*according to the melanoma network of canada, about 7,300 canadians were diagnosed with melanoma in 2017. (considering we have a population of about 36 million people, that means that i had about a 0.0002% chance of this happening to me. it is rare. probably should have bought a lottery ticket too!)
*the most significant risk factor for developing melanoma is being exposed to uv rays via sunlight or tanning beds. (i never got sunburns growing up, but i definitely spent tons of time outside in the sun… lifeguarding, cottaging, traveling. but tanning beds weren’t for me. made me feel claustrophobic AND i was already dark!)
*other risk factors include having a fair complexion, the number/type of moles you have, a family history of skin cancer, and a history of severe sunburns. (fair complexion? don’t think so.)
*the original mole that was removed from my left shoulder was 1.1 mm in depth. the margins were free of cancer cells. (ALL THIS CAUSED BY 1.1 mm?!!! to put it in perspective: a dime is about 1 mm thick. any melanoma that is deeper than 0.8 mm is considered at a higher risk, but a thick very high risk melanoma would be 4 mm.)
*i was being followed over the last year every three months. (the dermatologist thoroughly checked my skin, i had my lymph nodes palpated, and my blood work done. i seemed healthy. before each appointment, i would get anxious, and then it would pass, assuming i was worrying for nothing.)
*i was lying down at the gym about to do a bench press, when i felt something hard deep in my left armpit. (i had my year follow up PET scan scheduled for two days later. it turns out i wasn’t worrying for nothing.)
*when that cancerous lymph node was removed it measured 2.8 x 2.1 x 1.7 cm. (i saw it when they removed it. i was sedated but not unconscious. it looked like the way you picture cancer in your mind: dark, grotesque and deadly.)
*on june 11th (in canada, now), i had the remaining lymph nodes taken out of my left axilla. pathology came back after 4.5 weeks. 27 lymph nodes were removed. 0 had cancer in them. (axilla is a fancy word for armpit. also, 0 out of 27 is good news!)
*with the new staging and the size of the original lymph node, i am technically N1B T2A, which is another way of saying melanoma stage 3B. (i won’t go into the stats around recurrence at this stage, as it isn’t as reassuring as i would like. i will say that doctors do not shy away from giving the information, which as a pragmatic person, i appreciate.)
*there are two primary adjuvant treatment options for melanoma stage 3B (after surgery). one is immunotherapy (which boosts the immune system response to the cancer cells), and the other is targeted gene therapy (for melanoma with the BRAF gene changes). my cancer does have the BRAF gene change, which makes the cells grow and divide too quickly. (from my very basic understanding, the targeted gene therapy can be quite difficult to tolerate. on the other hand, immunotherapy can have some complex side effects, but it sounds like many people are able to manage them. with my staging and context, we are leaning towards immunotherapy.)
my brain is constantly swirling with facts, figures, statistics and terminology. at the end of the day they mean nothing for the individual: for me there is either a 0 or 100% chance that i will have a recurrence, there is no in between.
i ran into a friend’s dad the other day. he is a doctor, and i have known him for years. he reminded me that people make decisions all the time that are not based on statistics, but based on your spirit and what you want from life. i know i have many balls in the air, and they will gradually settle – a treatment path will become clear. moving forward i will do my best to consider all the facts and figures (without being side tracked by them, as hard as that is), while also balancing my instincts and personal life context (and how i want to live).
*it is a fact that you can get a sandwich for 3 euros in brussels, belgium. i have a hate/love relationship with that city. during my backpacking adventures in europe in the early 2000s, it was by far my least favorite city. i felt unsafe, the weather was horrible and my hostel was in a bad part of town. during the summer of 2017 (when this photo was taken), i returned to brussels for my “brussels redemption tour”. it lasted a mere 36 hours but i was staying in a gorgeous apartment with a friend, explored some beautiful parks around town, and ate a damn good sandwich (but i definitely did not get the cheapest combination and paid well over 3 euros!)
