Early Diagnosis

A history of recent evolution or "changing" in a mole has been documented as a key to the diagnosis of melanoma. The American Cancer Society included a "change in a mole" as one of its "Seven Warning Signs of Cancer" in a major public education campaign. The importance of evolutionary changes in detecting melanoma is particularly important in small, early, and in situ melanomas where traditional "ABCD" criteria are often inadequate to make a clinical diagnosis.
If you notice a change in a mole (color, size, border,etc), get to your dermatologist ASAP.

Also, from personal experience, when you do follow ups with the dermatologist make sure he orders CAT Scan or Pet Scan to see what is going on internally as well. My husband had a melanoma on his shoulder removed. It was insitu.
The oncologist turned us over to the dermatologist for follow up. He went every 4 months for 2 years and the dermatologist JUST LOOKED AT THE OUTSIDE SKIN AND DID NOT SEND HIM FOR SCANS TO CHECK INSIDE. He developed a cough and our GP sent him for CT scans. He was diagnosed with stage 4 metastic melanoma. He was told there was nothing that could be done---it was too late. 3 months later he died. By the way, he saw the dermatologist earlier in the week that the GP sent him for CT scans, and was told "See you in 4 months, your skin looks fine.

Thank you so much for this post.  I am 24 and was just diagnosed with a melanoma in situ on Thursday, April 24, 2008.  The surgeon who is now going to excise it on May 8 told me that I should not worry and did not need to see an oncologist or really pursue it at all other than getting my moles visually checked by the dermatologist ever 3-6 months for a couple of years.  After reading about this I am much more concerned that I could have other melanomas on my body currently, and will probably get more in the future.  My husband thinks that I am overly concerned, that it is probably already gone just from the biopsy and that I will probably never have another one.  I do not think I am overly concerned, I am just grateful that this one was caught so early.  I have a family history, a grandmother, an aunt, and a cousin who have all had at least one melanoma.  After reading this forum, I think I will pursue the most aggressive preventative measures possible!

Nikel-I have read many responses on various issues over the years, but have never felt a need to join and respond until now. I am 32 and the mom of  a 3 and 5 year old. I was just diagnosed with melanoma in situ (at least) on 4/28/08. My derm. did a shave biopsy and based on the thinness of less than 1mm, the pathologist could only diagnose in situ. However, he wrote "melanoma in situ at least, malignant cells transcend the base of the biopsy." So I won't really know my stage until the wide biopsy is done. Unlucky for me it is on my cheek, right in the middle of my face. So I will be reminded of this disease, however it turns out, every day I look in the mirror. I am still looking for a plastic surgeon I really like, but I have scheduled surgery for this friday may 9th. I am meeting another on wednesday and am praying he can fit me in for surgery soon. My original diagnosis 3 years ago was a ruptured blemish. Boy was he wrong! I really want it out now and can't wait the month some are saying it will take just for me to get a consultation. It's kind of sad people are getting face lifts and boob jobs while I have cancer growing on my face. I too am afraid my body is full of cancer. I've had a bit of a rough year medically and am so afraid this is the link causing so many symptoms in me. I've had tingling in my hands and feet and a cough that lasted 6 months. It finally went away a month or so ago, but I can't stop thinking about it. I also have many many moles and wish all could be removed. My dr. of course said that is not possible and not necessary. If it truly is in situ, he recommends only baseline bloodwork, a chest xray and 3 month skin checks. After reading previous posts, I would like to have more done.

Nikel-what type of biopsy did you have done for your initial diagnosis? Anyone else? Have you ever heard of an initial diagnosis of in situ come back stage IV. I am so scared and keep thinking of my kids and how much I want to see them grow up. I'm trying to think positive, but the tears keep coming. Sorry so long, but I'd love any responses.

Hi.  I am getting a wide excision on May 8, where are you located?  I can give you my plastic surgeon's info if you want, he is really good and very helpful.  I am in Maryland.  I am very frustrated actually with the dermatologist I am using because I called for an appointment with the actual doctor (versus the physician's assistant I saw initially) and the receptionist said he wasn't available to see me until September, even though I told her I had melanoma and was worried that there was more cancer in my body than has been found already.  I made an appointment and got in to see a nurse practitioner at another dermatologist and she said just come back every 6 months, I asked for some kind of test to make sure I am totally cancer free; she just went and asked the doctor and said they feel it is not necessary.  I researched and found a blood test that can supposedly locate as few as 10 melanoma cells in your blood stream, before it even has reached any other organs it is called a FSH ELISA, I have an appointment at the original dermatologist with the physicians assistant on May 19 after I get the wide excision so I am going to ask for that blood test, if they say it is not necessary I think I'll just go to Quest Diagnostics and get it anyway.  I've never heard of a melanoma in situ coming back as stage 4 in a wide excision, but I don't know that I would have heard of it.  Maybe you could convince them to give you a PET scan to ease your mind?  I hope so.  Best of luck, let me know how your wide excision goes on May 9.

Nikel-Sorry to hear you are having trouble with your dermatologist. I had to wait 5 months for my initial appt, but now I really like him. It's also hard knowing the diagnosis was delayed 5 months though. I had a lot of questions for him and he called me back that night at 6pm to answer all of them. I just hope if I see something concerning they get me in quick now that I have been diagnosed. I had my pre-op physical and chest x-ray done today. I live in Ohio, otherwise would love another plastic surgeons name. What type of biopsy was your original and where is the m. located? I did an online search for FSH ELISA and didn't come up with anything. Do you have a web address that you found this info at? I agree if they won't do it, it may be worth doing myself. It sounds very interesting. Good luck with your wide excision, please keep me posted as well.

Here are some URLs:

http://www.cancer.org/docroot/NWS/content/NWS_1_1x_Detecting

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=18

I thought I had seen it called an FSH ELISA but maybe I am wrong, if so I am sorry!

 

Nikel