You have Cancer... - My Second Shift...

October 24, 2018

“You have cancer” were the 3 words uttered to me over the phone by a nurse. Is it strange to say that I wasn’t surprised? I knew something wasn’t right; I felt it in my gut the moment I laid eyes on a strange-looking mole on my arm.

October 12, 2018

I immediately texted a neighbor of mine, who 5 years ago was diagnosed with Melanoma; and with glowing recommendations she referred me to her dermatologist. Without hesitation, I phoned Dr. Michael Wangia to make an appointment. I was expecting to wait a few days/weeks for an opening in his schedule, but was surprised to find out that he had an opening at 11:00 AM that morning. Needless-to-say, I jumped at the opportunity and booked the appointment.

As I sat in the exam room waiting for the doctor to come in, I told myself that I was NOT going to mention the strange-looking mole on my arm; I wanted to see if he could find it during my full body exam.

When the exam began, Dr. Wangia started at my feet; he looked in between my toes, at the soles of my feet, and even at the coloring of my toenails. This was strange I thought. I’ve never had a full body exam where the doctor examined my feet in this much detail.

He then moved up my body and examined my legs where he found a discolored mole on my left knee. This mole had been there forever; since I was a little kid. He then took out his medical marker and circled it. He then moved to my back and found another discolored mole on my right side; and again he circled it with his marker. Then he moved upwards to examine my arms and chest; and his eyes made a beeline for the mole that I was concerned about. Oh shit I thought. My suspicions must have been right. Without saying anything, he took out his marker and circled the mole.

In total, I had 4 moles removed (one from my right knee, one from my groin, one from my back, and the one from my arm). Upon finishing his exam and the removal of my moles, he encouraged me to have my husband study and learn my back. He said “your husband needs to know your back like he knows your face.”

As I put my clothes back on and walked out of the exam room, the nurse informs me that it will take about 2-3 weeks for the results to come in. I seriously hate the waiting game. I can assure you that I’m one of the most impatient people I know.

Ten days after my biopsy, I get a call from the pathologist office asking if the spot on my back had been biopsied before. I remember having a mole on my back removed in 2016, and another mole removed in May of this year, but I wasn’t sure if THIS particular mole was in the same location as my past moles. It could be a possibility that it was the same spot but I wasn’t sure. The pathologist responded by thanking me for the information and hung-up the phone. Now my fears were really starting to set-in. Why ask me if the spot on my back has been biopsied before? If the spot on my back was clean, then why would it matter?

October 22nd: The call

Two days later, I finally get the call: Mrs. Kozma. The 3 moles removed from your leg, groin and arm, are benign, however the mole from you back was Melanoma. You have cancer.

I froze. I didn’t know what to say. To be honest, I wasn’t surprised; something in my gut knew this news was coming. I don’t know how to explain it; I just knew. I just didn’t think it would be on my back.

I immediately started to have flashbacks. In 2014 when I was pregnant with my 3rd child, my dermatologist at the time removed a suspicious-looking mole from my stomach. It came back as Severe Dysplastic Nevi (in other words, a very unhealthy mole not yet cancerous but would turn into melanoma if untreated). After the poor biopsy results, my dermatologist did a full body exam 3 days later and found another suspicious looking mole on my back – but due to an issue and miscommunication with my insurance company, he was unable to remove it without a high out-of-pocket cost for me. Instead, he advised me to go see a different dermatologist to have it looked at ASAP. Being that I was pregnant (pregnancy brain), I never called another dermatologist.

Fast Forward to July of 2016: I just finished my mommy makeover surgery and decided that it would be a good time to schedule all my yearly doctor’s appointments before the school year began: OBGYN, dentist, dermatologist, etc. So I made an appointment with a new dermatologist and requested a full body exam. According to him, there was nothing too concerning on my skin. During the exam, I remembered that my other dermatologist in 2014 recommended that I get a mole removed from my back. I ask the doctor if anything looks suspicious on my back in which he replied “No. Everything looks healthy with the exception of 1 dark mole. We can remove it today.” And so I did have it removed. The results – healthy.

Fast forward to May 2018: I noticed that I had a freckle on my back that hurt to the touch – but not all the time (just on occasion it would feel tender – usually after a workout or a long stressful day at work). I asked my husband to look at the mole as I couldn’t see it clearly in the mirror – he thought it looked normal. However, I still felt something wasn’t quite right, so I called my dermatologist for an exam. He too agreed with my husband in that it looked normal, but he decided to remove it anyway due to my previous history of severe dysplastic nevi. The results – healthy.

Both times I had the moles removed from my back, I never had a feeling that something was seriously wrong. It wasn’t until I saw this strange looking mole on my arm that something inside my gut just didn’t feel right. I was so nervous about this mole on my arm compared to all the other’s I’ve had removed over the years. Come to find out, the mole that concerned me the most was healthy. It was the mole on my back – that had been removed just 5 months prior – that was Melanoma. The Melanoma was 0.4 mm deep. How on earth in 5 months did I go from having healthy skin to developing a Melanoma 0.4mm deep. I know 0.4 mm doesn’t seem like much – but once the melanoma reaches 0.75 mm depth, then you need to be concerned about the possibility of the melanoma spreading to the lymph nodes (Stage 3).

October 26th,

I just completed my Melanoma surgery where they removed a huge chunk of skin from my back where they cut all the way to the muscle (if you have a weak stomach, I encourage you NOT to look at the photos). Because of my diagnosis at such a young age, Dr. Wangia will be sending my tissue sample for a BRAF mutation gene exam. The BRAF gene tells the cells how to make a certain protein (B-Raf). This protein is part of a signaling pathway that regulates cell growth, cell movement, and cell death. When the BRAF gene mutates and fails to give correct instructions, cells can become cancerous; 50% of melanoma patients have the BRAF gene – meaning that future melanoma are difficult to prevent.

As for now, I will be waiting on the results of the 2nd biopsy and the BRAF report. I hate the waiting game. I pray for clear margins on this new biopsy – I feel in my gut that the margins will be clean (my gut feeling haven’t been wrong yet). I’ll be returning to the office in two weeks to have my stitches removed as well as another dark-suspicious looking mole on my back. This is just the beginning of a lifelong battle; but i’m up for the challenge.

If I’ve learned anything from this experience, it would be to go see my dermatologist regularly (no more pregnancy brain excuses – lol). So many people think melanoma is not a big deal; they are wrong. Melanoma is a big deal. It is dangerous and it is deadly. Catching it early is key. I pray that I’ve caught it early. I pray that Dr. Wangia found my “primary cancer site”. Luckily, he feels confident that he has found the originating spot. But for now, a huge weight has been lifted off my shoulders and replaced with a painful scar on my back. This will serve as a daily reminder to check my skin and to let my guy feelings (God) to continue to drive my decisions.