The Little Freckle That Was … Melanoma

It’s just a little freckle, right? Wrong! Since May is Skin Cancer Awareness Month, I thought this was the perfect time to share a journey that shockingly ended up with the diagnosis of melanoma, the deadliest form of skin cancer, and share precautions to prevent it. With over five million cases diagnosed each year, skin cancer is the most common cancer in the United States, and prevention should be taken seriously.  

It gets gory from here, and no one wants to experience what I am about to share, I promise! This story hits close to home as my husband, David, is the one who had that little freckle. As the story goes, the pivotal point was when the little freckled CHANGED – it got darker brown and changed in size and shape.

For the past few years, David had had a little freckle about the size of a lentil on his right cheek. We all noticed it, and he had visited a dermatologist a few years ago, but it had started to change and was now the size of a small lima bean. Last July 4th, when our neighbor told him he had dirt on his face, I told him it was time for the not-so-little freckle to go. That said, I wanted it removed by a board-certified plastic surgeon because it was located in the middle of his cheek – you know you want your face to look its best.

Dark brown area — change in color and size

I made an appointment with Dr. Endara at PerfecTenn in Columbia to finally have the freckle removed. I will leave out the part where my husband almost faints when he gets injections in his face because of his vagus nerve – that’s another story. As a precaution, Dr. Endara sent the lesion to pathology, and when the doctor personally called with the results, it was clear that the news was not good. It was melanoma, and now larger margins needed to be taken. Unfortunately, the following skin biopsy also showed melanoma.

At this time, Dr. Endara said, “This isn’t about looking pretty anymore. It is time to go see a dermatologist.” Dr. Endara’s office scheduled an appointment with Dr. Robb, a board-certified dermatologist at the Skin & Allergy Center in Spring Hill, to remove a significantly larger portion of my husband’s cheek. This time, we are talking about a gaping hole in his cheek and three and a half inches of stitches, but yet again, the margins were not clear. After one more biopsy, clear margins were finally attained.

At this time, Dr. Endara said, “This isn’t about looking pretty anymore. It is time to go see a dermatologist.” Dr. Endara’s office scheduled an appointment with Dr. Robb, a board-certified dermatologist at the Skin & Allergy Center in Spring Hill, to remove a significantly larger portion of my husband’s cheek. This time, we are talking about a gaping hole in his cheek and three and a half inches of stitches, but yet again, the margins were not clear. After one more biopsy, clear margins were finally attained.

After two months, four separate biopsies, and hundreds of stitches (slightly exaggerating), David was finally ready for the reconstruction of his right cheek. The procedure was under general anesthesia, and Dr. Endara took roughly 90 minutes to strategically rotate the skin on his cheek to minimize scarring and make sure the skin remained viable. Once again, as a precaution, another biopsy was sent to the pathologist.

When Dr. Endara called a week after surgery, it was with utter disbelief as the biopsy came back showing melanoma. How could this be possible? Even Dr. Robb thought it could be a false positive, so a sample was sent to an oncology pathologist for verification, where it was confirmed positive for melanoma AGAIN! The course of treatment this time was six weeks of a topical chemotherapy cream to attack the cancer cells. Once the treatment had been completed, the punch biopsies came back negative. Such good news!

Six months after the initial biopsy to remove a freckle, it was time for the final surgical procedure, which would thin out the grafted skin to make it flush with the rest of the cheek. This, too, was under general anesthesia at the hospital, but a much quicker procedure with minimal stitches. Of course, Dr. Endara did a stellar job!

As David’s cheek continues to heal, the light at the end of the tunnel is in sight. At his last appointment in March, Dr. Endara anticipated a little more thinning would be needed, an in-office procedure this time, and some microneedling to camouflage the scars later this summer. Now, I’m not allowed to tell David, “I told you so,” anymore, but ladies, if you need to wife-guilt your husband into going to the dermatologist – DO IT!

The two key words I want everyone to remember are EARLY DETECTION. Let me say that again: EARLY DETECTION. What does early detection mean? It means going to the dermatologist for annual skin checks and understanding the importance of sun protection. The most notable point is that skin cancer is one of the most preventable and highly treatable cancers when detected early – so there is hope.

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