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    Old 11-22-2003, 01:12 PM   #1
    rara11
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    Question possible melanoma?

    Hello,

    I am grateful for this site. I am pretty freaked out after a visit to a dermatologist a few days ago. He was very cold, arrogant, vague, no bedside manner! So I think I am more worried because of his demeanor. He gave me a few concerned looks that I asked about and he said, "well I don't think it's ".....and I finally filled in "dire?" and he agreed. Anyway, I have a fairly large, (5 mm) light brown mole, flat with a tiny darker brown spot on one bottom edge. It is right above my breast. It is oval shaped, appears symmetrical but there is a partial irregular border on one side. No redness, itch, crust, black, bleeding. I have had several new sun spots or freckles, etc (always had freckles) since I got into my 40's. I am 46. The mole has been there maybe a year, and I never thought much of it till recently--no changes, but it is bigger than my others. The doctor said he will do a shave biopsy in 4 weeks. I don't know if it's normal to wait that long for a suspected melanoma? Also the type of biopsy--does this take enough tissue? I noticed after the visit that the mole is surrounded by a white circle, separate pigment from the mole. MY husband says it is a distinct white circle. I read that this could be a halo nevus, which are often benign (but maybe not???) The doctor told me nothing, never said what he suspected!!! Since the appt. I have been a wreck, pressing on the mole, pressing on the other breast, looking at it...now I have some intermittent minor pain, what feels like burning, maybe, inside my breast, not in or on the mole. Could this be from all my pressing, etc.? Should I call the doctor? I would greatly appreciate any thoughts!! I am scared. Thank you very much.

    Last edited by rara11; 11-22-2003 at 01:22 PM.

     
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    Old 11-22-2003, 01:46 PM   #2
    Saraly
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    Re: possible melanoma?

    I'm surprised he's waiting so long just to do a biopsy, they're usually done at the same time as the exam. I have read that if you have a halo nevus you should be screened quickly as there's a higher likely hood of another mole or the haloed mole being melanoma. It may also mean that it's nothing. If it was a halo nevus wouldn't the doctor have said so? You could go for a second opinion, there's an excellent pigmented skin lesion department at Mass. General Hosp. if you're near Boston. In the meantime I don't think poking and prodding will help the mole any. If your dermatologist is good and he's not concerned I wouldn't be too concerned.

     
    Old 11-22-2003, 02:25 PM   #3
    Rick7799
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    Re: possible melanoma?

    You don't sound very happy with your doctor. I think that part is so important. If I were you I would follow up on this since you got this far and then find yourself another dermatologist.

     
    Old 11-22-2003, 03:38 PM   #4
    lidia09
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    Re: possible melanoma?

    Hi Rara
    Your experience sounds a bit similar to some of the doctors I met. Most were very reluctant to actually use the words 'cancer' or 'malignant'. They mainly referred to things as 'sinister' or 'non-sinister' - a bit like 'passing on', passing over' or 'losing' instead of simply dying! I think some doctors are often a bit worried about the reaction they'll get from the patient.

    When I first showed my mole (later to be diagnosed as malignant melanoma) to a doctor. I got a vague response too. However, on asking the straight question "Do you think this looks suspicious?" I got the straight reply of "Yes." I didn't have any biopsy, my GP just cut the whole thing out & sewed me up, about a week after she saw it first. About 4 weeks later, a larger area was removed by a general surgeon & only after that did I see a dermatologist. I went there every 3 months for 3 years & was then discharged.

    That was more than 5 years ago & I'm still here to tell the tale, with no further malignancies that I'm aware of.

    Saraly is right, stop prodding & poking around with it Try not to worry so much, even if it turns out to be malignant, you could very well be telling the same story as mine in 5 years time.

    Lidia

     
    Old 11-22-2003, 08:31 PM   #5
    rara11
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    Post Re: possible melanoma?

    Quote:
    Originally Posted by Saraly
    I'm surprised he's waiting so long just to do a biopsy, they're usually done at the same time as the exam. I have read that if you have a halo nevus you should be screened quickly as there's a higher likely hood of another mole or the haloed mole being melanoma. It may also mean that it's nothing. If it was a halo nevus wouldn't the doctor have said so? You could go for a second opinion, there's an excellent pigmented skin lesion department at Mass. General Hosp. if you're near Boston. In the meantime I don't think poking and prodding will help the mole any. If your dermatologist is good and he's not concerned I wouldn't be too concerned.
    Saraly,
    I did leave out a couple of things. When he examined me, he said he was concerned (after I prodded him) but that he didn't have time to do a biopsy (very harried), like I was bothering him. He also said that it wasn't "dire" as I said before. And, seeing my concern, I did ask if it was melanoma (he again said that he was concerned, but we could do a biopsy or watch and wait if I preferred!!! ) So if he said watch and wait maybe that's good but maybe he is just a lousy doctor. I really don't know WHAT he meant. This is why I am so freaked out. Should I be waiting for the biopsy? I don't know. Wouldn't he worry about a lawsuit or something? (not that that is my plan!) I actually self-diagnosed the halo nevus myself after the appt., after doing research, so I don't know about that either. And, I did call Mass General and could not get an appt. till a few days after the biopsy. I made it anyway. Any more thoughts? I am going to continue to try a second opinion but it is so hard to get in. Thank you very much!!!!!!

     
    Old 11-22-2003, 08:32 PM   #6
    rara11
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    Re: possible melanoma?

    Quote:
    Originally Posted by Rick7799
    You don't sound very happy with your doctor. I think that part is so important. If I were you I would follow up on this since you got this far and then find yourself another dermatologist.
    Rick,

    Thank you. As I said to Saraly, I don't know what to do about waiting. I know I need the scheduled biopsy, but in the meantime I am so anxious--yes the doctor caused much of this anxiety. Thanks!

     
    Old 11-22-2003, 08:40 PM   #7
    rara11
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    Re: possible melanoma?

    Quote:
    Originally Posted by lidiajamjar
    Hi Rara
    Your experience sounds a bit similar to some of the doctors I met. Most were very reluctant to actually use the words 'cancer' or 'malignant'. They mainly referred to things as 'sinister' or 'non-sinister' - a bit like 'passing on', passing over' or 'losing' instead of simply dying! I think some doctors are often a bit worried about the reaction they'll get from the patient.

    When I first showed my mole (later to be diagnosed as malignant melanoma) to a doctor. I got a vague response too. However, on asking the straight question "Do you think this looks suspicious?" I got the straight reply of "Yes." I didn't have any biopsy, my GP just cut the whole thing out & sewed me up, about a week after she saw it first. About 4 weeks later, a larger area was removed by a general surgeon & only after that did I see a dermatologist. I went there every 3 months for 3 years & was then discharged.

    That was more than 5 years ago & I'm still here to tell the tale, with no further malignancies that I'm aware of.

    Saraly is right, stop prodding & poking around with it Try not to worry so much, even if it turns out to be malignant, you could very well be telling the same story as mine in 5 years time.

    Lidia
    Lidia,

    Thank you. I am glad you are doing so well. That is encouraging for you and everyone else. If you look at my reply to Saraly he did say he was concerned, but also said we could watch and wait, and no more clearcut answers. Do you think I should try to get someone to look at this in case it should be cut out? My biopsy is Dec. 12. Unfortunately, I don't think I can get another appointment
    before that. I am going to call my primary doctor tomorrow,who I like, and see if he has any thoughts about what to do. I don't know if he would be able to diagnose it or do anything, but I will pay for the second opinion visit, I don't care. I just don't know what to do. I will stop poking and prodding as you all say! I think that part is nothing to worry about. Thank you very much.

     
    Old 11-22-2003, 08:44 PM   #8
    rara11
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    Re: possible melanoma?

    Quote:
    Originally Posted by lidiajamjar
    Hi Rara
    Your experience sounds a bit similar to some of the doctors I met. Most were very reluctant to actually use the words 'cancer' or 'malignant'. They mainly referred to things as 'sinister' or 'non-sinister' - a bit like 'passing on', passing over' or 'losing' instead of simply dying! I think some doctors are often a bit worried about the reaction they'll get from the patient.

    When I first showed my mole (later to be diagnosed as malignant melanoma) to a doctor. I got a vague response too. However, on asking the straight question "Do you think this looks suspicious?" I got the straight reply of "Yes." I didn't have any biopsy, my GP just cut the whole thing out & sewed me up, about a week after she saw it first. About 4 weeks later, a larger area was removed by a general surgeon & only after that did I see a dermatologist. I went there every 3 months for 3 years & was then discharged.

    That was more than 5 years ago & I'm still here to tell the tale, with no further malignancies that I'm aware of.

    Saraly is right, stop prodding & poking around with it Try not to worry so much, even if it turns out to be malignant, you could very well be telling the same story as mine in 5 years time.

    Lidia

    Lidia,

    I forgot to say that wouldn't a dermatologist know enough to cut something out right away if it was that concerning? Geez!

     
    Old 11-23-2003, 06:00 AM   #9
    Saraly
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    Re: possible melanoma?

    From what you're saying this doctor sounds weird. I have been seeing dermatologists for thirty years, had over 20 Basal Cell Carcinomas removed and one in situ melanoma and have never had to make another appointment just for a biopsy. If there were more than two Basals I would come back a few days later because my insurance only allows two per visit. If the doctor was even the least bit concerned I think the mole should have been removed. I can't believe he said he didn't have time!! It takes all of 5 minutes and that's with a slow doctor. The tissue would be sent to a pathology lab and they would let the doctor know if more tissue needed to be removed.
    Do you know this doctor well? Have you used him before?
    Is he affiliated with a good hospital?
    Maybe you should call Mass Gen. back and let them know you are very anxious and ask them to call you if there's a cancellation.

     
    Old 11-23-2003, 10:14 AM   #10
    rara11
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    Re: possible melanoma?

    Quote:
    Originally Posted by Saraly
    From what you're saying this doctor sounds weird. I have been seeing dermatologists for thirty years, had over 20 Basal Cell Carcinomas removed and one in situ melanoma and have never had to make another appointment just for a biopsy. If there were more than two Basals I would come back a few days later because my insurance only allows two per visit. If the doctor was even the least bit concerned I think the mole should have been removed. I can't believe he said he didn't have time!! It takes all of 5 minutes and that's with a slow doctor. The tissue would be sent to a pathology lab and they would let the doctor know if more tissue needed to be removed.
    Do you know this doctor well? Have you used him before?
    Is he affiliated with a good hospital?
    Maybe you should call Mass Gen. back and let them know you are very anxious and ask them to call you if there's a cancellation.
    Saraly,

    Thank you for your responses. Yes, he does seem weird. This is my first visit to a dermatologist and I have no comparison. I wasn't conerned when I asked for a referral and my primary never saw the mole. I just don't understand any of this and I am so nervous. I keep wondering if maybe he wasn't concerned, he did say we could watch and wait, but he said he was concerned. I feel like I am almost afraid of him! My primary is really nice and I am going to call him tomorrow. The reason I haven't pursued this more is because I know a couple of people (my husband for one) who had suspected basal or squamous cell on his forehead and he had to wait a month for a biopsy so he is reassuring me to no avail (his was basal). Maybe the HMOs here are just worse. But I will pay for a second opinion visit (I offered to at Mass General), but if I can't get an appointment anywhere I don't know what to do. Maybe it IS nothing much, now I feel like I am being overly concerned since a couple of people have said that they had to wait also. It is my dermatologist's vagueness and arrogance that have caused my extreme worry! I did ask again, twice I asked, at the end of the visit if it was a melanoma and he just gave me this concerned look and said he can't diagnose it without pathology!!!!!! So lots of mixed messages!!!!

    It sound like you have been through a lot with your skin and it also sound like you had good doctors. I am glad you are doing well and it is so kind of you to try to help me. I will call my primary and call Mass General again if that seems best. Thank you! I will let you know what happens.

     
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