Sarah Spencer: Melanoma Survivor
Oddly enough, my skin cancer story began with my birth! Well, to be more specific I was born with a congenital nevus (aka, birthmark) on the second toe of my left foot. It was a dark, asymmetrical mole that I always thought was ugly and so for the first thirty-odd years of my life, I just ignored it until it became impossible to ignore. In my early thirties, this mark began to slowly change. It was almost imperceptible at first, so it didn’t raise a red flag right away. Eventually, I did notice that it appeared to be getting bigger and by this point, it was even starting to itch and give off little random burning sensations. My husband and I made an appointment with a dermatologist but in the meantime, I was googling all about melanoma. After finding out about the “ABCDE” warning signs of melanoma, I was fairly certain already that this was what was going on with my toe. But I still couldn’t really comprehend what a melanoma diagnosis would mean for me.
On New Year’s Eve 2013, the P.A. at the dermatologist’s office called me and confirmed my suspicion. Not understanding the sneaky and aggressive nature of melanoma, I just assumed that the offensive birthmark would be cut off, I’d have a little toe scar, and that life would go on as usual. I was so very wrong! The dermatologist’s office referred me to MD Anderson Cancer Center in Houston. I went to my first appointment not really knowing what to expect but I definitely DID NOT expect to be told that the top half of my toe would need to be amputated. The surgical oncologist informed me that I was in good company as Bob Marley had also been diagnosed with “acral lentiginous melanoma” and she reassured me that although I was undergoing a distal toe amputation, I would still be able to wear flip-flops—silver lining!
The biopsy showed the melanoma was very slow-growing, not very deep, and there was no visible mitosis. I was assured that prognostically, this was all very good news. But to be on the safe side, I would also undergo a sentinel lymph node biopsy while I was in surgery for the toe-top removal. My oncologist informed me that she was 98.99999…% confident that the melanoma had not spread.
Despite her well-intentioned and optimistic prediction, unfortunately even the best doctors are not always right. The sentinel lymph node biopsy revealed a microscopic amount of melanoma in the largest of three nodes. This advanced my clinical staging to Stage 3A. My heart sunk. After picking it up and dusting it off, the next course of action was an inguinal lymphadenectomy wherein another 16 lymph nodes were removed and dissected. Good news this time, all of those lymph nodes were clear!
All follow-up scans since the last surgery have shown “No Evidence of Disease” and for this, I am so grateful. But fear of recurrence is always in the back of my mind and the permanent side effects of the operations I had are a daily reminder of the physical and emotional damage that melanoma can leave behind.
