There are two definitions for the word perimeter that I’ve heard frequently in the last year. The first and most obvious, a basketball term, is a description of the space beyond the foul circle. It’s a place where the game’s most talented shooters, when left unguarded, are the most lethal.
The other — the jagged circumference of a mole. Another place, albeit much smaller, when left unchecked that is also deadly.
During a routine skin check last year, my dermatologist stumbled upon a spot on my upper right bicep. It was roughly the size of a pencil eraser and looked normal enough, but somehow gave her pause. She took a scrape of the spot with a razor blade, sent it to a lab for a biopsy and assured me she didn’t think it’d require any further attention.
A few days later, I got a call from the dermatologist’s office. She was wrong. The biopsy came back as “severely dysplastic,” meaning that the mole was on the verge of becoming melanoma (though dermatologists tend to disagree about this — some consider it Stage 0 melanoma).
“You need to come back,” the receptionist said. “And you need to do it soon.”
I’d been through this before, having had a moderately dysplastic mole excised from my upper back a few years prior. I got the sense from the tone of her voice on the phone call, though, that this time would be different. There was more urgency.
The mole with its now-dangerous perimeter had to go.
About a week later, I took the morning off of work and settled into what looked like a dentist’s chair and waited.
After getting prodded about 12 times with a local anesthetic in a large needle (hey, they had to get through these massive biceps of mine somehow!), I had to wait again — this time for about 30 minutes for the anesthetic to spread.
There was nothing to do but watch as patches of my upper arm became white as the drug seeped in and took hold. The necessary needles, cautery tools and bandages sat on a rolling tray right at eye level — enough to cause a full-blown panic attack for the needle-averse (which, thankfully, I am not).
Finally, the doctor returned and thus began a 45-minute process of cutting my skin down to the subcutaneous fat layer and removing the abnormal tissue. How do I know that’s what he was doing? Because I could see him carving away in my peripheral vision. Again, not for the faint of heart.
Cut. Cauterize. Cut. Cauterize. Cut. Cauterize. The process felt like it took four hours. I felt no pain but I could feel the cold tugging of scalpel across skin. Smelling the burning of my own flesh was equally as unpleasant.
Some time later, I got sewed up like a broken doll with two rows of four stitches — one row buried underneath another on top.
The doctor packed my forearm full of bandages to cushion between the sutures and the giant bandage he applied before circling my upper arm with an Ace bandage.
I left with some ibuprofen, strict instructions to stay out of the sun and to apply Neosporin frequently. My arm throbbed for two days.
All that, I thought, for a little 3 cm cluster of pigmented cells.
Ten days later I returned to have the stitches removed. In its place, I sported a raised four-inch-long diagonal slash. What should have felt like a win — I’d gotten out ahead of something that kills nearly 1/7th of the 70,000 people it affects each year — felt more like a weight.
Fortunately, mine is more of a cautionary tale, at least for now, though the large scars across my back and upper right seem to indicate more of a fight than was necessary.
The weight came from knowing that I’ll have to return every year and hope that the sunscreen I’ve begun to use recently will ward off any future surgeries. It came from knowing that, more than likely, the damage is already done.
According to SkinCancer.com, the average person’s risk of developing melanoma doubles if he or she has had five sunburns in a lifetime, and increases your lifetime risk by 80 percent if those sunburns occur as a kid.
I’ve had summers — thank you, travel softball — where I’ve gotten five sunburns in a month. Blistering, lobster red sunburns. I used tanning beds frequently in high school to be tan for prom season or softball season or because it’s-the-dead-of-winter-and-this-feels-great-right-now season. I can’t change that now, and that’s what frustrates me most.
It could have been worse. But it could always be worse, too, and that’s what I worry about every time I schedule a yearly appointment.
I’m telling this story not to lecture, but because none of the warnings I read felt real until I lived it. Now those two scars remind me that I live it every single day. You might not have to. Go get a skin check. It’s 10 minutes that may save you 10 years.