New Melanoma Diagnosis

Discussion in 'Medical Topics' started by NewMelanoma, Jul 18, 2017.

  1. NewMelanoma

    NewMelanoma Guest

    Hello All,
    I just received word that my biopsy showed that a mole was a Melanoma. The long and short of it is that it is below the magic 0.75mm depth, though not far. The other good news was that the pathologist and doctor both agree that it is very contained with none of the other "magic" details that lead to greater concern.

    I've reached out to the famous Dr. Bruce (Today) and plan to enlist his help if he will have me. Once I speak with him, I hope to share as much as is allowable or advisable regarding the process I go through. There are many stories, threads, and points of data online, none of which have truly helped me measure what my level of aviation concern should be for the type of diagnosis I have. I hope that my telling of the process is helpful for others.

    Stay Tuned.
    NM
     
  2. Let'sgoflying!

    Let'sgoflying! Touchdown! Greaser! PoA Supporter

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    Best of luck, NM. May it soon be NMM (no more melanoma).
     
  3. Velocity173

    Velocity173 Final Approach PoA Supporter

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    Good luck to ya. I had a Melanoma scare a few years ago. Fortunately the biopsy turned out negative. Everyone should see a dermatologist anytime you have a mole that looks suspicious.
     
  4. JOhnH

    JOhnH Final Approach

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    My sister had a real scare about 6 years ago. She had this big black thing on her back, around 1.5 inches in diameter. Diagnosis came back "Melanoma in-situ". The Dermatologist got it all out on the first surgery and she has been fine ever since. The dermatologist said the whole office almost panicked when they first saw the diagnosis.

    She still has a big scar on her back, but she looks at it as a reminder of how lucky she was, and how important it is to see her Derm every year or so.
     
  5. Rushie

    Rushie Line Up and Wait

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    So sorry about your diagnosis but glad it seems to be caught early enough to cure. Thanks for sharing the story as it unfolds, I'm sure people's stories help many more than ever post to say. Cancer seems to be stalking almost all of us.
     
  6. azure

    azure Final Approach

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    Very sorry to hear of your diagnosis NM. The important thing now is to get it removed (if it wasn't prior to the biopsy) and to do everything possible to prevent spread/recurrence. Attend to health first, and best of luck!

    On the flying end of things, you didn't say whether you were BasicMed eligible? If you are, just a FYI: cancer is NOT automatically disqualifying for BasicMed, and you would NOT need a one-time SI just because you were dx'd with it.
     
  7. brian]

    brian] Cleared for Takeoff

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    I feel for you ... went through this recently myself. Focus on health first. then bitch about the FAA - worked for me ...

    Good luck ... and hope we see you back in the air soon...
     
  8. NewMelanoma

    NewMelanoma Guest

    Thank you everyone for your kind words! I appreciate it. I am away on work and so that makes getting this diagnosis a bit harder not being with my support network.

    Answering a few questions:

    They did remove the entire mole during the biopsy. The doctor prefers to increase the margin an additional 1cm and conduct pathology on it to confirm no cells got away from the original melanoma. I am having that done on Monday.

    I have a second mole that I will have them evaluate as well. If that too has melanoma, then I will most definitely be heading in for a sentinel biopsy... not fun. If not, I still will likely do that as it is required for the SI, but at least we will know it is only needed from one point rather than two.

    I am not sure that Melanoma is something that doesn't require an SI. I took the basic med learning course and it is specifically called out. If it is not an SI under basic med, I will likely go that route, but still be aggressive in my medical care and monitoring as I tend to be overly cautious on important thing.

    Lastly, Health First. I have enough pilot friends that if I cannot regain my ability to be PIC that I can get that taste of flight occasionally. It wouldn't be the same, but being in the air is being in the air. With me not pursuing anything that amassing hours would benefit, I don't need to be logging time to enjoy it. Flying with friends is more fun anyway!

    NM
     
  9. azure

    azure Final Approach

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    I'm not sure what you mean by "specifically called out". I took the course myself (I'm flying under BasicMed) and don't recall that cancer was discussed except possibly as a health issue that should not be ignored and that MIGHT make you unsafe to operate an airplane, depending on the type of cancer and how advanced it is. You don't seem to be anywhere near that stage, though of course you have to discuss that with your doctors, just as you would for LSA, and when you go for the BasicMed exam you have to satisfy the examining doctor that your condition isn't going to cause a safety issue. But FYI, there are only a few conditions that require the one-time SI under BasicMed: certain psychiatric, neurological, and cardiac conditions. No form of cancer is included in that list. You can find the full list in Q11 of the FAA's BasicMed FAQ (just google it).

    Again, it's great that you are putting your health first and being aggressive and proactive in getting this treated. Best of luck for a complete cure and a long flying life!
     
  10. steingar

    steingar Touchdown! Greaser!

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    DO NOT SCREW AROUND WITH MELANOMA!
     
  11. jsstevens

    jsstevens En-Route PoA Supporter

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    :yeahthat:

    I had a good friend in his mid 40's, healthy and fit. Had a spot on his face. Melanoma. 14 months later he was dead.

    That said, it sounds like you're doing the right things and I trust your dermatologist has nailed it.
     
  12. pmanton

    pmanton Line Up and Wait

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    I'm coming up on my medical due date and need to find another doc. My guy got caught by a melanoma and was gone in 2 months !! :(
     
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  13. Agreed on not something to mess around with. I have one other mark that is somewhat suspicious that I am going to have checked out, but it looks like it is more of a normal, non-concerning mark... but I'll let the pros make that call.

    My grandmother died of melanoma before I really knew her, so the message was clear from the word go when this was noticed.

    NM
     
  14. NM Original

    NM Original Guest

    Hello All,

    I appreciate all of the well wishing from everyone on here. As of today, I am 100% Melanoma free. The additional margin taken a few weeks ago was 100% void of any cancer cells from the original excision to the final additional margin border. I had my first full body skin check and the dermatologist is very optimistic about the remaining moles on my body, but we will be seeing each other every 3 months for a full head to toe check and monitoring.

    As for future treatment and the 3rd class medical, I will be going to path of Basic Med. My dermatologist is on staff at a major university medical college and works specifically with the oncology group there. In consultation with a leading researcher, she said the sentinel biopsy wouldn't be necessary unless I have a new cancer discovered and that annual MRI's seemed a bit excessive.

    My quarterly visits include lymph node checks to be sure there isn't any other change.

    My next stop is a GP for the physical required for Basic Med and a discussion on how we monitor my health in an ongoing manner to watch for anything else that could come up related or unrelated to melanoma, including any signs of brain issues.

    Thanks again for your support!!!

    Cheers,
    NM
     
  15. denverpilot

    denverpilot Taxi to Parking

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    NM,

    Do not miss or skip your follow ups and if you sense anything at all is going wrong, or see anything anywhere that gives you concern, get it checked QUICKLY.

    Melanoma took my aunt in her mid-40s. She'd had things removed, decided after doing some of the follow ups that she was "fine". Docs didn't push. And then she found a spot under an armpit.

    She went in and it had metastasized and was already in the lymph nodes, was in her brain a few months later and a month or two after that, she was dead.

    Do the follow ups completely and watch yourself carefully. Don't skimp. It goes too fast to stop once it gets out of control.
     
  16. midlifeflyer

    midlifeflyer Final Approach

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    BTDT. Mine was shallow but there were still hoops. It's navigable but you need your ducks in a row and have a good senior AME.
     
  17. steingar

    steingar Touchdown! Greaser!

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    I suppose some explanations in order. Tumors all derive from either normal cells are their precursors, so called "stem cells". In the case of melanoma the tumors derive from cells called melanocytes. These are the cells that make melanin, the pigment that makes our skin and hair dark. Melanocytes make melanin in response to UV radiation as a defense, UV radiation is bad for you as it can cause damage to your DNA. Thus melanocytes are being bombarded with UV all the time, making them very tough and difficult to kill, a good thing for a cell exposed constantly to DNA damaging agents.

    The other side this doubly-edged sword is when they go bad, such as in melanoma, the cancer cells can be very difficult to kill. This is in contrast to some T-cell lymphomas. T-cells are an immune cell that responds to things like infection. They multiply when they're needed and die off quickly when the need is gone. The cells are easily killed, and often tumor cells derived from them are likewise.
     
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  18. Rushie

    Rushie Line Up and Wait

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    Nice explanation, thanks. We had a friend die very young, in his 30s from melanoma. He was fair skinned, blue eyed and blond and had moved to Hawaii for a few years before he was diagnosed. He was one of my karate teachers. Very nice guy. I introduced him to the girl who became his wife. Then felt guilty because she was widowed so young. She never remarried.
     
  19. rbridges

    rbridges En-Route

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    Melanoma can be an ugly, ugly bitch. It can metastasize like you wouldn't believe. Glad you caught it early and are safe (knock on wood)!
     
  20. NM Gone

    NM Gone Guest

    Great comments regarding skipping visits.

    I had my first head to toe exam and everything looks clear. We have a few to watch, but the doctor was very comfortable with where I'm at.

    I won't be skipping visits. Everyone needs to put on ZINC sunscreen, especially when you are flying. Ask a senior captain at any airline about all of the moles pilots have removed.

    Thanks again for the support!
     
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  21. Ryanb

    Ryanb En-Route PoA Supporter

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    I won't be the first to say that sunscreen is a necessity. I have an SPF30 w/ Zinc Oxide being the only active ingredient. Skip any chemical sunscreen. Zinc Oxide protects against the entire UV spectrum on its own, so there's no need for any other ingredient to be added. Most chemical sunscreens do not cover both bands of UVA, while Zinc Oxide does. Remember, UVB cannot penetrate glass, so you don't have to concern yourself with that if you're indoors, however UVA penetrates glass and clouds, so having adequate protection is a must. Also keep in mind that UVA is the wavelength responsible for sunspots, moles and most wrinkling of skin that we experience throughout our lifetime. UV increases with altitude so it's definitely important to wear while flying. The winter is just as important, since UVA is the primary band that reaches earth surface.

    It takes less than 5 minutes out of the day to apply sun protection. You don't think it's necessary, until it is.
     
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  22. Ryanb

    Ryanb En-Route PoA Supporter

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    Those are the folks who are most susceptible to UV damage along with red headed people.
     
  23. azure

    azure Final Approach

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    Good post. Zinc oxide is certainly the most elegant solution, but anything that is advertised as broad spectrum UVA/UVB should be adequate. I've always used Neutrogena Dry Touch SPF 30 because it is less oily in feel than most, and it is UVA/UVB. The active ingredient is "helioplex" which is obviously some proprietary chemical type preparation (they list the active ingredients, all organic compounds and none appears to contain zinc). But it doesn't matter as long as it protects against both UVA and UVB.
     
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  24. Ryanb

    Ryanb En-Route PoA Supporter

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    I've seen that in the store, but have never used it. The reason I'm not a fan of chemical based sunscreens is because they breakdown a lot faster than mineral based. Chemical sunscreens penetrate the skin and absorb UV radiation and convert it into harmless infrared heat. Once the chemical agents have been used up, the sunscreen is no longer effective, hence the reason it's recommended to reapply every two hours. Mineral based sunscreens sit on top of the skin and reflect UV back into the atmosphere and will last much longer than any chemical sunscreen. Of course any sunscreen is better than nothing, I've just been one that tries to go the most natural route possible.

    Keep in mind that the word 'organic' has a different meaning in chemistry than it does in food.
     
  25. frfly172

    frfly172 Touchdown! Greaser!

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    Good luck,hope it all works out for you.
     
  26. azure

    azure Final Approach

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    That's a good point. I will often reapply if I've been in the sun for a long time, but there are times I do forget to do so. If I may ask, what brand do you use? I may try it!

    Don't get me started on "organic" foods! Yes, I'm well aware of the two meanings and in fact wasn't even thinking about the food-related meaning when I wrote that. Neutrogena lists "avobenzone 3%, homosalate 8%, octisalate 5%, octocrylene 4%, oxybenzone 4%". I guess the --salates could be inorganic or mineral-based (I've actually never heard of those), but the others are obviously organic compounds.

    Edit: I googled those --salate ingredients and they're actually salicylate esters, so also organic compounds.
     
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  27. Ryanb

    Ryanb En-Route PoA Supporter

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  28. Rushie

    Rushie Line Up and Wait

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    That's right. Back before ships were invented, the humans that made their way to the north lands evolved fair skin to manufacture vitamin D. Then when you move somewhere like Hawaii, you have more intense sun exposure and little to no melanin protection. (Nature's sunscreen.)
     
  29. steingar

    steingar Touchdown! Greaser!

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    The flip side is if you've a dark complexion and you live in sufficiently northern latitudes you can develop ricketts.
     
  30. Ryanb

    Ryanb En-Route PoA Supporter

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    That's very rare though and uncommon. You don't have to get Vitamin D through UV radiation, although it's the most common and abundant source. Fortified foods and supplements take the place when the UVB doesn't reach high enough levels, like during the winter months in most places.
     
  31. Rushie

    Rushie Line Up and Wait

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    Exactly correct. There are flip sides to almost everything. Africans for example who carry the genetic mutation for sickle cell anemia have a natural immunity to malaria.

    Back before we artificially fortified milk and cereal and invented supplements, people living in the northern climes got their vitamin D during the winter months from organ meats and fish oil.
     
  32. TedR3

    TedR3 Pre-takeoff checklist

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    /
    Congratulations, on your good news.

    This is a great example of the benefits of Basic Med. I had to go through the SI process for mine: https://www.pilotsofamerica.com/community/threads/melanoma-and-my-medical.40254/ It took countless hours of my time and probably about $4K all told over 5 years.

    So, you managed to dodge two bullets!
     
  33. Skip Miller

    Skip Miller En-Route PoA Supporter

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    ...and onboard nuclear submarines.
     
  34. Hey folks,

    I'm still here! I've passed my first head-to-toe skin check and the pathology is all good. The doctor is classifying the cancer as "In Situ" and we are into the first 3 years of quarterly skin checks.

    In looking at the Basic Med requirements, I came across something that I hadn't noticed previously. On the "ISSUE" track, it now lists "OR Melanoma in Situ" in addition to the less than .75mm deep requirements.

    Given that, I may be good to go for the 3rd class again without the requirement to do the annual MRI's. I have a call into my normal AME to confirm, but this would be fantastic!

    I'll keep you all posted as the process continues. If that is qualifying, I may need to submit something on box 60, or it may be able to wait until my renewal. I'll let you all know what I learn.
     
  35. steingar

    steingar Touchdown! Greaser!

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    Don't know what the 3rd class will do for you beyond Basic Med, unless you plan to fly to Canada. Congrats on ridding yourself of the stuff.
     
  36. Thanks!

    Canada is an important one for me as is the ability to fly heavier or faster aircraft. I also may want to instruct and instruction seems more straightforward under 3rd class. But, were it not for that, BasicMed is pretty good.