Wednesday, December 17, 2008

The Beast is Awakened

On a warm, late summer day in 2003, Rachel and I were hanging out with friends in the back yard, sitting around the pool and conversing. The conversation somehow turned to moles and other anomalies on our bodies. Rachel noted a mole that had started to turn darker than normal on her left thigh. The mole had been present on her body since at least her high school days, as was proven by looking at old pictures after the fact. One of Rachel's friends, a surgical tech at the time, said she should get it looked at by the dermatologist soon. We made note of it, and scheduled an appointment within a couple of weeks of that day in the back yard.

So, the day comes where she goes to get checked out by the dermatologist. Let it be noted that Rachel is by nature a fair skinned Caucasian woman; her normal skin tone is quite light. She has a multitude of freckles and moles scattered over the majority of her body. The mole on her thigh worried the dermatologist, so they did a "punch biopsy" on it. It was comparatively large, with a radius of 7mm. It was sent off to the lab while we waited for the results.

We were nervously anticipating the response from the dermatologist, when we got the call that put this roller coaster ride in motion. We were told that the biopsy results from the mole on Rachel's thigh had come back positive for malignant melanoma. Needless to say we were upset by the news. We really didn't know how to react at the time; neither of us were prepared for the news of one of us would be diagnosed with cancer (any kind of cancer!) at age 25! We had a good cry and after that bucked up and decided we would fight this beast no matter what it threw at us. At this point she was at least a stage 1...

A week or so later, she was scheduled for the wide incision where they remove all cancerous tissue from the original area of the malignancy. It was her first surgery. It was low risk; however, once it was complete, she would have to have a JP tube inserted to drain fluid from the wound area, and she would be admitted for a few days. Unfortunately, shortly thereafter, she would have to go through a sentinel lymph node biopsy, which required another surgery, a minor one to remove it and check for melanoma "mets" or metastasized melanoma cells in the first lymph node that pulls toxins from the area of the original malignancy. The results come back as malignant; the melanoma had metastasized to her sentinel lymph node. Stage 2, check.

Because of the malignancy in the sentinel node, she had to have a regional lymphandectomy in her left groin to see the extent of the spread of the melanoma. Already feeling beat down, we buckled down and she went through her third surgery. Being the trooper she is, she made it through well, and the news, while upsetting, was not as bad as it could have been. The bad news: There was melanoma present in some of the regional lymph nodes...she is stage 3. The good news: The amount found was quite small; just a tad bit higher than microscopic amounts were found. She would have to be put on Interferon treatments.

Not even three weeks into the initial Interferon treatment regimen, Rachel's labs showed severe increases in her liver enzymes. Due to the minimal amount of melanoma found in the regional lymphandectomy, and the fact that this interferon was damaging her liver so badly, the oncologists suggested we stop the treatment.

Was it the right decision? Should we have pressed the issue? Looking back in retrospect, I almost regret not pursuing things a little further. Of course, at that time, I agreed with the doctors and figured all would turn out well. We finished out my tour of duty in Norfolk, and I got orders to go to Yokosuka, Japan in 2005. Despite her medical history, she was cleared to make this 3 year tour with me. Things went great for almost the entire time we were overseas...more to come on that in my next post.

Tanning beds produce more than 3 times the amount of UVA rays, affecting deeper tissue and more apt to cause long term skin damage, than the sun. Long term effects of exposure to these UVA rays is linked to malignant melanoma, damage to the immune system, weakening and loss of elasticity of the skin's inner tissue. If you go tanning, you double your chances of developing skin cancer. Tanning is the body's response to injury caused by exposure to the skin, and can cause age spots, crow's feet, and most of all, wrinkles.


Anonymous said...

Please don't regret your decision to stop interferon. I also only got through 11 treatments and had to stop.THat was seven months ago and my blood levels still are not normal. From what I have read, interferon is a gamble anyway with only one in ten getting a response. It is still questionable if it extends life at all or even disease-free time. So please don't feel bad about stopping....I wish you and your beautiful wife all the best. We're in this struggle together.