View Full Version : actually a question about Path reports/Dysplatic Nevi

04-23-2009, 09:55 AM
I am awaiting my results from Tuesday's mile removal surgery(5 excised and two shaved).

I asked the surgeon if he was concerend about Melanoma. He said no. I asked him worse case scenario, he said Dysplastic Nevi. Hmmm. I had atypical moles so I had them removed. Isn't Atypical Moles and Dysplastic Nevi the same?

When I asked him if the path report comes back with Dysplastic Nevi and what do we do. He told me that ALL of my atypical moles must be excised(and I have a lot, upwards of maybe 10-20). Lifestyle change, no sun, etc etc....And skin checks every 6 months.

So basically he says him and I would become good friends. I just don't get the difference between the two.

They are defintitely NOT BCC. They were all brown or black, with a fried egg center of different color, And one was brown, and looked like it had little "claws" coming off of it. None bigger then pencil eraser.

So, why does it take SO long for Pathology? At first I was told two days. Now I hear maybe tomorrow, but more likely Monday.

I still do not see how he can say he is not concerened about Melanoma. Because only Pathology can say either way. But I would assume if it was bad, and it WAS melanoma, I would be experiencing other symptoms for mestasis. And I had just a full CT Scan not to long ago as well. Nothing.

Hmm, thoughts?

04-23-2009, 03:21 PM
I had a melanoma removed 2 years ago, and have done quite a bit of "learning up" on melanoma in the time since then. Mine developed all on its very own, it was not a previous mole that changed, just to be clear. I've had moles of all shapes and sizes and some have been removed, some have not. That gives you a very brief history for me.

Now, there are some red flags that pop up for me, but then, I really don't know your doctor. Here's what I see:

1. Removing 7 (!) moles at one time is really quite a lot. The most I had removed at one time was 3, and that was only because I insisted (my pre-melanoma days). Removing a mole for cosmetic reasons is one thing, and understandable. Removing a mole "just to see" is, to me, kind of suspicious. But then, I didn't see what the moles looked like.

2. Atypical moles and dyplastic moles are, indeed, the same thing. Now, there are two very different trains of thought regarding this. The National Cancer Institute, along with some doctors, have advocated for removal of ALL atypical/dyplastic moles. This train of thought believes atypical moles have the capability at some time, potentially, becoming a melanoma. Unfortunately, the research on this is sketchy. The other train of thought, adhered to my most dermatologists, is that atypical moles are just moles that are misshapened, and if a melanoma develops it will develop before a mole becomes atypical.

To explain this a little better: the first way of thinking believes a normal mole develops and may just exist for an entire lifetime. However, it may change and become atypical or dyplastic. When that happens it is best to remove it, as it has a possible chance of becoming melanoma. It may, it may not.

The second way of thinking believes there really is no "intermediate" stage. Either a mole is a normal mole or, if it develops into melanoma, it had melanoma while it was a normal mole. I know for me personally, the 3 moles I had removed in my pre-melanoma days all fit the "A, B, C, D, E" of melanoma. And all three came back just normal moles. Then, the perfectly round, symmetrical, small mole on my knee that just seemed to grow rather quickly was biopsied, and came back as melanoma. So, what I thought had the potential to be melanoma wasn't, and what I thought just couldn't be melanoma, was. I have a tendency to buy into the second way of thinking. I think your doctor believes in the first way of thinking. You will have to do your own investigating.

3. While there are some dermatologist who do still advocate the removal of ALL dysplastic nevi, I really didn't think the practice was all that common any more. Be very careful of a doctor who wants to start removing ALL moles - they get paid per procedure, and if can inspire fear, well, patient beware.

4. And as far skin checks are concerned? I've only heard of that for patients who have had melanomas removed, so that would cause me to be cautious as well. Now, I am a HUGE believer in skin checks, and I do believe that everyone should have one annually. But even I, as a melanoma survivor, will only need bi-annual skin checks for 5 years. After that, I will only need them once a year. So, according to your doctor, will you need bi-annual skin checks forever? For a limited time? What would that limited time be?

I don't mean to scare you, but when melanoma metastasizes, it really does give very few signs until it is quite far along. At the time of my diagnosis, there was a gentleman who had come to the doctor because he was feeling a little run down. They ran some tests - and found out he was stage IV melanoma. Inoperable, terminal, and nothing that could be done. He had between 6 to 9 months. There is a reason why survivors, warriors, and caregivers of this cancer call it "the beast." BUT you have not even heard anything about your path report yet, so you don't even need to begin thinking about any of that. Pathology results can take up to 2 weeks (I was lucky, I got mine in 2 days - bad news just won't wait, it seems). And, you are correct, only a pathologist can determine if there is melanoma.

If melanoma is present, deal with it then. If it isn't, I would suggest doing some questioning. Getting a second opinion would definetely be something I would check into. Why live like a melanoma patient, when you don't have melanoma? I certainly wouldn't want to wish this on anyone!

Good luck!