John Mellancamp’s Daughter, Teddi, Endures Her 13th Skin Cancer Surgery– ‘Real Housewives’ Star Has Part of Shoulder Skin Removed

Mellencamp captioned her most recent Instagram post, “Surgery went well! I specifically went through a ‘wide excision melanoma, soft tissue defect reconstruction with adjacent tissue rearrangement.’

“Basically they cut out the area of my shoulder and replaced it with a flap of skin from below on my back (swipe to see the area before surgery). But the pain and discomfort are all worth it.”

She continued, “The outpouring of love and prayers in the comments and DMs has left me speechless (which is tough). I wish I could respond to everyone but please know I am forever grateful.

“Please get your skin checked. I promise you do not want to go through this. #skincancerawareness #melanomaawareness.”

Included in the post, Mellencamp shared a photo of herself in recovery with a thumbs up, along with an image of her back prior to surgery, revealing what area of skin on her shoulder they would be cutting out, and a video of herself admitting the surgery was painful but she’s “grateful” for having it done.

Mellencamp also took to her Instagram story to share some insight into her cancer journey, after an immunotherapy cream treatment didn’t work, saying in one of her videos, “I’m out of surgery. Now I’m just waiting to be discharged to the nursing facility. It’s pretty painful but I am so grateful that they did such a great job.

“Whew, that back skin is tight…struggle bus, but I’m hoping they got it all.”

In another video clip, showing Mellencamp, who was widely considered the face of “Real Housewives of Beverly Hills” (RHOBH) during her time on the show, in route to a nursing care facility, where she discovered the post-op process as “a lot of damn pain but worth it.”

It’s great to see Mellencamp, who is married to CEO and Founder of Skyline Security Management Edwin Arroyave, who she shares four children with, sharing her skin cancer story and doing so with an immense amount of support on hers— from her fans, family, and friends.

Prior to her surgery, her husband shared some heartfelt words alongside a sweet photo, writing, “As Teddi goes in for the biggest surgery in her melanoma journey today, I just wanted to share how her absolute strength through it all has been nothing short of incredible.

“I know this battle is close to being won, and I cannot wait to see how she continues to impact every person around her. I love you, Mama.”

View this post on Instagram

A post shared by Edwin Arroyave (@tedwinator)

Mellencamp’s surgery comes after the reality star revealed her immunotherapy treatment she underwent for her back did not work.

She explained in an Instagram post shared about a week ago, “Long story short: The immunotherapy treatment did not work on my melanomas. I had a wide excision removal on my most recent melanoma last week to see if it did and sadly it did not.”

“I have been presented with a couple new options and I have decided with my doctors that the best next course of action is have surgery on December 26th to remove a larger portion of problematic area. I don’t like going under and my anxiety is popping off but I have faith all will be ok and that the reason this is happening to me is because I am able to raise awareness.”

Mellencamp concluded, “After surgery, when god willing my margins are clear, we will continue to monitor my body closely every 3 months. In the meantime, I am so looking forward to spending Christmas with my loved ones and hope this is a reminder to book your skin checks for the new year.”

View this post on Instagram

A post shared by Teddi Mellencamp Arroyave (@teddimellencamp)

Understanding Melanomas

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, according to SurvivorNet’s experts. You’ll want to watch them and tell your doctor about any changes you notice.

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

WATCH: How do perform a skin check using the ABCDEs?

SurvivorNet experts recommend avoiding unprotected sun exposure because ultraviolet (UV) radiation can lead to melanoma. Tanning beds pose ultraviolet radiation risks for skin cancer and should be avoided. Many dermatologists recommend using spray tans to reduce the risk of melanoma skin cancer.

What Are the Symptoms of Melanoma?

The most important thing to look out for when it comes to finding melanoma is a new spot on your skin or a spot that is changing in size, shape, or color, SurvivorNet’s medical experts say.

When you check your skin, use the acronym ABCDE as your guide:

• Asymmetrical moles: If you drew a line straight down the center of the mole, would the sides match?
• Borders: Is the mole irregular or jagged?
• Colors: Are there multiple distinct colors in the mole?
• Diameter: Is the mole larger than 6 millimeters (mm), about the size of a pencil head eraser?
• Evolution: Has the mole’s color, shape, or size changed over time?

If you answered “yes” to any of these questions, our experts say it’s time to see your dermatologist for a skin check.

Treating Melanoma

With breakthrough treatments like targeted therapy and immunotherapy now available, people who are diagnosed today with melanoma have a much better chance of living a long and healthy life than ever before.

The American Cancer Society says the five-year survival rate for localized melanoma that has not spread is 99%. For melanoma that has spread to other parts of the body, the five-year survival rate drops to 71% for regional spread and 32% for distant spread.

If you’re diagnosed with melanoma, there’s a good chance surgery is going to be the treatment your doctor recommends. In the early stages of the disease, removing the cancer usually leads to a cure.

For an early-stage melanoma that is close to the skin surface, Mohs surgery might be an option. This technique removes skin cancer, layer by layer, until all the cancer is gone.

Stage 1 melanoma surgery consists of simple, in-office removal of the cancerous cells by a dermatologist. If the cancer is thicker, your surgeon will remove it through a technique called wide excision surgery.

Stage 2 and stage 3 melanoma surgeries are performed by surgeons or surgical oncologists, not dermatologists. You may also have a sentinel lymph node biopsy to see if the melanoma has spread to the first lymph node where it’s most likely to travel. If your cancer has reached this first lymph node, it may have spread to other neighboring lymph nodes and organs.

After surgery, the removed tissue and lymph nodes are examined to measure the melanoma and find out if it has clear margins. Clear margins mean the cells around the area of tissue that was removed don’t contain any melanoma. When there aren’t any cancer cells left around the removed area, your cancer is less likely to come back.

RELATED: Continued melanoma treatment after surgery.

Treatment for stage 4 melanoma has changed over the years. Targeted drugs and immunotherapy have been shown to be more effective than chemotherapy.

For melanoma patients who need additional treatment after surgery, they are likely to receive adjuvant therapy (treatments administered after surgery). Adjuvant therapy is designed to improve outcomes and decrease the risk of recurrence. The Food and Drug Administration (FDA) has approved some adjuvant therapy treatments for melanoma, which include:

• Pembrolizumab (Keytruda) – This medication is an immunotherapy that helps your immune system attack and kill cancer cells. It is a PD1 inhibitor drug that works by blocking the PD1 pathway used by cancer cells to hide from the immune system.
• Nivolumab (Opdivo) – Another form of immunotherapy, nivolumab is a PD1 inhibitor that works similarly to pembrolizumab.
• Dabrafenib (Tafinlar) and trametinib (Mekinist) combination – This is a targeted therapy combo for patients with a BRAF V600E/K mutation fueling their cancer. About 50% of melanomas have BRAF mutations.
• Ipilimumab (Yervoy) – This medication is also an immunotherapy. Ipilimumab works by blocking CTLA4 protein, which is found normally on T-cells, and keeps immune cells alert to fight off cancer cells and stop their growth.
• Interferon alpha (FDA-approved, but no longer recommended by the National Comprehensive Cancer Network (NCCN) Melanoma Panel.)

Wide-Excision Surgery vs. Mohs Surgery

The type of surgery Mellencamp underwent was a type of wide excision surgery, which the mom of four described a “wide excision melanoma, soft tissue defect reconstruction with adjacent tissue rearrangement” on her social media page.

According to the American Cancer Society, “When melanoma is diagnosed by skin biopsy, more surgery will probably be needed to help make sure the cancer has been removed (excised) completely. This fairly minor operation will cure most thin melanomas.

“Local anesthesia is injected into the area to numb it before the excision. The site of the tumor is then cut out, along with a small amount of normal skin around the edges (called the margins). The wound is usually stitched back together afterward. This will leave a scar. The removed sample is then viewed with a microscope to make sure that no cancer cells were left behind at the edges of the skin that was removed.”

The ACS explains further, “Wide excision differs from an excisional biopsy. The margins are wider because the diagnosis is already known. The recommended margins vary depending on the thickness of the tumor. Thicker tumors need larger margins (both at the edges and in the depth of the excision).

“The margins can also vary based on where the melanoma is on the body and other factors. For example, if the melanoma is on the face, the margins may be smaller to avoid large scars or other problems. Smaller margins might increase the risk of the cancer coming back, so be sure to discuss the options with your doctor.”

Meanwhile, the American Society For Dermatologic Surgery describes wide-local excision when “the skin cancer and a small margin of healthy tissue around it [the cancer] is cut out, usually in a football-shaped ellipse. Once the tissue has been removed, the edges of the wound are sutured together. The tissue then is sent for processing and margin evaluation by a pathologist.”

“Wide-local excision often is used for BCC and SCC on lower risk body sites (such as the body or arms/legs) and for early stage melanomas that still are confined to the skin and have not spread into deep levels of tissue or other parts of the body. If caught early, the procedure can cure melanoma. In other cases, additional treatments may be required,” the ASDS adds. “Since wide-local excision requires the removal of healthy skin, it results in a larger wound. In certain places on the body, such as the head and scalp, it can be difficult to suture the wound edges back together, necessitating skin grafts to close the wound. Recovery time can vary greatly depending on the size and site of the cancer.”

Many other people battling melanoma have Mohs surgery, state-of-the-art technique developed in the 1930s by Dr. Frederick Mohs, to remove their carcinoma. Mohs surgery is a microscopically-controlled surgery where thin layers of tissue (typically, skin cancer tissue) are removed until the surgeon reaches clear tissue.

WATCH: What Is Mohs Surgery?

“You’re able to remove a very conservative margin around the cancer and study it in essentially real-time,” Dr. Sumaira Aasi, director of Mohs and Dermatologic Surgery at Stanford, told SurvivorNet in a previous conversation. If, when the surgeon examines the tissue under the microscope, cancer is found, the surgeon goes back and removes some more tissue.

The idea is that by making the tiniest cuts and evaluating them microscopically, the surgeon knows for certain that all the cancer is out when the last piece of tissue proves to be clear. It is often done as an outpatient procedure with local anesthetic.

“The Mohs surgeon will take a conservative cut circumferentially around the cancer where we’re able to preserve healthy tissue,” Dr. Aasi added. “We’re able to process the tissue and look at the cancerous tissue and know where there are still tumor cells persisting. Because as the Mohs surgeon removes the cancer, it’s mapped out, and we can go back specifically to the areas where we see cancer cells and take, again, another conservative margin or amount of tissue.”

Surgery is the Best Option for Melanoma

Questions to Ask Your Doctor

If you are diagnosed with skin cancer, you may have some questions for your doctor. SurvivorNet suggests some of the following to help you on your cancer journey.

• What type of skin cancer do I have?
• What treatment options exist for my type of melanoma?
• Will insurance cover this treatment?
• Would treatment through a clinical trial make sense for me?
• What resources exist to help manage my anxiety because of this diagnosis?

Contributing: SurvivorNet Staff

Learn more about SurvivorNet's rigorous medical review process.

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