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Cancer: Skin Message Board

Cancer: Skin Board Index

Okay, so hereís why Iím scared.

Went to the dermatologist for the first time because I was concerned about a nail stripe I had (turned out to be nothing). I had him check out a mole Iíd noticed on my right middle toe (on the side).

He gets this concerned look on his face and says ďyeah, we should probably get that off youĒ. When I emotionally recovered from that reaction I asked what it could be, and hereís what he said:

ďWell thatís not melanoma, RIGHT NOW.Ē
ďRight now, thatís an atypical nevus.Ē

Whatís concerning, no scaring the hell out of me is that to my knowledge, you canít just TELL the difference between an atypical mole and melanoma just by looking at it. And the fact he called it atypical means it shares visual characteristics with melanoma, which to me means IT LOOKS LIKE MELANOMA. I donít know if his use of the term ďright nowĒ was a definite or if he just wanted to ease my mind but with a disclaimer.

He did go on to say that it was ďunlikelyĒ to be anything serious and that I shouldnít worry (again, right now) but that we should remove it anyway because itís on a toe and Iím less likely to keep an eye on it.

Now Iím a professed hypochondriac, a condition I am actively seeking counseling for, but Iím in that dangerous state of mind where Iím second-guessing a medical professional.

Hereís the main reasons for my concerns-

-You canít confirm what an atypical nevus really is until you do an excision and biopsy, which I am scheduled for Monday.
-As far as the ABCDE criteria that seems to be popular:
-Itís not a perfect circle, but ovular. I CAN divide it in half and produce two identical sides. I donít know if symmetrical means you have to be evenly divide it no matter which way you look at it.
- Itís on the side of my toe, a place I donít typically look, so I have no idea if itís new, old but changed, or if itís been there all my life.
-The color seems to be uniform throughout most of it -very dark brown but lighter towards the edges. It could be black near the center, but that seems to depend on what light Iím in.
-To my eyes the borders seem fairly normal.
-It is smaller than 6mm (maybe 4-5mm) but I hear that doesnít matter over much.
-Its texture is the same as the skin around it.

The doc wanted to have it removed as soon as possible. I donít know if thatís because thereís a cause for alarm, or because he didnít think Iíd keep an eye on it being as itís in a usual place.

Iím not particularly at risk for melanoma, as other than a sunburn I remember having once as a kid, I donít fit the other factors. I donít spend much time outdoors in the sun, Iím not fair skinned (I am Asian so I have dark skin, dark eyes, dark hair), no family history of skin cancer. Other cancers, yes, but the dermatologist said it shouldnít matter in this case. I also only seem to have the one atypical mole, a fact that seems to be in debate as being either bad or good.

All my personal knowledge of melanoma comes from the internet which I am told is not always accurate. Ironic, as Iím asking online, yes?

Is there anything that can ease my worry in the meantime? I have to wait another five days until I get the thing cut off me and who knows how long after that to get the biopsy results. Iím not eating or sleeping well, and Iím absolutely consumed by this.
Had the mole on my toe removed last night. While I was there, I had the surgeon take a look at three more suspicious (in my opinion) marks on my body.

-What looks like a bloody spot or bruise under a toenail. I jacked my toe pretty hard months ago and had bleeding, thought it was broken, etc. I had thought it had healed but now I have a little bloody spot. So of course I think it's acral lentignous melanoma, the type that seems prevalent in Asians. I've had a GP/derm look at it, and the surgeon look at it and the consensus is that it's a hematoma (blood bruise) but I should also just watch it. No nail streak, I was just wondering why it would take this long to appear and why it wouldn't have grown out by now. It's possible the bruise was under my nauil fold and is just now presenting. I do think it's growing out so perhaps I am worrying about nothing.

-Tiny dark brown mole on my ribs. My main concern is that I don't recall there being one before. Again, doc says to keep an eye on it. Wife says she thinks it's been there all the while. Choosing not to worry at this time.

-Weird shaped mark on a SENSITIVE AREA. It's one of those moles where i can't really tell the size as it's on skin that stretches for you to have to look at it. I personally didn't think it looked like a a macule or lentigne, maybe. But doc says it looks like a mole so he takes a punch biopsy. Was hoping he could dismiss it on sight, but I suppose it's wiser to check.

So, they say I should have biopsy results in a week. I'm planning to call earlier in hopes I won't have to spend Labor Day on edge.

Meanwhile my fear has only increased. Still having trouble eating and waking up to a pounding heart each morning. I'm terrified as every nightmare scenario possible is running through my head. I'm replaying every single thing a doctor has said to me over the last week, trying to extract some additional hope or reassurance:

-"You're at a very low risk", "you shouldn't worry", "I don't see anything suspicious or concerning". These statements seem banal as again, i don't think docs can tell a mole is "safe" just by looking at it. Also, risk factors seem ineffectual as criteria as I keep hearing stories of folk who get cancer without ANY of the risk factors. I suppose that's what scares me about cancer most of all: the fact you can just GET IT and sometimes you don't know until it's too late.

-"Even if you didn't know what melanoma was, you'd probably know something was wrong with you" this from my dermatologist. I am confused by this one.

-"The ABCDE criteria is more of a public awareness message than actual scientific control". This seems to ring true as aytipcal moles meet at least one or all of the criteria and can just be atypical. Of course it now seems to me that there's just no way of knowing beforehand.

I'm terrified of mainly the following:

-The fact that sometimes melanoma doesn't present itself until it's advanced. Every ache and pain I've acquired in the last month is now worrying me because I'm convinced it's due to metastasis. I have lower back pain that is due most likely to the fact I am front heavy and I have bad posture, but still it trips my worry button. Also I lost something like 20 pounds in the last 6-7 months without even remotely trying...unexplained weight loss worries me.

-Currently, there's more proof I HAVE melanoma than NOT. Only reassurances I don't thus far are the statistics, personal testimonies from friends about THEIR atypical moles, and doctors' conjecture. None of which are hard proof. The fact I had to have something REMOVED and now being TESTED is shaking me. I've had excisions before, but it was for things definitely ruled out as noncancerous BEFORE (cysts and whatnot).

I'm starting to realize why I'm really freaking out. I think deep down inside me I know things are going to be okay, but I was raised to always prepare myself for a worst-case scenario.

In this instance, the worst case-scenario is I find out I have months to live and I just can't deal with that. In my mind I keep seeing multiple hopsital trips, treatment sessions, chemotherapy, surgery, disfigurement, the increasing misery and dwindling hope of my loved ones, and then dying. It keeps playing out in my mind 24/7. At the same time, all of the plans my wife and I have for the future now seem to have a tentative quality. It's all in doubt...having kids, making it as an artist, growing old together.

Realizing that if I did indeed die in the next few years, she'd still be young enough to move on with her life and that she'd have to forget about me in order to be happy. That i'd have to become nothing more than a memory to her.

That's a dark place I just went to, and I'm sorry. I don't mean to bum people out, but this is what I'm facing at present. All signs point to me overreacting, but this is my personal nightmare and it's hard to deal with.
DC1977 Hi!!!!!!! how did your mole turn out. I am going through the same thing and i too am a hypochondriac.

I found a mole about 3-4 mm on the side of my big toe. THe skin there is the same as the skin on my foot sole. i made a couple appointments for next week at first week of november. I am soooo worried. I have an exam at 8 am and here i am looking up melanoma.

i am supper nervous because Acral Lentiginous Melanoma usually starts on foot soles and palms and nail beds and is more common amoung asians and blacks. and i'm asian! :((((((((((((

its also really dark in color.

i know theres nothing i can do until i see a doctor. if it is melanoma at least it is (hopefully) in the first stage. murrrrrr ..... and i too had a parent who had a longgg struggle with cancer. so anything abnormal makes me feel like my life is flashing before my eyes and i need to write a letter to everyone.

im so anxious..
Hi there. Sorry it took me a while to respond.

I know where you are, emotionally. As you may have read above, it was a very dark time for me, to go through what you are going through now. Thereís nothing worse than fearing the unknown and the unusual.

But I got help and I am a lot better now. Iím hoping I can give you some encouragement too. If I can, I think going through what I went through will be worth it.

My moles (had more than one) turned out to be completely benign. And I mean completely. It surprised the doctor, frankly, as he was sure there would be some dysplastic cells. Turned out, they were just atypical.

The big thing Iíve learned since then is that there is a clear difference between ďatypicalĒ and ďdysplasticĒ qualities in mole. Atypical just means it doesnít look like a normal mole. Thatís all. Appearance. The physical qualities the ABCD criteria have you look for are guidelines because atypical moles are more likely to have dysplastic cells.

Dysplastic means that the cells in said mole are unusual. Again, this does not mean you have skin cancer, just that thereís a higher risk. And higher risk does not mean you WILL get cancer, just that you need to be mindful.

Iíve found some more interesting spots on my body since then, and Iíve had the fortune of getting everything checked out by two medical professionals (my dermatologist and the dermatological surgeon). So far, all clear. I have even been pronounced to have ďboringĒ skin.

Speaking of ALM in particular, it does sound frightening, yes? That was the main reason I had my toe mole removed, as the doctor said. I took the opportunity to get some facts:

-Just having a mole on your toe does not mean ALM. Itís unusual to get a mole there, true, but not impossible. You can get moles anywhere. Its mere presence does not indicate skin cancer. Mine was between the toes, and the doc told me it was removed because Iíd be less likely to keep an eye on it if it did start changing or whatnot. It was the scariest thing on me, the doctor said in my follow up, but even so it turned out to be absolutely nothing.

-Yes, Asians, Africans, and other darker-skinned races are more likely to get ALM, but Ėand here is the important part- thatís if they get it at all. ALM accounts for about 6% of ALL melanoma cases. And melanoma, as Chele mentioned above, is a rarer form of skin cancer, as compared to basal cell or squamous cell carcinoma. So, weíre looking getting an uncommon variation of an already uncommon disease. Itís not impossible, which is why youíre getting checked out (unfortunately thereís nothing that can make cancer impossible, just very unlikely), but the odds are in your favor.

-Having a symptom doesnít mean you have the disease, something every hypochondriac (myself included) would do well to remember. Iíve had two additional symptoms of ALM since, one which sent me screaming to another doctor. I had a dark spot under a toenail (turned out to be a hematoma, and has currently grown out of my nail) and dark spots on the sole of my foot (pressure discoloration- this was gained on the foot I had the initial surgery on and since Iím a heavier person, and was walking funny already, this was an easy diagnosis).

So end result is: seeing your doctor is a good thing. Itís always best to consult a professional if youíre worried about something. But as of right now, it doesnít sound you have anything to worry about. You have a mole. Is it in an unusual place? Yes, but my own personal experience tells me that quality alone doesnít mean you have a horrible disease.

Also, my personal advice is stay off the internet when it comes to checking symptoms. Iíve had to promise my wife this. Are there legitimate websites for medical advice? Sure there are, but remember this: they canít check your symptoms. Every body is different and our perception of a symptom may be different than the ďuniversalĒ norm. The best case scenario in self-diagnosis is that youíre terrified in the time before you see an actual medical professional.

I know itís a rough time right now. My heart goes out to you, as Iím still sort of recovering. But the thing to remember is this: as of this moment, right now, you do not have any sort of disease. Itís true, one day a doctor may tell you different, but thatís then, if it happens at all. Right now, today is what you want to focus on. Hard to do, I know, but speculating will just make you miserable. Donít fear what doesnít exist at this time. And as far as the odds go, your chance of having a terrible disease is outweighed by the chance youíre fine, healthy, and have a good life to look forward to.

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