Over the years you tend to develop a lot of scars, both
physically as well as emotionally. I
guess in both situations the scars are noticeable, other times not so
much.
My most noticeable physical scar is on the front of my
neck. I hadn’t thought about it in some
time, but for some reason I noticed the scar this past week. It’s about the size of 25-cent piece (a “quarter”
in the US & Canada, in Australia about the size of a 10 cent piece, and a
one Euro coin in Europe). It’s located
at the base of my neck where the collarbone meets the mid line of my chest and
neck.
I remembered back to when I first noticed the mole; it would
have been in the late 1980’s. I was
surprised that there was this rather large and discolored mole staring back at
me in the mirror, where I could have sworn had not existed the day before…it
was as if it just appeared overnight….perhaps it did and I hadn’t noticed. Why hadn’t I noticed it before I thought to
myself? I pressed on it, nope, not
painful but with an unusual shape, not exactly what all of my other moles
looked like which were mostly round and single colored.
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| Australian beach culture TW at the Beer Can Regatta Darwin, Australia 1987 |
I’m also not sure what motivated me, a 20’s something guy to
go get it checked out, but non-the-less I made an appointment with my then
doctor at Sunnybrook Hospital in Toronto to have someone take a look at
it. Was it the fact that my mum had a
number of skin cancers taken off her face in her later years or perhaps it more
out of curiosity than anything else – to be honest I can’t remember the motivation?
As you can imagine growing up in country Australia during
the 1960’s and 1970’s the use of sunscreen was non-existent. Nope, every summer you’d get sunburned each
day until you didn’t… (eventually turning brown and tanned with every passing
day). I’ve got to tell you that the
first sunburn of the year was always extremely painful, often a combination of
sunburn and windburn….can you say lobster colored? The extreme heat and sensitivity was painful
beyond belief. However the worst of it
was the inability sleep – you guessed it we had no air conditioning so it was
often hotter in the house during the summer nights than outside.
Dad was fortunate that he had a very high pain threshold, so
invariably his first sunburn would be followed that night by a scolding hot
shower (he picked this trick up when he was working on the sugar cane farms in
North Queensland during the early 1950’s and swore by it – his advice still
rings in my ears to this day “you have to equalize the heat to take away the
burn”. In essence treating the burn
with another burn to numb the skin….
As kids we religiously followed his advice but with the most painful
side affects known to man.
So let’s tally up the situation here – Australian summer sun
(often getting into the 40C range), no sunscreen, exposed for up to 6 hours to
a combination of hot north wind, clear cloudless sky in full sun…followed at
the end of the day by a scolding hot shower and no moisturizer or Aloe to help
sooth the deeply burned skin. This was
an annual “right of passage” to enter the summer season. Prior to working during the summer we’d by in
the backyard or at the local pool, but as I got older and began working on the
local farms I worked exclusively without a shirt and for those days I was exposed
up to 12 hours in the full sun.
So it shouldn’t come as any surprise that when I went to the
doctor and showed him the mole he was a little worried with its shape, size and
general demeanor. He asked if he could
take a biopsy, not that I knew what that meant until he gouged out a deep chunk
of mole and placed it in a test tube and sent it off to the lab for analysis.
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| Dysplastic Nevi - unevenly shaped, often discolored or multi-colored |
Now in those days I lived about 20 minutes away from the
hospital, so be generous and say that it took me 40 minutes to get home that
day. From the moment I stepped in the
door of my apartment the phone was ringing.
I ignored it and assumed it would go to my new fangled voice mailbox
(come on it was the 80’s after all :-), but less than a minute later it rang
again, thinking it was coincidence I again ignored it, but with the third time
in five minutes I decided I’d better answer it.
It was the doctor’s office calling – we need you in here
tomorrow morning at 8:00 am, did you not get the five messages we’ve left for
you? My response was obviously, ah, no
I hadn’t but what’s going on – why do I need to be there so early? “Oh no need to worry, but please be here
first thing…”, but it was clear there was an urgency to the nurse’s
request. An uneasy feeling began to
settle over, followed by a rather restless nights sleep, or should I say
non-sleep.
An evasive answer to a direct question was unsettling unto
itself, particularly given the afternoon biopsy and doctors initial concerns,
but the worst of it was all the possibilities as to why it was so important to
be there first thing. Why the urgency I
wondered?
I arrived at the doctor’s office at 8:00 am sharp, and was
immediately ushered into the doctor’s office.
Nothing is more worrying that the doctor saying “not there’s really
nothing to worry about, but….”. It was
the “but” that I wasn’t so keen on!
He quickly explained that he thought I had a mole that he
didn’t like the look of and that the results were inconclusive from the biopsy. We need get that taken off immediately and
sent for more pathology tests. He
further explained that if I had a family history of Dysplastic Nevi (which my
mum had) or other forms of skin cancer that I had an increased risk of contracting
a Melanoma, in fact 12 times the risk! I
found out after the fact that it’s very difficult to tell the difference
between a Melanoma and Dysplastic Nevi without these further tests, hence his
concern and immediacy of the consultation.
Clearly it had to be removed pronto! So after poking me with six or seven needles
to make the area completely numb, he set about taking off the offending
mole. Not just taking it off, but to be
fair “gouging” a chunk of skin and tissue out the size a 1 – 2 cm cube. I guess its best to safe rather than sorry
so he cut to the depth of my muscle, cartilage and collarbone. Surprisingly it didn’t bleed too much as he
sowed my up with about a dozen stitches.
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I could check off most of these with my first Dysplastic Nevi - scary as hell! |
It hurt like hell after the anesthetic wore off, but not so
bad considering the alternatives. I went
back to see him in the days following to check on the healing process and to get
the results from the pathology test. As
you can imagine those few days were harrowing as I fretted over the
possibilities…
“This one was all clear, it was a Dysplastic Nevi but I need
to see you in three months to review your other moles. Over the ensuing visits he measured each of
the moles he thought to be a little unusual to make sure that they weren’t
growing.
It took two additional tries to get the entire mole out as
it started to come back around the edges of the original scar in about the
second month post op. With each
successive operation they took even larger chunks of skin, over a larger area. He finally was able to stem the tide with the
third time being lucky - no further growth or discoloration coming back. OMG – finally!
Since then, although my original doctor has long since
retired I’ve had a further eight moles removed by the other family doctors I’ve
had over the ensuring years. Fortunately
for me each one of them has been of the Dysplastic Nevi variety, but again
noticing my scar this past week has served a stark reminder of for my annual
check up – yes, you guess my first question will be “Can you check my moles?”
Epilogue:
Here are some scary facts:
In Australia, particularly with my age group (mid 40’s – mid
50’s):
·
Skin cancers account for around 80% of all newly
diagnosed cancers
·
Between 95 and 99% of skin cancers are caused by
exposure to the sun
·
The incidence of skin cancer is one of the
highest in the world, two to three times the rates in Canada, the US and the
UK.
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