April and May are by far the best months of 2014 for me as I get a break from dealing with melanoma. My scars have healed well, I got my prognosis, it's a shock to the system but I am gradually coming to terms with it. Now I just need to get on with my life.
I have a surveillance plan in place, in line with the UK protocol for malignant melanoma patients. I will see the dermatologist every 3 months for 3 years, then every 6 months for the rest of my life. As I had one mm I now have an increased risk of developing another mm in the future. There is of course also the much scarier scenario of future spreading of the cancer to the lymph nodes and internal organs. This can happen as microscopic cells may have 'escaped' from the primary cancer on the skin before the mm was cut off and can travel to other parts of the body (through the lymphatic system or the bloodstream). So one thing I need to do going forward is to regularly self-check my lymph nodes for any swelling, especially in the neck and armpit areas (where we have many of these glands) as given the location of my primary tumour, this is where it would more likely spread first. It would be the beginning of June when I noticed a swollen gland in my neck, and my fight with melanoma would continue. But until then I enjoyed my 'melanoma break'.
One word on lymph nodes, if I may, as they have become such an important part of my body for me to be aware of, such a common word I use in my daily conversations (and not just the ones I have with myself!), such an important aspect of my life, and yet I must confess that I lived 37 years in blissful medical and anatomical ignorance of the fact that we have such wonderful glands in our body.
The lymph nodes are glands situated all over the body and are connected by a network of lymphatic vessels. They form part of the lymphatic system which is one of the body's natural defences against infection. Cancer can develop in the lymph nodes in two ways. It can start there as a primary cancer, the cancer that starts in the lymph nodes is called lymphoma. Or it can spread into the lymph nodes from a primary cancer elsewhere in the body, this is known as secondary or metastatic cancer. In this latter case the cancer cells which are found in the lymph nodes will be the same type of cancer cells as the primary tumour. For example if melanoma spreads from the skin to the lymph nodes it will be melanoma cancer in the lymph nodes, this is important and different types of cancer are treated differently.
The most common sign of cancer cells in the lymph nodes is that one or more of the lymph nodes become enlarged. However, if there are only a small number of cancer cells in the lymph nodes, they may feel normal. A CT (computerised tomography) scan or MRI (magnetic resonance imaging) scan will enable to make a diagnosis of secondary cancer in the lymph nodes. CT and MRI scan should be performed when there is risk of spreading of cancer to the lymph nodes. Very often when a primary cancer is removed through surgery, the surgeon will also remove some of the nearby lymph nodes. It's important to know whether a primary cancer has spread to any nearby lymph nodes, as it helps assess the risk of the cancer coming back and whether further treatment is necessary.
So there I am, in April 2014 (having learnt quite a bit about lymph nodes) but feeling very positive and happy. I appreciate being 'wound free' and healthy, I carry the scar on my back from the wide local excision as a sign of strength to overcome difficulties. I exercise a lot, I go to my Salsa classes, I travel to Italy, I spend time with the amazing people I am lucky enough to have in my life. I also finish my training and qualify as a Personal Trainer, and whilst for the time being I don't look for a career chance (as, remember, I still have my job in insurance) I am loving being able to apply what I have learn to my own fitness regime and I feel great within myself.
At the time of writing, in October 2014, after having faced much harder battles against melanoma during the summer months, I feel mentally as well as physically exhausted and I so hope I can soon experience a similarly happy period to the one I had in April-May to enjoy. Another melanoma break. Funny how I am not even thinking anymore about life before melanoma. That will never come back, I know this much. I know that I will never be as carefree and light-hearted as I used to be. The dark shade of cancer will always be cast in my way, it will follow my steps, sometimes more silently, sometimes more overwhelmingly. But I am nonetheless longing for a time when I feel again physically powerful and mentally strong and confident that I can win not only the next battles but this whole war against melanoma.
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