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Why A Freckle Could Be The Death Of Me

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Once upon a time, there was a new spot on my left palm. A tiny, pale-brown freckle-thing at the outer base where the hand meets the wrist. I nonchalantly mentioned it at my annual mole-check in 2006; a biopsy showed it was benign.

A few months ago, the shadow-scar that remained post-biopsy was itching slightly, enough to catch my hypochondriacal attention. Dr. Macrene Alexiades said not to worry, scars can itch, "But you know what? It's been bothering you, and the rule is if a mole develops symptoms, we biopsy it. We can do that, and then we'll know for sure and you'll be done with it." Only two stitches, she said, and no swimming or dancing for two weeks. After the procedure, I had to hold my hand above my heart to stop the throbbing pain. I slept poorly at first because any pressure on that tender spot hurt like hell. I couldn't touch the hand to the steering wheel, so driving was hard. I couldn't open a jar or tie sneakers for a week or two. I couldn't do Down Dog for six weeks.

When the punch-biopsy results came back, Dr. Alexiades called me at 7:30 a.m. "It's not benign." Something about not being able to compare to the previous biopsy because of a technicality, so they can't call it just a recurrent atypical mole. "Therefore, the pathologist favors a diagnosis of evolving melanoma," she said. My mind fogged. I write and edit stories about melanoma; I don't get melanoma. What is she talking about? But there it was. And yet it wasn't. Surely the m-word was being mentioned because of a technicality.

But Dr. A. explained that it would be necessary to remove more skin because that's the protocol for melanoma. One centimeter all the way around the ghost of the freckle. They'd be taking a chunk of flesh the size of a half-dollar. No cartwheels for a year was my guess.

I fussed about all that, I guess, because it was a good distraction from my mid-life fear: now I know what I'm going to die of, what's going to rob my daughters of their mother too soon. Melanoma is the black-belt of skin cancers. It travels stealthily, horizontally through the skin and sets up satellites that can get busy. Left untreated, melanoma can kill you. And the really clever thing about this skin cancer is it shows up where the sun don't shine. Hence my palm. A good dermatologist checks between your toes, in your scalp and even your genitals.

I'd never have imagined how many top medical minds in New York City who would then spend a good deal of time taking very seriously my 3 millimeter mystery. I am fortunate to have health insurance. To start with, I called two friends who are plastic surgeons: Dr. Darrick Antell and Dr. Cap Lesesne; they quickly educated me. I consulted a hand-orthopedist, Dr. Stephen Yang, who talked about doing a graft from my forearm or thigh to fill in the blanks. I'd be in a cast for a few weeks. Then I was at NYU Cancer Center to meet with Dr. Russell Berman, a surgical oncologist, who suggested I see the hand-plastic surgeon he works with, Dr. Sheel Sharma. He said no graft; we could do a simpler flap by taking skin and blood vessels from the heel of the hand and flipping it over to cover the hole. Lovely.

Meanwhile, we got a second opinion from a top pathologist at Memorial Sloan Kettering, who I sensed leaned towards calling it just an atypical mole, but scientific minds must be strict, thank goodness, so either way, the prudent thing to do is another excision to get rid of the skin where, if it were melanoma, there might be an insidious satellite. I'm on board with that! But this pathologist suggested another test, using stain and special light to hunt microscopically for any of the known chromosomal abnormalities of melanoma.

I lost sleep waiting those two weeks. What if it comes back positive? If it doesn't, I silently promised myself, I'll celebrate. And I will preach: Use sunblock, and be sensible about the sun; enjoy it a little here and there with nothing less than SPF 15 that protects against both UVA and UVB. Never fry in the sun. Get over the idea that a tan is necessary or even healthy. It's not. Period. Living longer is way sexier than a tan.

While I waited, everything else paled in importance. Big deal if my ex forgot which custody weekend was which. My new Web site still isn't finished? Oh well. Never mind that my kids aren't finishing their chores during Regents. Who cares if the new guy doesn't call back. All I truly care about is....

Negative!

I felt blessed. Feel blessed. I celebrated not by taking a day off as I'd planned, but by letting go all the nonsense-stress usually engendered in me by the small stuff. I celebrated by celebrating that I do not yet know what will kill me. I still face surgery, but slightly smaller -- about the size of a quarter. No Down Dog for a few months? I'm up for that.