My Cancer Story and A Rocking Chair Love

Dear Readers,

Today is Melanoma Monday and I wanted to take a little time to share my story with you…

Earlier this spring I received a call from my doctor that changed my life. A routine skin check biopsy revealed invasive malignant melanoma.

Let start at the beginning….

Skin checks and biopsies are not new to me. I had my first mole removed in the 4th grade, a few more during middle and high school, and lots more during college and my early adult years. I’m not exaggerating when I say that I stopped counting at twenty. Among the removed spots were some precancerous and in situ legions that resulted in minor surgeries on my back, abdomen, and foot.

As my oncology surgeon said when she saw me for the first time, “You have that textbook Irish skin for skin cancer - fair with a warm (red/pink) undertone.” We discussed my lifestyle, which is very healthy, and she said that this diagnosis was likely to come regardless of my current healthy lifestyle. It is a diagnosis steeped in a combination of genetics and skin type, and that as little as one to three sunburns in my childhood years would have been enough to cause the damage needed for the cancer to later develop. She explained that given my first removal and biopsy in the 4th grade, the genetics were there and the environmental damage was already done so it was only a matter of time. And without my routine skin checks and removals, it would have been much earlier than now.

 I was already on a six-month skin check schedule, and I had rescheduled my most recent dermatology appointment once because of the craziness of life. As the new appointment grew closer, I almost rescheduled again. Why? Again, because of demands on my time and energy. I try my best to create a home environment that promotes rest and peace but being a family of five with all that entails, it still gets hectic. I didn’t want the overwhelm so I planned to reschedule again. But when I went to call to cancel the upcoming appointment, a little voice in the back of my mind said to go to the appointment (Thank you, Holy Spirit). I was already going to be at Hopkins that morning for my cardiology appointment, so I kept the appointment even with all of the other things demanding my attention.

That decision saved my life.

That Monday morning, I went to my appointment just to check it off my very long and ever-growing list of things to do. I was somewhat bored while I had my skin checked yet again and when my doctor said she wanted to biopsy a spot on my back, they checked previous visit photos and decided it was best to remove it the same day. Not a problem - as I said, it was something I've had done many, many times before. They numbed the spot, performed the biopsy, and bandaged the area.

No big deal. I left the office and didn’t think twice about the biopsy.

Until Thursday evening.

I saw a message come through my Hopkins portal about the pathology report. I opened the message that noted I would be contacted by my doctor. I glanced at the biopsy result and saw Invasive Malignant Melanoma.

I thought, "Okay. Melanoma. It will be okay. They probably got it all or I'll just need to go back and have more removed. It’s fine."

Then I saw the rest of the report. The biopsy was positive for lateral spread, and the cancer was evident in the lymphocytes surrounding the initial melanoma. Not good. But the depth measurement, while invasive, looked to be minimal. A little relief.

I am familiar with pathology reports and while I read the rest of the results one thing stuck out. There was a note section that documented that the dermatological team discussed my case and submitted my results on March 26th at 1:51pm.

 I wondered why it was necessary to include this in the report. I mentioned it to both my husband and my mom. I had never seen it on any previous pathology reports, so why was this different?

The next morning, as I prepared for our homeschool co-op day with my daughter, I received a phone call. It was one of the doctors from my dermatology team calling just before their office was to open. 

There’s a jolt that hits when a doctor tell you that not only do you have cancer but that it’s a rare and aggressive form of cancer. It suddenly is no longer just a pathology report, but it becomes real.

My heart pounded and I felt lightheaded listening to the her explain the necessity of immediate action. This doctor had been in my earlier appointment with my regular doctor (they work in pairs) but I didn't know her as well and her directness was abrupt.

 Even though I had read the results the night before, I was still shocked.

I cried.

I called my husband.

Then pulled myself together and took my daughter to her co-op classes.

I was still reeling in the shock of everything and called the office back to speak with my regular dermatologist because I needed to hear her thoughts and ask the questions that were running through my mind after that first call. While I tried to write with little success in a parent work classroom, my husband left work and came to be with me at co-op. (Yes, I am a lucky girl).

A few minutes after he arrived, my dermatologist called and we talked for a good while. She reassured me that hearing the news was difficult and it was okay to be scared and upset. She understood the weight of the diagnosis and talked me through what everything meant. Melanoma is one of the fastest moving cancers and the primary treatment is surgery and secondary immune therapy. My cancer wouldn’t be officially staged until after surgery, but they estimated within Stage 2. While melanoma accounts for only 5% of all skin cancers, my diagnosis of invasive malignant melanoma accounts for just 1% of all skin cancers.

She clarified that this form of melanoma is extremely aggressive and has the ability to travel to distinct organs within SIX WEEKS. And if it spread it would be be very hard to contain and treat.

Six weeks.

That's all the time it would take to move from an early stage to stage four. If I had rescheduled my appointment, it would have been too late. She said that if I had rescheduled, we would be in a very different situation and wouldn’t be having the same conversation.

The pathology report note that confused me the night before became clear as she continued explaining the process. The Hopkins oncology surgeons have four weeks to complete melanoma excision surgery and other necessary treatment from the date and time of the diagnosis. She said that my report was sent as urgent to the surgical team, and she believed I would be scheduled for surgery within two weeks and would not have to wait the entire four weeks. 

If you’ve ever experienced surgical centers, you know that they are packed with appointments. So she explained that the oncology team would meet to discuss any new cancer cases and triage them for placement. They would bump another lower risk dermatological patient and fill that spot with my surgery. I don’t have any idea who was rescheduled for me, but I pray for that person as well.

The Hopkins surgical team called me just two hours after I got off the phone with my doctor and scheduled me for surgery 12 days later. It was within the two-week period as my doctor had predicted.

 There was a plan and I was relieved that the remaining cancer would be removed as soon as possible. I will not go into the surgery other to say that it was hard. It was painful (the local anesthesia was not working), and I had excessive bleeding that led to issues with my heart arrythmia. It has been a difficult recovery. We are on week four post-surgery and my husband is still cleaning and changing my incision area twice a day. (Did I mention that I am a lucky girl?)

I am so grateful to have had the surgery when I did. Recovery has been rough, but I’ve had three c-sections so I’m not new to difficult recoveries or scars. Scars are symbols of survival and new life and I cherish them.

I met with my oncology surgeon on my two-week post-surgery check-up and suture removal, and she clarified that while the cancer had spread from the epidermis into the dermis, it did not appear to have left the dermis before the excision surgery. There was a clear margin. It was not only good news, but wonderful news. If we had waited another week or two, that likely would not have been the case. And while there is the possibility that lone cancer cells migrated undetected, the risk is low.

My treatment is not over. I will have follow-ups every three months for biopsies, skin checks, and lymph node checks, for the rest of my life. The first year with no new cancer spread is the biggest indicator of successful surgery. Then after three years cancer free, the outlook for the original melanoma is very positive. There is a high probability of melanoma returning, but as long as it’s caught early, we should be able to stop it.

For someone like me, who has always looked forward to growing old, it was hard to consider that it might not be the case. That a couple weeks could have made such a difference in my diagnosis. And I thought about my life in that context.

I know - looking forward to being old is an odd thing to say as so many people dread aging and do everything they can to stop it. I always got the weirdest looks when I would say things like I was excited to get older. Yes, I understand that there are obstacles as you age, but there are obstacles at any age. I’m more joyful with each passing year than I was the year before. If you've been around for a while or you're one of my past students, you know that I often talk about natural, graceful aging and the beauty that comes with aging. I've taught about the Blue Zones and what a blessing aging is for years, and it’s my absolute favorite thing to teach with my biology students.

I recently finished teaching about the Blue Zones and natural aging with my students at the university this past week and this experience gave me a deeper perspective this semester than I previously held. I shared a story and a philosophy with them that has stuck with me since high school. This idea has meant so much to me that I actually broke up with a guy in college because he had a bad attitude about getting older. I knew that was not the kind of person I wanted to spend the rest of my life with.

In high school we had a history teacher that I adored, and I was blessed to have had the chance to teach with her in later years as well. Her and her husband worked together at the school, and she would always tell us to marry someone you want to grow old with, sitting on front porch rocking chairs. I called it A Rocking Chair Love :)

I did just that when I married my husband, Bill. One of the first things I bought after our marriage almost twenty years ago, were two rocking chairs for the front porch of our first home. My mom would joke that we were like old people and I would say, “I hope so.” We still have two rocking chairs on our deck now. They don't just look pretty. They are a reminder of the beauty of growing old together in those rocking chairs.

The weight of this cancer diagnosis and everything that came with it has been heavy, making it difficult to breath at times, but those rocking chairs are still there rocking back-and-forth despite or maybe because of the challenges and obstacles that arise.

Because in the end, God is GOOD. Life is GOOD. And while our life on earth is a gift to be cherished each day, our ultimate home is Heaven.

I have never been more full of joy and peace than right now. I don’t wish for days past - I never have. I love watching God at work in our lives and dream about the days to come.

And I hope you do too.

Love & Blessings,

Colleen Marie