That Little Spot On My Arm

I noticed the spot on the back of my arm just above the elbow 2 or 3 months ago. A little smaller than the end of a pencil eraser and in a spot I was pretty sure I didn’t have a mole before. Black and blue and the edges a little ragged. I must have thousands of moles but none like this one.

The funny part, if anything about this could be funny, is my wife drew maybe 20 circles on my back and legs for the dermatologist to examine. No circle for my little spot!

Off to the dermatologist and he agreed my "spot" was of concern. Some local anesthetic, a scalpel cut, and my little spot off was for a biopsy.

Some bad news

Two weeks later when the call came, I could guess the bad outcome because my dermatologist, and not one of his nurses, was on the line.

Malignant Melanoma. Melanoma is the most serious type of skin cancer. It develops in melanocytes, the cells that produce melanin. Melanin is the pigment that gives your skin its color.¹

My diagnosis was confirmed by tests at 2 different labs. The good news and bad news: The melanoma is very thin but my skin is even thinner and the melanoma is already below the thickness of my skin.

Parkinson’s and cancer

People with Parkinson’s disease (PD) are less likely to develop most cancers than the general population with at least one glaring exception. People with Parkinson’s have a higher risk of developing melanoma than the general population.²

Conversely patients with melanoma are at higher risk than the general population of developing Parkinson’s. PD and cancer are 2 opposite diseases, one arising from cell proliferation and the other from cell degeneration.²

In the case of melanoma, the diseases are positively linked. Until recently, levodopa was thought to be the connection. A more recent study has concentrated on genetic links.^2,3

Worried out about my diagnosis

While I knew my little spot wasn’t good news, the actual diagnosis has freaked me out. Not unusual, I’m sure. A number of unhelpful thoughts have come crashing in.

One that almost every person with cancer feels is "I want this cut out of my body right now!' "Shoulda, woulda, coulda" thoughts storm your brain. "How could this tiny thing be life threatening?"  Shock, denial, anger, guilt.

Surgical removal

Melanoma, when diagnosed early and found to be localized, now has a very high cure rate. The main treatment for localized melanoma is surgical removal, or excision, of the primary melanoma on the skin.

If the growth is not localized, treatment and survivability become much more complicated with lymph node surgery, radiation, chemotherapy, and immunotherapy among the treatment choices.⁴

For my case, the next step is Moh surgery. The Mayo Clinic defines Moh's Surgery as a precise surgical technique treat skin cancer. During the surgery, "thin layers of cancer-containing skin are progressively removed and examined until only cancer-free tissue remains."⁵

Depending on the establishment of a clear boundary, surgery to examine adjacent lymph nodes for any metastatic melanoma cells present is potentially in the cards.

Routine checklist

Here are 3 "To Do" items for people with Parkinson’s: