Another new diagnosis

Hi All,

Quick backstory, I'm a 42 year old male, no family or personal history of cancer. I have dark hair but blue eyes so I'm probably considered fair skinned. I'm definitely someone who enjoys being outside, and while I wouldn't consider myself a sun worshipper in the typical terms, I'm out enough that I, admittedly, should be better about covering up and wearing sunscreen. I have taken it more seriously recently, but I've definitely had my share of sunburns.  

This past summer whilst on vacation my wife and kids said there was a mole on my back that looked strange. I didn't take it that seriously, and said I'd go in and have it looked at but always had some excuse as to why I hadn't yet called the doctor. I hadn't been to see my primary care physician in a few years as for the most part I'm healthy, active, don't have any major health issues (aside from asthma which is very well controlled). I'm also a fantastic procrastinator and someone who is good at minimizing the severity of things.

Eventually I got around to calling my doctor and scheduling an appointment (last month, November 2015). I figured I'd bundle in a cholesterol and blood pressure check, flu shot, etc. I could also ask him what the current suggestions were for a 42 year old in terms of prostate and colon screening.

I showed the doc the mole and he said "dysplastic nevus", wasn't terribly concerned but absolutely agreed that a trip to the dermo (to which I have never been, incidentally) was totally worth it for peace of mind. He recommended a practice that was a bit more of a drive but that he had good experiences with. I called and made the appointment immediately, assuming that if I didn't do it now while it was on my mind, it might not happen.

I believe they saw me the next week. I showed the doctor the mole, and she looked around a little bit more at my back. "Yeah, we could biopsy that … but I'm actually more concerned about this one." She pointed to a much smaller mole further up near my shoulder/neck. "Which?" It had never really stood out to me (probably in part because I couldn't really see it). She took a picture and showed me. That one? That's nothing. Nonethless, she did a shave biopsy of the two of them, and I was on my way.

Over the next couple of weeks, I read up briefly on the types of skin cancer, but didn't take it seriously as I figured I had nothing to worry about. Of course interspliced within the waiting period was the Thanksgiving break, which added to the delay of the results. Every couple days it would pop into my head "Huh, I wonder if those lab results have come in … ", and then about as quickly I'd forget. There was probably nothing to report. Eventually I'd call them and they'd say "oh, yeah, nothing there, carry on!" On the Monday after Thanksgiving, I thought "I'll call them this week." I didn't. They called me on Friday.

It was the doctor. "That mole you came in for is nothing. But the one further up came back positive for melanoma. The initial lab sent it on to another lab for a closer look, and they verified it. You should have it removed completely for a more in depth diagnosis." (OK, thats not an exact quote, but that's what they said). I was in shock, but I didn't panic really. I scheduled the procedure for the following Tuesday, which was yesterday. I should have asked more questions, but I wasn't really prepared.

Between last Friday and yesterday, I read up on as much as I could about melanoma, trying to stay on the clinical/factual side and not too much on the anecdotal/personal story side. It obviously isn't that the latter information isn't important, but I really just wanted to know the facts for now. I had more questions about the labs findings but given the timing, I wasn't able to reach the doctor and figured everything would be available when I got there. The best thing for me at the time was education.

When I got to the doctor's office  yesterday, armed with the knowledge of diagnoses, stages, procedures, etc. I asked for the pathology report. Here are the specs:

Nevoid melanoma, Breslow thickness of 0.75mm (at least), no ulceration detected, mitotic rate of 1/mm2, vascular invasion not detected. The stage is pT1bNxMx … I'm guessing those x simply mean that they can't determine the spread to lymph nodes/distant sites because the biopsy is only the raised layer from the shave.

The doctor did a wide excision with a 1cm margin, the whole thing is about 2 inches long (and still bandaged). Fortunately, I think it went fine, and now, a day after, I don't have much pain. The doctor said that she didn't think a sentinel node biopsy was required a this time, and to see what the full diagnosis from the sample was before proceeding. She did order an LDH test and a chest x-ray in the meantime. She checked lymph nodes in my neck and groin and said everything felt fine there.

That's where it all stands. From my searching and reading, it sounds entirely likely that, aside from yearly trips to the dermo, I could be done with this. I hope that's the case. I don't think I have any major questions right now, but any insight or things this community thinks are worth looking into further would be greatly appreciated. I think I'm doing ok emotionally, and trying to just hang in there until I know the full extent. It will most likely be a couple weeks until I have the next results. 

Thanks for reading.