Home Forums Melanoma: Newly Diagnosed – Stages I & II Recent Stage 1a diagnosis

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    Hi everyone,

    Four days ago my dermatologist called me and asked if I could come to his office the same day. While there he told me that the mole on my calf I cut out the week before was a stage 1a melanoma. The wide excision was scheduled for the next day, and now I’m sitting here with lots of thoughts and questions.

    It really had me rattled since it had passed two annual mole checks, the most recent one in November where it was looked at specifically. It was only my feeling of paranoia that led to it being cut out. It’s an amelonatic melanoma, so a particularly sneaky kind apparently. From what I understand of the lab report, a blood work report that came in normal and good, and what the doctor told me, the only way things could look better was if it was an in situ and not a 1a (and a relatively thin one at that).

    Since I’m a quite fit 34 year old male with no other health issues, it really shook me.

    So despite me intellectually knowing I shouldn’t worry about the next steps (apart from heightened mole vigilance and liberal use of sun screen), it’s really hard to actually get there. I have several questions running through my head:

    – What if this was only one mole of several?

    – What’s my risk of recurrence?

    – Am I at risk for other cancers?

    – What if I already have something else?

    – What if I’ve missed something?

    – What if the blood work didn’t cover everything I have? (remote risk of course)

    – What if it has spread (arguably it can’t given the stage, excisions and the blood test, but still)

    – How can I not question every single itch or ache I have in my body? (mindfulness practice likely and regular checkups, but still)

    I don’t expect this forum has all the answers, but any input would be very appreciated.

    It’s a pT1a non-brisk superficial at 0.3mm Breslow, with a “Nil” on Regression, Ulceration, Microsatellites, Perineural invastion, Lymphovascular invastion and Desmoplasia. Mitosis is a 0 per mm2. First excision specimen was 0.6cm x 0.5cm x 0.6x cm, Surgical margins was “in-situ component” and “Peripheral: Involved”. For the invasive component: Peripheral margin: [blank] and Deep margin: Uninvolved.

    Catherine Poole

    Congrats on finding this melanoma early. You are obviously good at vigilance in checking your skin. I would suggest you have whole body photography and keep it on your computer. When you suspect a change go back to your photos for verification. Your doc should really be doing this if you have a lot of moles to watch. You are not necessarily more apt to get other cancers or even more melanomas. But this type of following will provide some reassurance. Are you going to a teaching based university practice? That might be a good idea. Incorporating photography into your check ups with definitely increase the chance of early intervention. We posted about this here on the forum. Please feel free to post more questions. Please read this: https://www.docwirenews.com/abstracts/hem-onc-abstracts/improved-melanoma-outcomes-and-survival-in-patients-monitored-by-total-body-photography-a-natural-experiment/


    Hi Catherine,

    Thank you for taking the time to reply and for starting this forum.

    I’m Swedish (Type 2 assessed skin) but I currently live in Singapore, and the lab report came from the Singapore National Skin Centre – presumably they are very good at this.

    I’ll talk to my dermatologist about photography next week when I go in to discuss the WLE report. It’s a dermatology clinic, so no university practice unfortunately. But photography definitely sounds like I will get some peace of mind.

    I understand that it’s quite rare to have two melanomas on different parts of the body, is that correct? And while I doubt it’s “0 mitosis per mm2” but rather “<1 mitosis per mm2", I gather that it is also a good sign?

    My biggest fear is that despite my vigilance and the blood test the melanoma has spread somewhere, and I just haven’t found it yet. I know there are no such things as medical guarantees, but I’ve convinced myself I’m as healthy as can be – I just have to stay vigilant.

    My dermatologist will do quarterly checks, but I’m considering going to a different dermatologist as well every six months for a second opinion. While I don’t fault him for not assessing the removed mole as a dangerous amelonatic melanoma, it’s more for the peace of mind and a second opinion.

    Catherine Poole

    I think you know your body better than anyone else. Trust your intuition. If they don’t do whole body photography, do it with the help of a friend/relative etc. I know that feeling that it may have spread elsewhere and the fear that accompanies it. I’ve been there! But you just have to live your life and enjoy each moment and keep the vigilance going. You could get another opinion on the pathology if you want, it would be an out of pocket expense through the labs of Dr. Martin Mihm in Boston.

    Don’t forget to breathe!


    Hi pwsg3455,

    It sounds like you caught it early, which is great news and something that you should focus on.

    Only item I would emphasize is just keeping on your checkups and screening going forward. Take care!

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