake moles – beauty marks – were the rage in the era of Marie Antoinette. Men and women pasted on what nature had sprinkled on me like pepper. Of course women also rouged their nipples and men wore white wigs. It is easy to covet, enjoy, what isn’t real.

Nature’s tattoo, that’s how I describe my moles today. A swirl of cocoa-colored constellations that only I can name. My moles are a part of me, too many to count, a visual anchor when I look at my arms, my legs, my chest.

Fifteen years ago a mole on my stomach started to shimmer and grow. Its progress was noticeable, frightening. The mole was removed, a biopsy done: Displastic, indicating the presence of pre-cancerous cells. A narrow white mark, thick with a ridge of keloid scar tissue, is all that remains. This and the knowledge that I am at risk for melanoma, and have to avoid the sun.

Waiting for the next mole to morph was a slow trickle of sand through a large hourglass. Yesterday the sand ran out.

The dermatologist checked my scalp, my eyes, the soft tissue in my mouth; my neck and shoulders, the broad sweep of my back; hips, then legs, and in between my toes. She used a jeweler’s loupe and a sharp blue pen, inking circles first on my chest, then low on my belly. She’d pause, reconsider, then wipe off a mark with a cool swipe of alcohol. The others were scraped off, tested, results mailed to me in a week.

“It’s nothing to worry about but we have to be sure,” she said.

Three needle sticks of Lidocaine, two oversized bandages, and it was done. The lab tech left the room, glass slides clicking on a stainless steel tray.

I sat up and studied bloodied Q-tips in the trash. My moles were elsewhere. Underneath the tan stickers was a raw patch of skin where a starburst pattern of black moles used to be.

I spent a lifetime learning that I am more than the sum of my skin. It took less than 45 minutes to alter a tattoo more personal than any artist could create.

When I peel this bandage off tonight, I’ll know that what lies beneath is the real beauty mark.

Next up: Susan needs surgery