I spent a little time considering whether or not to be open about this, and create a Blog.  It’s been a worrying couple of months and certainly puts life into perspective.  It’s important to help raise a little awareness, even if in my case it’s just amongst friends and peers.

On 20 Sept I was diagnosed with a melanoma (skin cancer) on my left forearm.  It was certainly a shock at the time although Yve and I were prepared for this news.  You could say I was lucky, in that it was caught relatively early thanks to a nudge from Yve.

Here’s a little information on Melanoma, taken from MacMillan Cancer Support.  Please read this!

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Melanoma is a cancer which usually starts in the skin, either in a mole or in normal-looking skin.  The number of people who develop melanoma is continuing to rise.  More than 10,600 people in the UK are diagnosed with melanoma each year. 
 
Melanoma develops from melanocytes, which start to grow and divide more quickly than usual and start to spread into the surrounding layers of skin.  When they grow out of control they usually look like a dark spot or mole on your skin.  Finding and treating melanoma early is very important.  If a melanoma is not removed the cells can grow down deeper into the layers of the skin.  These layers contain tiny blood vessels and lymph channels.  Lymph channels are tiny tubes which carry lymph fluid and connect to lymph nodes (sometimes called glands) through the body.  This is part of our immune system, which helps to fight against infection.  If the melanoma cells go into the blood vessels or lymph channels they can travel to other parts of the body.
 
The main risk factor for melanoma is exposure to ultra violet (UV) light, through natural sunlight or artificially from sunbeds or lamps.  UV light damages the DNA in our skin cells and can cause skin cancers like melanoma.  People with fair skin, red or fair hair, blue eyes, and freckles are more sensitive to the sun.  They burn more easily and are more at risk of getting melanoma.  People who have a lot of moles….family history of melanoma….
 
About half of melanomas start with a change in normal looking skin.  This usually looks like a dark area or an abnormal new mole.  The other half develop from a mole or freckle that you already have.

Signs and symptoms and other information can be found here
 

How did it happen, and the Process
 
I’m unsure when my melanoma actually began.  I’ve always had a normal looking mole on my left forearm, nothing significant.  At some point in the last two years a second mole of the same colour started to develop next to it.  I didn’t think anything of it at the time.  You can see the mole(x2?) on my Facebook picture which was taken after a race in June 2011.  It wasn’t until the end of 2011 that the new mole started to change colour, at first to a darker brown.  At some point during spring 2012 it went black, and then began to rise above the surface a little by July.

It wasn’t until this point that Yve started to get a little concerned, having been a bit more educated on the subject.  If she had not been around then who knows how long I would have left it before seeing a GP.  I must admit it didn’t look right, so I made an appointment.  The GP referred me to a Dermatologist at Kingston Hospital on 22 Aug.  He said it was abnormal and that a biopsy would be required to rule out any malignant growth.

The biopsy, or ‘local incision’ would take place at the Surgery Unit (Kingston Hospital) and involve cutting a piece of flesh around the mole to be sent for analysis.  This took place on 31 Aug.  Despite being quite sore for a few days and managing stitches I was able to get back into some exercising and racing within 10 days (see previous Blog).

The next three weeks were the toughest.  Yve and I started looking at websites (this doesn’t help!), checking out pictures of similar looking moles/melanomas, and then checking out mortality statistics.  I won’t go into this because although the odds are very much in my favour, it’s not something you want to think about.   I was still holding out for it not to be cancerous, and if it was that it was in early stages.  Yve was a lot more concerned than me.  I told her I’d seen it grow 1-2 years previous and she thought we’d caught it too late.  She started hearing stories from her work colleagues of friends who had died including a young Personal Trainer in Australia who left it for 2 years, and died.  Simple as that.  It got into his lymph channels and they were too late.

At the 20 Sep meeting with the Dermatologist I was given the bad news.  It was a 0.57mm Breslow (depth from skin surface), Type 1a.  The good news was that it was caught early.  Anything deeper than the epidermis (1mm) goes from Type 2-4.  Obviously the deeper it goes into the dermis (1-4mm), the greater the risks of the cancer latching on to blood vessels and getting into lymph nodes.  I was told the cancer was effectively out, but because of a remote possibility of spreading they needed to perform another local ‘1cm wider excision’.  This would involve cutting at least 1cm around the current scar.  I was then passed on to a Macmillan (Specialist) Nurse, who was effectively my Counsellor and first contact for further information.  I have to say she has been fantastic, very friendly and informative.

The original date for the wider excision was 25 Oct, but they managed to find a slot a little earlier, on 10 Oct.  However, due to an “administrative error” they accidentally put me down for a leg skin graft at the same time.  It sounded like the end of training and racing for the rest of the year, but thankfully the Macmillan Nurse sorted it out.

The second cut was far more uncomfortable than the first.  I had to wait for two hours, and then when the excision finally took place I was given about four local injections, but could still feel the skin being pulled hard and stitched-up.  The arm bled during the evening, but I did not experience as much pain as I was expecting.  It has now been five days since the excision and I’m able to use the arm, although I get pains when putting on clothing  or anything else that requires extended and/or twisting the arm.  At least the worst is out of the way.

As mentioned in the Macmillan information, I have always been high risk since I have light skin and hair and have burned a fair bit in my life.  My outdoor training has not helped.  Part of this is down to my own negligence.  I have used 8-20 factor creams generally, except for when I race abroad when I’ve used 40-50 factor.  I’ve always been happy to burn a little on the first few days of a holiday abroad.

I never expected to get skin cancer.  Despite being high risk it’s still relative, and the chances of getting a skin cancer are very low.  I was unlucky.  But it has to happen to someone.  And I encourage everyone to keep an eye on their skin and do a check-up of moles.  If something doesn’t look right then see your GP.

Click here for a list of what you should be looking for

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Looking forward

I have to return for a skin and lymph node check-up every 3 months for 5 years.  There is a small chance (1/10 from some sources) that I will develop another melanoma in the next 5 years, so I have to be on the case when it comes to high factor creams, and how I train and race.  I will not be sunbathing anymore(!), but I won’t let the risk factor affect my life.  As far as I’m concerned it’s come and gone and I now have to take a few more precautions!

The Caesars Camp 50mile Ultra takes place on 20 Oct.  I was very much looking to this event.  It’s right up my street – technical xc running over (10 mile) laps.  There is a 100mile event taking place at the same time.  I won the 100 last year, passing halfway in 7hr59min.  The record for the 50mile event is 8hr10min, so I know I can beat the record.  The question is of course who else might turn up on the day.  Have a wound check and re-dressing on 17 Oct, and then will carry out run and resistance (to see if the left arm can take my weight) tests to make sure it’s safe to race, optimally.  There are two downhill trenches of note and two stiles on each lap.  It will also probably be muddy, so I need to make sure I can handle a slip or trip.
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