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?