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New to site – looking for advice

› Forums › Cutaneous Melanoma Community › New to site – looking for advice

  • Post
    • May 4, 2015 at 4:06 pm
    tgeorge1
    Participant

    Please bare with me, this is kind of long!   I'm looking for some insight from folks I suspect may understand where I'm coming from.  I’m a 32 Yr old male with fair skin, blue eyes, blonde/light brown hair.  Thankfully, I’ve never had melanoma but have a family history. My Grandmother had one about 10 years ago – she is alive and well today, my Grandmother on fathers side died from melanoma in her 70’s or 80’s and her son and daughter – my aunt and uncle on my fathers side – have had melanomas in the past (unsure what stages) – both are also alive and well today.  My father and mother have not had any skin cancers.  About 5 years ago, I had a basal cell carcinoma removed from inside my ear.  I have gone for regular skin checks annually since then. At my last annual exam last December, a concerning mole was removed from my back which came back as a mildly dysplastic nevus.  For some reason it was at this point in time when I began to do some research, that I began to have anxiety for the first time over the chances of melanoma.  After this exam and biopsy in December, I began to really evaluate and look at all of my moles much closer than I ever had previously.  I went back to the dermatologist in late Jan because I had one that just didn’t look right to me – they biopsied it (I think more for my peace of mind) and it came back as a normal mole.  From my continued and now much closer evaluation of my moles, I noticed something on my face – a small nodule – that I noticed from pictures hadn’t gone away in almost a year and got concerned.  I went back in last month to have it checked and it was absolutely nothing – scarring from my own picking at it.  As of now, I have my next appointment scheduled for the end of June which will represent 6 months since my last full body scan in January.

    I find trying to balance not wanting to be paranoid at every single mole on my body that doesn’t look right, with being proactive if something were to be “bad” so that I could catch it early.  Since I never have looked at my moles as closely as I do now, it’s difficult for me to know what has changed.  Once that look odd might have always been that way for all I know!  I’ve got many odd looking moles.  The biopsy in January – other than my BCC – was the first time they had ever biopsied one and I think it was more out of an abundance of caution due to my personal and family history.  My derm tried to assure me that if I am coming in every 6 months for a full scan, if something were to turn bad, they’d likely catch it early. I also know from reading these boards, that isn’t always true.  I also know I can’t go in every single month to have them look at me, especially because I’ve never had a melanoma!  So I’m faced with the decision of waiting until my next appointment versus going in far too often. I try to remind myself that my derm would have told me to "watch this one" or done a biopsy at my last visit if something was alarming but what if it the mole has changed and I just didn't realize it?  Is this mental battle I’m having over being paranoid about every mole versus wanting to be proactive, normal?  How do people handle this?

    Here’s a perfect example, I have a very large mole that has been on my neck – just above my collar bone – for as long as I can remember. I remember as a child being told “it looks fine just keep your eye on it”.  I’ve always pointed it out to my derms at my visits and they always assure me that while it’s large (about 10mm) and not pretty looking, it is “fine”. Never have they even wanted to biopsy it.  Lately – at least in the last two weeks I’ve noticed – a tiny bump in the upper half of it.  It’s hardly noticeable to the eye and I can’t even tell there’s something there if I simply run my finger over it.  But if I look closely enough and spread the skin out, it’s there and I don’t ever remember seeing it before.  The bottom half of this mole has a hair protruding out so part of me wonders if this is just a hairless hair follicle.  It’s a perfect example of not knowing if I should just continue to watch and wait for more pronounced growth,/change (assuming it hasn't always been there unbeknownst to me), if I can it wait until my next exam in June to have the dermatologist evaluate it knowing that’s only about 6 weeks away or should I make an appointment (even though I was just there!) to have it seen asap?  This is the problem I’m facing.  I suspect some might say "don't take any risk" if you are worried go have them look at it however I just had a full body scan three months ago including this one of concern. I used to only go for annual visits however after the recent mildly dysplastic nevus biopsy, they recommend every six months.   

    Everything out there in regards to the characteristics of melanoma to watch out for are extremely helpful but when you haven’t always paid close attention to each mole and then begin to, it’s hard to really know.

    Sorry for the long post, it did help me to feel better just to share it! If anyone has any thoughts/recommendations, etc I'd apprecaite hearing them.

Viewing 2 reply threads
  • Replies
      • May 4, 2015 at 5:49 pm
      Janner
      Participant

      The easiest and best solution is to take photographs of your troublesome moles NOW.  Do it in lighting you can duplicate.  This is your baseline.  Take up close views then further back so you can orient where this particular mole lives.  Add a ruler to the photo and maybe a number so you can make things easier to identify.  Then MONTHLY, do a comparison against those pictures in the same lighting.  Lighting is critical because you may think there is change when it is just a difference in how the area is lit up.  If it changes, bring it to the attention of your derm.  Changing moles don't have to be melanoma, but they are a red flag not to ignore.  Body photography gives you an independent eye.  You don't have to worry if this one is funky or did it really change because you have baseline photos to help.  Even with photos, there were times I was convinced something had changed.  Pulled out my photos and guess what, that spot had always had those characteristics.  Photos take away imagination.

        • May 4, 2015 at 7:58 pm
        tgeorge1
        Participant

        Thank you! That is a great idea. Is there a recommended type of light or that doesn't matter as long as it's consistent?

        In regards to bringing something to the derm's attention that appears to be changing, is there a rule of thumb on whether or not it's ok waiting for the next 6 month body scan which may a couple of months or a month away versus going in immediately?  Obviously I would think if it's bleeding or has very visibly grown and changed over a few weeks period I'd think one shuold go in immediately but with more subtle changes, is it "ok" to wait til that next appointment or is that taking too large a risk?

        • May 4, 2015 at 9:24 pm
        Janner
        Participant

        Lighting:  The trick is to make sure the lighting itself doesn't appear to show change.  So I'd take some pictures in different lighting and immediately compare and see how things look.  When you can say the basic features are good in both the pic vs reality, that's what you use for future checks.

        Waiting is a "gut" call.  I waited several months for a mole I "knew" was melanoma before going to a derm.  I waited for insurance reasons.  3 months later, it was still in situ.  I'm pretty practical with this stuff and not overly dramatic.  If you post on most sites, they will say "get seen right now" and be alarmist.  But truthfully, most melanoma is slow growing.  So my basic rule of thumb is something like this:  If you see some changes and you're going in a month, I personally wouldn't change my appointment unless, as you say, you saw dramatic daily changes.  If my appointment were 4 months out, I'd probably give my derm a call looking for something sooner.   I've been doing this for a long time now and the fear of immediate death 🙂 isn't there.  I just try to be reasonable without being too alarmist or too lacksidaiscal.  Common sense?

        • May 5, 2015 at 5:20 pm
        tgeorge1
        Participant

        Thank you very much for your thoughts!  I agree, having common sense is important.  While I'm sure my derm would have no issue seeing me as often as I'd like, the reality is that it isn't practical to go more than every six months unless something is dramatically changing. I just have to get comfortable with this and I think the picture taking and evaluation beyond all the self-checks I am doing, will help!

        One more question, as I mentioned in my first post, my mother and father have not had any skin cancers however my mom's mom had a melanoma removed and my fathers bother, sister and mother have all had at least one with his mother dying from one. Family history seems to clearly be a factor in having melanoma and I'm curious if there is a difference whether it's a direct parent or as in my case, a grandparent, uncle and aunt.  Are there any studies out there that have looked into this and the degree of separation within a family and risk factor?

        • May 5, 2015 at 5:20 pm
        tgeorge1
        Participant

        Thank you very much for your thoughts!  I agree, having common sense is important.  While I'm sure my derm would have no issue seeing me as often as I'd like, the reality is that it isn't practical to go more than every six months unless something is dramatically changing. I just have to get comfortable with this and I think the picture taking and evaluation beyond all the self-checks I am doing, will help!

        One more question, as I mentioned in my first post, my mother and father have not had any skin cancers however my mom's mom had a melanoma removed and my fathers bother, sister and mother have all had at least one with his mother dying from one. Family history seems to clearly be a factor in having melanoma and I'm curious if there is a difference whether it's a direct parent or as in my case, a grandparent, uncle and aunt.  Are there any studies out there that have looked into this and the degree of separation within a family and risk factor?

        • May 5, 2015 at 6:55 pm
        Janner
        Participant

        Melanoma can run in families and NOT have a genetic defect.  It's as simple as having higher risk features (blond/red hair, blue eyes, type 1 skin) and sun habits.  Families often share the same sun habits.  A genetic defect doesn't miss generations and has an extremely high likelihood of showing.  (I have one and was given a 76% lifetime risk of melanoma).  But since you mention no one with multiple primaries and your parents don't have melanoma, it's more likely that there are other factors more responsible than a specific melanoma defect.  < 10% of melanomas are said to have any genetic defects, the defect I have supposedly encompasses 2-4% of melanoma warriors.  In the end, it really doesn't change anything.  You know about the risk of getting melanoma and that's big.  Many people have no clue about melanoma.  So don't worry about family history because it changes nothing in how you approach watching your body. 

        • May 5, 2015 at 6:55 pm
        Janner
        Participant

        Melanoma can run in families and NOT have a genetic defect.  It's as simple as having higher risk features (blond/red hair, blue eyes, type 1 skin) and sun habits.  Families often share the same sun habits.  A genetic defect doesn't miss generations and has an extremely high likelihood of showing.  (I have one and was given a 76% lifetime risk of melanoma).  But since you mention no one with multiple primaries and your parents don't have melanoma, it's more likely that there are other factors more responsible than a specific melanoma defect.  < 10% of melanomas are said to have any genetic defects, the defect I have supposedly encompasses 2-4% of melanoma warriors.  In the end, it really doesn't change anything.  You know about the risk of getting melanoma and that's big.  Many people have no clue about melanoma.  So don't worry about family history because it changes nothing in how you approach watching your body. 

        • May 10, 2015 at 2:12 am
        tgeorge1
        Participant

        So today I happened to be at a large big box retailer that happened to be doing free skin and spot checks through the American academy of dermatology with a board certified dermatogist. I figured I'd take advantage of the opportunity and have them look at the aforementioned mole. The derm doing the checks was using a dermoscope and commented that there were a "a lot of blood vessels" she could see.  She seemed concerned and didn't think I should wait until my next regular appt if I didn't have to. I asked what they meant and she said either nothing or that they were trying to do something they shouldn't be. She recommended I follow up with my regular derm for a biopsy which I plan to do asap.  Has anyone heard of this with regards to the blood vessels?  The portion of the mole that seems to maybe be growing blanches which I always thought was a positive sign. It's on a mole and I don't think it's a BCC which I've had one of. Obviously the biopsy will be conclusive but is the appearance of blood vessels in a dysastic Nevis through such a lense a sign of melanoma? Or no way to tell just based on that? Or if it was melanoma would it be very early stage? She didn't seem to want to say either way , which I guess i understand but obviously doesn't make me feel great either about this mole.  Also given I have been stretching my skin and pinching it to try to get a better look at it quite a bit lately, could I have caused the irritation and messed with the vascular network myself causing more blood vessels to be seen in that area?

         

        • May 10, 2015 at 2:12 am
        tgeorge1
        Participant

        So today I happened to be at a large big box retailer that happened to be doing free skin and spot checks through the American academy of dermatology with a board certified dermatogist. I figured I'd take advantage of the opportunity and have them look at the aforementioned mole. The derm doing the checks was using a dermoscope and commented that there were a "a lot of blood vessels" she could see.  She seemed concerned and didn't think I should wait until my next regular appt if I didn't have to. I asked what they meant and she said either nothing or that they were trying to do something they shouldn't be. She recommended I follow up with my regular derm for a biopsy which I plan to do asap.  Has anyone heard of this with regards to the blood vessels?  The portion of the mole that seems to maybe be growing blanches which I always thought was a positive sign. It's on a mole and I don't think it's a BCC which I've had one of. Obviously the biopsy will be conclusive but is the appearance of blood vessels in a dysastic Nevis through such a lense a sign of melanoma? Or no way to tell just based on that? Or if it was melanoma would it be very early stage? She didn't seem to want to say either way , which I guess i understand but obviously doesn't make me feel great either about this mole.  Also given I have been stretching my skin and pinching it to try to get a better look at it quite a bit lately, could I have caused the irritation and messed with the vascular network myself causing more blood vessels to be seen in that area?

         

        • May 10, 2015 at 2:12 am
        tgeorge1
        Participant

        So today I happened to be at a large big box retailer that happened to be doing free skin and spot checks through the American academy of dermatology with a board certified dermatogist. I figured I'd take advantage of the opportunity and have them look at the aforementioned mole. The derm doing the checks was using a dermoscope and commented that there were a "a lot of blood vessels" she could see.  She seemed concerned and didn't think I should wait until my next regular appt if I didn't have to. I asked what they meant and she said either nothing or that they were trying to do something they shouldn't be. She recommended I follow up with my regular derm for a biopsy which I plan to do asap.  Has anyone heard of this with regards to the blood vessels?  The portion of the mole that seems to maybe be growing blanches which I always thought was a positive sign. It's on a mole and I don't think it's a BCC which I've had one of. Obviously the biopsy will be conclusive but is the appearance of blood vessels in a dysastic Nevis through such a lense a sign of melanoma? Or no way to tell just based on that? Or if it was melanoma would it be very early stage? She didn't seem to want to say either way , which I guess i understand but obviously doesn't make me feel great either about this mole.  Also given I have been stretching my skin and pinching it to try to get a better look at it quite a bit lately, could I have caused the irritation and messed with the vascular network myself causing more blood vessels to be seen in that area?

         

        • May 5, 2015 at 6:55 pm
        Janner
        Participant

        Melanoma can run in families and NOT have a genetic defect.  It's as simple as having higher risk features (blond/red hair, blue eyes, type 1 skin) and sun habits.  Families often share the same sun habits.  A genetic defect doesn't miss generations and has an extremely high likelihood of showing.  (I have one and was given a 76% lifetime risk of melanoma).  But since you mention no one with multiple primaries and your parents don't have melanoma, it's more likely that there are other factors more responsible than a specific melanoma defect.  < 10% of melanomas are said to have any genetic defects, the defect I have supposedly encompasses 2-4% of melanoma warriors.  In the end, it really doesn't change anything.  You know about the risk of getting melanoma and that's big.  Many people have no clue about melanoma.  So don't worry about family history because it changes nothing in how you approach watching your body. 

        • May 5, 2015 at 5:20 pm
        tgeorge1
        Participant

        Thank you very much for your thoughts!  I agree, having common sense is important.  While I'm sure my derm would have no issue seeing me as often as I'd like, the reality is that it isn't practical to go more than every six months unless something is dramatically changing. I just have to get comfortable with this and I think the picture taking and evaluation beyond all the self-checks I am doing, will help!

        One more question, as I mentioned in my first post, my mother and father have not had any skin cancers however my mom's mom had a melanoma removed and my fathers bother, sister and mother have all had at least one with his mother dying from one. Family history seems to clearly be a factor in having melanoma and I'm curious if there is a difference whether it's a direct parent or as in my case, a grandparent, uncle and aunt.  Are there any studies out there that have looked into this and the degree of separation within a family and risk factor?

        • May 4, 2015 at 9:24 pm
        Janner
        Participant

        Lighting:  The trick is to make sure the lighting itself doesn't appear to show change.  So I'd take some pictures in different lighting and immediately compare and see how things look.  When you can say the basic features are good in both the pic vs reality, that's what you use for future checks.

        Waiting is a "gut" call.  I waited several months for a mole I "knew" was melanoma before going to a derm.  I waited for insurance reasons.  3 months later, it was still in situ.  I'm pretty practical with this stuff and not overly dramatic.  If you post on most sites, they will say "get seen right now" and be alarmist.  But truthfully, most melanoma is slow growing.  So my basic rule of thumb is something like this:  If you see some changes and you're going in a month, I personally wouldn't change my appointment unless, as you say, you saw dramatic daily changes.  If my appointment were 4 months out, I'd probably give my derm a call looking for something sooner.   I've been doing this for a long time now and the fear of immediate death 🙂 isn't there.  I just try to be reasonable without being too alarmist or too lacksidaiscal.  Common sense?

        • May 4, 2015 at 9:24 pm
        Janner
        Participant

        Lighting:  The trick is to make sure the lighting itself doesn't appear to show change.  So I'd take some pictures in different lighting and immediately compare and see how things look.  When you can say the basic features are good in both the pic vs reality, that's what you use for future checks.

        Waiting is a "gut" call.  I waited several months for a mole I "knew" was melanoma before going to a derm.  I waited for insurance reasons.  3 months later, it was still in situ.  I'm pretty practical with this stuff and not overly dramatic.  If you post on most sites, they will say "get seen right now" and be alarmist.  But truthfully, most melanoma is slow growing.  So my basic rule of thumb is something like this:  If you see some changes and you're going in a month, I personally wouldn't change my appointment unless, as you say, you saw dramatic daily changes.  If my appointment were 4 months out, I'd probably give my derm a call looking for something sooner.   I've been doing this for a long time now and the fear of immediate death 🙂 isn't there.  I just try to be reasonable without being too alarmist or too lacksidaiscal.  Common sense?

        • May 4, 2015 at 7:58 pm
        tgeorge1
        Participant

        Thank you! That is a great idea. Is there a recommended type of light or that doesn't matter as long as it's consistent?

        In regards to bringing something to the derm's attention that appears to be changing, is there a rule of thumb on whether or not it's ok waiting for the next 6 month body scan which may a couple of months or a month away versus going in immediately?  Obviously I would think if it's bleeding or has very visibly grown and changed over a few weeks period I'd think one shuold go in immediately but with more subtle changes, is it "ok" to wait til that next appointment or is that taking too large a risk?

        • May 4, 2015 at 7:58 pm
        tgeorge1
        Participant

        Thank you! That is a great idea. Is there a recommended type of light or that doesn't matter as long as it's consistent?

        In regards to bringing something to the derm's attention that appears to be changing, is there a rule of thumb on whether or not it's ok waiting for the next 6 month body scan which may a couple of months or a month away versus going in immediately?  Obviously I would think if it's bleeding or has very visibly grown and changed over a few weeks period I'd think one shuold go in immediately but with more subtle changes, is it "ok" to wait til that next appointment or is that taking too large a risk?

      • May 4, 2015 at 5:49 pm
      Janner
      Participant

      The easiest and best solution is to take photographs of your troublesome moles NOW.  Do it in lighting you can duplicate.  This is your baseline.  Take up close views then further back so you can orient where this particular mole lives.  Add a ruler to the photo and maybe a number so you can make things easier to identify.  Then MONTHLY, do a comparison against those pictures in the same lighting.  Lighting is critical because you may think there is change when it is just a difference in how the area is lit up.  If it changes, bring it to the attention of your derm.  Changing moles don't have to be melanoma, but they are a red flag not to ignore.  Body photography gives you an independent eye.  You don't have to worry if this one is funky or did it really change because you have baseline photos to help.  Even with photos, there were times I was convinced something had changed.  Pulled out my photos and guess what, that spot had always had those characteristics.  Photos take away imagination.

      • May 4, 2015 at 5:49 pm
      Janner
      Participant

      The easiest and best solution is to take photographs of your troublesome moles NOW.  Do it in lighting you can duplicate.  This is your baseline.  Take up close views then further back so you can orient where this particular mole lives.  Add a ruler to the photo and maybe a number so you can make things easier to identify.  Then MONTHLY, do a comparison against those pictures in the same lighting.  Lighting is critical because you may think there is change when it is just a difference in how the area is lit up.  If it changes, bring it to the attention of your derm.  Changing moles don't have to be melanoma, but they are a red flag not to ignore.  Body photography gives you an independent eye.  You don't have to worry if this one is funky or did it really change because you have baseline photos to help.  Even with photos, there were times I was convinced something had changed.  Pulled out my photos and guess what, that spot had always had those characteristics.  Photos take away imagination.

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