Melanoma: Prevention, Detection, and Treatment (cont.)
When we will re-excise, when we go back and take a very narrow border around an abnormal mole, is when the pathologist tells us two things; one, there is architectural abnormality, and cytological atypia that is severe. So I'm not quite sure what this pathology note means because it only talks about the architecture and doesn't talk about the bricks, whether or not the cells are severely atypical. It would be that that would make us do a narrow re-excision.
So what your daughter is not supposed to have is a cancer operation because she did not have a malignancy. You might consider getting the pathology reviewed by an expert in melanoma and funny moles.
A tan actually does protect the top layers of the skins from further sun damage, so mild to moderate sun exposure so that at end of the summer you've got some tan, probably means you're a white person who lives on a sunny planet, and does not mean that you've done something stupid. So, being moderate about sun exposure, staying out of the sun between 10 a.m. and 4 p.m., wearing a broad brimmed hat and using a sunblock with a high SPF when you're going to be out in the sun for some time, is prudent.
Living in the basement so you never see a ray of sun isn't good for you, so a little bit of sun exposure is, in fact, just fine.
You only have two relatives with melanoma which is compelling from a human perspective but no so compelling from a genetic perspective. Take care of your skin -- don't get sunburned, see a dermatologist and tell him about your family history, get a thorough skin examination, talk about having photographs of the skin which you get a copy of to help you with self-examination and go from there. You should protect your children from getting sunburned and you should tell your brothers and sisters that they should be screened by a dermatologist to have their skin looked at top to bottom.
There's a test for a gene that explains susceptibility to melanoma. I don't think it's worth it, because if you find you have the gene you would do what I just told you; if you find out you don't have the gene you would do what I just told you. It isn't going to change how you manage yourself.
It's still best to make the diagnosis with a biopsy and get all the melanoma out with surgery. For the present, my advice is to stay tuned.
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