Mom, 32, Diagnosed With Melanoma After Doctor Dismissed Unusual Spot On Her Wrist As ‘Nothing To Worry About’

In a recent interview with the ASCO Post, Eilian explained, “I have many of the risk factors for melanoma. I’m fair-skinned, blue-eyed, and have a family history of melanoma, as well as other skin cancers, so I’ve always been diligent about practicing sun safety and maintaining annual full-body skin exams to catch any suspicious moles or lesions that could potentially be malignant.

“That is why it is so frustrating that despite my best efforts, in 2010, I was diagnosed with stage II melanoma, a diagnosis I believe could have been prevented.”

Melanoma: Overview 

Looking back on how she showed her dermatologist “an odd-looking dark spot” during her annual skin check, two years in a row, Eilian recounted her doctor telling her “No, it’s fine. Don’t worry about it.”

It wasn’t until another year passed that her toddler daughter thought she had chocolate smudged on her wrist before her annual check-up.

“Her reaction and the fact that my regular dermatologist was running late to the appointment, necessitating a switch to another physician for the exam, gave me the courage to insist the lesion be removed, even as he, too, assured me I had nothing to worry about,” Eilian said.

However, days later Eilian received a voice message from her doctor apologizing and admitting he was “wrong,” before informing her she had melanoma and needed further testing.

She explained further, “A pathology report from a follow-up punch biopsy of the malignancy found that I most likely had stage II melanoma.

“Even though a physician I had consulted for a second opinion said I probably qualified for a lymph node biopsy to determine whether the cancer had spread to distant sites, it was not recommended. Fortunately, I found a surgeon who was able to successfully remove the tumor with clear margins and preserve the mobility in my right hand.”

Eilian concluded, “Because of the high rate of recurrence in melanoma, even after nearly 15 years since my diagnosis, I see a dermatologist every 3 months to ensure the cancer hasn’t recurred and to check for any new skin cancers.

“Although I’m thrilled to say I have been cancer-free since my initial treatment, the anxiety that the cancer will eventually come back is always with me. Prior to my diagnosis, going to the doctor never sparked any concern. Now, I recognize my good health is not something I can take for granted, and none of us is guaranteed an illness-free future.”

Understanding Melanoma

Melanoma starts in the same cells that give your skin, hair, and eyes their color. In melanoma, the cells change in a way that allows them to spread to other organs.

Changes to a mole you’ve had for a while or a new growth on your skin could be signs of melanoma.

You’re most likely to find melanoma on sun-exposed skin areas like your face, neck, arms, and legs. Surprisingly, you might also find them in other places as well, like:

• The palms of your hands or soles of your feet
• On your eyes or mouth
• Under your nails

The top way to protect yourself is by staying out of the sun, especially during peak hours, and avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma.

According to experts like Dr. Anna Pavlick, an oncologist at NYU’s Perlmutter Cancer Center, tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided completely.

RELATED: How Do I Know My Skin Cancer is Gone?

Dr. Pavlick notes that people who are covered with moles stand a higher risk of developing skin cancer, especially people with dysplastic nevis syndrome, or “atypical” moles.

Atypical moles are those that are unusual-looking and, when seen under a microscope, they have irregular features. Although usually benign, a high number of atypical moles do signal an increased risk for melanoma, according to the Skin Cancer Foundation which says people with 10 or more atypical moles have 12 times higher risk of developing melanoma.

Warning Signs of Skin Cancer – Remember ABDCE

The most important thing to look out for when it comes to finding melanoma is a sudden, new spot on your skin or a spot that is quickly changing in size, shape, or color.

Dr. Cecelia Larocca, a dermatologist at Dana-Farber Cancer Institute, recommends implementing the ABCDE rule to determine if a mole requires further examination.

The ABCDE rule:

A: Asymmetry of the mole, or when one half of the mole doesn’t match the other
B: Border irregularity or Bleeding
C: Color change either lightening or darkening of a mole
D: Diameter greater than 6mm or enlarging moles
E: Evolving size, shape or color.

WATCH: Dr. Cecila Larocca on the ABCDEs of checking moles for signs of skin cancer

Melanoma that moves into the body, away from the skin, becomes an entirely different treatment journey for patients.

Treatment options for melanoma that has spread include targeted therapy and immunotherapy, which give people a better chance of living a long and healthy life than ever before. If you’re diagnosed with melanoma, there’s a good chance surgery will be the treatment your doctor recommends.

Cancer removal usually leads to a cure in the early stages of the disease. After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and determine if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma.

When no cancer cells are left around the removed area, your cancer is less likely to return.

WATCH: Dermatologic Surgeon Dr. Nima Gharavi, On The “Gold Standard Treatment” For Melanoma

The Melanoma Workup

Unlike other diseases, the workup for melanoma is pretty straightforward. For any skin lesions, your dermatologist will give you a head-to-toe visual examination to look for any other atypical moles or suspicious lesions.

If a growth warrants further evaluation, you might get a biopsy. And if advanced melanoma is found, you may need additional imaging and blood tests to help determine the best treatment plan.

Blood tests may include:

Complete blood count (CBC): looks at the number and types of cells in your blood, including red blood cells, white blood cells, and platelets
Comprehensive Metabolic Panel (CMP): measures the blood levels of certain enzymes, proteins, electrolytes, and minerals
Lactate dehydrogenase (LDH): an enzyme that’s increased in many cancers

Imaging tests may include:

CT scan: uses x-rays and a computer to create detailed images of your body
PET scan: uses radioactive materials (called tracers) and a special camera to create pictures of areas inside the body where cancer may be growing
MRI: Uses radio waves and magnets to create images of organs and tissues

A pathologist may also examine your tissue sample under a microscope to look for certain mutations. This is called biomarker testing, which helps determine the best treatment options for you. The BRAF mutation is the most common mutation found in melanoma tumors.

It’s important to remember that many atypical skin lesions are not cancer. So don’t worry if your doctor finds something that looks a bit strange it may just be a benign growth. If you have any concerns about the findings, be sure to talk with your doctor.

Pushing for a Correct Diagnosis

When it comes to your health, you should always be a little pushy as you know your body better than anyone else. When you see a doctor for a problem, don’t hesitate to make sure that your question is fully answered and that you are comfortable with the plan moving forward. From a doctor’s perspective, every problem should have a diagnosis, a treatment, a plan for follow-up, and a plan for what happens next if the treatment doesn’t work.

As a patient, if you don’t feel like each of these four things has been accomplished, just ask. Even if it requires multiple visits or seeing additional providers for a second opinion, always be your own advocate.

Be Pushy, Be Your Own Advocate, Don’t Settle

Dr. Zuri Murrell, director of the Cedars-Sinai Colorectal Cancer Center, previously told SurvivorNet that healthcare guidelines are meant to do the right thing for the largest number of people while using the fewest resources.

“The truth is you have to be in tune with your body, and you realize that you are not the statistic,” he said.

Additionally, Dr. Murrell says not every patient will “fit into” the mold, so it’s important to “educate yourself and be your own health care advocate.”

“Every appointment you leave as a patient, there should be a plan for what the doc is going to do for you, and if that doesn’t work, what the next plan is,” Dr. Murrell added. “And I think that that’s totally fair. And me as a health professional that’s what I do for all of my patients.”

The Importance of Getting a Second Opinion

After receiving a diagnosis, like cancer, it’s important to remember that you can, and should, talk to other cancer specialists about your disease.

“If I had any advice for you following a cancer diagnosis, it would be, first, to seek out multiple opinions as to the best care,” National Cancer Institute Chief of Surgery Steven Rosenberg told SurvivorNet in a previous interview. “Because finding a doctor who is up to the latest of information is important.”

RELATED: Second (& Third) Opinions Matter When Deciding Between Surgery or Radiation

As we highlight in several areas of SurvivorNet, highly respected doctors sometimes disagree on the right course of treatment, and advances in genetics and immunotherapy are creating new options.

Also, in some instances the specific course of treatment is not clear cut. That’s even more reason why understanding the potential approaches to your disease is crucial.

At the National Cancer Institute, there is a patient referral service that will “guide patients to the right group depending on their disease state so that they can gain access to these new experimental treatments,” Rosenberg says.

Cancer Research Legend Urges Patients to Get Multiple Opinions

Furthermore, getting another opinion may also help you avoid doctor biases. For example, some surgeons own radiation treatment centers. “So there may be a conflict of interest if you present to a surgeon that is recommending radiation because there is some ownership of that type of facility,” Dr. Jim Hu, director of robotic surgery at Weill Cornell Medical Center, tells SurvivorNet.

Other reasons to get a second opinion include:

• To see a doctor who has more experience treating your type of cancer
• You have a rare type of cancer
• There are several ways to treat your cancer
• You feel like your doctor isn’t listening to you, or isn’t giving you good advice
• You have trouble understanding your doctor
• You don’t like the treatment your doctor is recommending, or you’re worried about its possible side effects
• Your insurance company wants you to get another medical opinion
• Your cancer isn’t improving on your current treatment

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

---