Terrified of melanoma. "Severely" atypical mole. Please help. :(

[worriermama]

Hello everyone. I'm 33 and a lifelong hypochondriac. My health anxiety hadn't been centering around anything too terrifying for the past couple years, but now I am in the midst of a severe freakout which has been going on for the past three weeks.

I had made an appointment to see the dermatologist for a skin check and for one particular mole which has been growing in the past year or two. When the checked me out, there were actually two other moles he wanted to biopsy before the one that brought me to see him. One on my side which was very dark, almost black, and not large, but the edges were pretty jagged and it wasn't round. Another round black one on my back too. So he scraped them off and after two agonizing weeks I finally heard back. The one on my back was totally normal. The funny shaped one was "severely atypical." From my reading I understand that this means it may have never turned into melanoma, but that it had a higher chance of doing so, so I'm going back this Friday for a complete excision to get rid off all the atypical cells.

This "severe atypia" diagnosis has completely freaked me out. I have two small children who are the center of my universe and I now feel like I'm a walking time bomb for skin cancer. I have fair skin, tanned a lot when I was younger and got a few bad burns (peeled, but never blistered).

I'm now even more scared about the original mole, which is on the side of my breast, which I will also have scraped off and biopsied at my appointment on friday. I am REALLY praying that it is a sebhorreic keratosis. It seems to have a lot of the attributes of an SK. It has a crusty top layer of dry skin that periodically peels off, the texture is uneven, it's mostly round, and it itches mildly on occasion. It even has one or two tiny white "pearls" which apparently are common in SK but rare in melanoma. Still, I am so terrified. I have been imagining my kids growing up without me, basically playing out all kinds of absolutely horrible mental movies in my head. This whole upset has more or less ruined Christmas and New Years for me.

I guess my question is, if the doctor looked at my moles and felt that the one on my boob could wait and that the others needed to be biopsied first, that probably means he felt more confident that it's benign, right? He does still want to take it off, he just said that he wanted to do the other ones first.

As far as the "severely atypical" diagnosis goes, I know I am considered high risk for skin cancer but if I am vigilant about doing my skin checks and going in every 6 months for a professional check, is that enough to catch anything early enough that nothing more than excision would ever be required to cure it?

I thank you if you've read this far. I am really beside myself with worry lately. I'm glad my appointment is on Friday but I am dreading the wait for yet another biopsy. I just want to get all the funny moles off my body so I can start doing monthly checks with a clean baseline.

I would love to hear from anyone else has been doing the melanoma worry road... The things you find when googling are absolutely horrifying. I haven't had this kind of health anxiety since I became a mom and it is so much worse now that there are these two little people who need me. :(

[bin tenn]

I spiraled down the melanoma anxiety hole for a long time a while back. I know all about the scary junk you find on Google regarding melanoma and other skin cancers. The pictures, the diagnoses, the horror stories - all of it. I understand completely.

But what will worrying get you? Nothing. It will accomplish nothing. A "severely atypical" diagnosis doesn't mean much at all, IMO. If you're really up to speed with what Google says about melanoma, you probably know that melanoma, while seemingly common, is still actually quite rare. As such, a "severely atypical" mole may increase your odds, but given the rarity of melanoma as a whole, your risk is still that much more rare in comparison.

You'll be fine, I imagine. If you have any immediate concerns, surely you can consult the dermatologist. But hang in there, I don't think you have anything to worry about.

[worriermama]

Hi bin tenn, thank you so much for your very rational reply.

I appreciate that you've been there with the melanoma worry, but I'm sorry you've gone through it too. IMO it's one of the worse manifestations of health anxiety that I've ever experienced. For a long time I was worried about my blood sugar (I have mild reactive hypoglycemia) and blood pressure (high BP runs in my family), but these skin cancer fears blow all of that stuff out of the water in terms of drama, intensity, obsession, etc.

I actually hadn't looked into the melanoma incidence statistics. I will take your word for it that it's rare, and that is good to hear. It certainly does seem terribly common when you look at stuff online. And that horrific Melanoma Research Foundation forum which comes up in all my google searches and is full of HORRIFYING stories.

Anyway thanks again. My husband isn't worried, my parents don't seem worried, in-laws don't seem worried... I seem to be the only one freaking out about this. Hmm.

Thanks again for the helpful words.

[bin tenn]

The fact that we often say "this person" and "that person" and "other people" aren't worried about it, only I am, is usually a good indicator that were "making up" this stuff. :-P You're welcome. I hope you get out of that nasty obsession soon!

[Mikiuslorenzo]

Severely atypical is not melanoma. As a matter of fact Melanoma is extremely rare in an existing mole but they prefer to remove them nonetheless. Good practice really.

I had a mole removed a few months ago that looked exactly like a melanoma. Size, shape, blurred uneven edges the lot! The dermatologist said "this has got to come out!" There were no "ifs and buts" about it!
After a long wait for the biopsy results it turned out to be a freckle!!! I googled the name of this particular freckle (name escapes me right now) and found them to be extremely common for anyone over 40. (I am 45) All that panic for a freckle!

I know of two people who have had a melanoma and both had it removed and are now doing fine. In fact neither have had even a slightest suspicion of a recurrence in years! I also know a number of people who have had suspicious moles removed only for it to be nothing! Google seems to spit out all the horror stories but reality can be quite different.

Look at the positive, you have had a scare but you are fine! If anything from now on be pro active and be careful in the sun. Factor 30 all the way for me!

[Double_Rainbow]

The funny shaped one was "severely atypical." From my reading I understand that this means it may have never turned into melanoma, but that it had a higher chance of doing so, so I'm going back this Friday for a complete excision to get rid off all the atypical cells.

Yep, have it removed and get over it. Atypia is NOT cancer. It does NOT mean that you will get cancer. In fact, there is evidence that atypical moles are no closer to melanoma than the regular moles. At least half of white people have atypical moles, just never bother to have them diagnosed. You will be just fine. And it's not just easy for me to say, I've had two moderately atypical moles taken out.

I guess my question is, if the doctor looked at my moles and felt that the one on my boob could wait and that the others needed to be biopsied first, that probably means he felt more confident that it's benign, right?

I think so. I still don't understand why he didn't take that one at the same time also. At the midst of my melanoma fears I've had 5 moles taken out at the same appt. But that again, at least to me, reinforces the notion that the doc wasn't worried about it. So neither should you.

As far as the "severely atypical" diagnosis goes, I know I am considered high risk for skin cancer

Not really. And don't let your anxiety hang onto that thought. It is false.

but if I am vigilant about doing my skin checks and going in every 6 months for a professional check, is that enough to catch anything early enough that nothing more than excision would ever be required to cure it?

No reason to go every 6 months. Once a year is more than enough. Look at your skin every 3-4 months, if you see any changes, go have it checked out. Otherwise, live your life and be happy.

I just want to get all the funny moles off my body so I can start doing monthly checks with a clean baseline.

There is no such thing as a "clean baseline". What you really mean is that seeing moles provokes your anxiety. But no amount of biopsies will cure anxiety, I've had 13 in 6 months, trust me I know. Get comfortable with your body, know your skin. And use that as a baseline. All the best!

[worriermama]

Hi Mikiuslorezo and Double_Rainbow, thank you both for your kind replies.

I wasn't aware about the evidence that atypical moles aren't necessarily closer to melanoma? Everything I've read online talks about how severe atypia is basically just one step away from melanoma. That's what scared the daylights out of me. Lots of talk of how "it's a fine line" between severe atypia and melanoma, or that it can be so very difficult to distinguish between the two because they are so very similar, etc. etc.

I've also seen the stuff about how most dysplastic moles never become cancerous -- but does that apply to the "severe" ones too, if they're taken as their own category?

Sigh. I'm doing better than I was a few days ago but still anxious.

I think the reason he didn't remove the mole on my boob last time was because it was a little inflamed from rubbing against my bra underwire and he said that inflammation can muddy the biopsy results. But overall he just didn't seem as interested or concerned about it as the other two.

Anyway thanks again for the support, it is greatly appreciated!

[bin tenn]

I've also read articles about how "severely atypical" has nothing to do with being "closer" to melanoma. Yes, it's a common belief that it is, but modern studies apparently suggest that isn't the case. It's also not uncommon for clothing to irritate a mole and cause inflammation.

[lofwyr]

I went through the scariest medical issue in my life to date over something like this. Doctor thought it could be nodular melanoma, took it out immediately. I was beyond horrified. It took four days to get pathology back. Benign, no real good explanation for it. It looked and acted like nodular melanoma, but was totally benign. The point I am making, is our skin does some odd things. Most all of them not fatal.

[worriermama]

bin tenn -- That is really great to hear about the recent research, thank you! And yes, not only is that spot where my bra hits, it's also where one of the straps from the baby carrier sits when I'm "wearing" my daughter. I mean it doesn't dig in or anything, but it's definitely some added friction in the general area.

lofwyr, I am so sorry you had such a scare -- I would have died of fright. You're right about skin doing weird things. I stuck a band aid over the mole in question and I am going to do my best to not look at it until my appointment on Friday.