Hi,

I'm not a nurse but I've been a melanoma patient for many years so, while you are waiting for the nurse to answer your post, I hope you don't mind if I try and answer your questions from a patient's perspective.

I know it's a stressful time but firstly, try to put your diagnosis into perspective in that it's been caught the earliest you could catch a melanoma. Lentigo maligna is where the cells have started to change but it's been contained in the upper layer of skin, the epidermis. It is sometimes referred to as an In Situ melanoma in that it hasn't invaded the dermis. This means it couldn't have spread before it was removed so you should have no further problem from it. The Wide Local Excision they will do is just a belt and braces procedure to ensure a cell hadn't already broken away & is sitting in the surrounding tissue. Although the thought of a larger wound on your face is scary, it really is important to have it done. The Plastic surgeons that deal with facial surgery are top notch and most scars fade and are hardly visible within a year.

Please don't think about giving up work. Everyone at some stage has to take time off work for serious health issues, it doesn't mean you are making a fuss. Keeping to a normal schedule whilst waiting for the surgery is actually good for your stress as it distracts you. Just tell your boss or HR, if your employer as a HR department, that you are having this surgery, you don't know yet how long you will need sick leave to recover but that you will keep them updated. As a cancer patient you are covered under the Disability Act so your employer has to flexible & helpful about your needs, especially when you return to work (you can find more information on this CRUK website & the Macmillan website).

Regarding your other moles checking - ask at your next hospital appointment if they can do a quick check. After that (especially when you are discharged) you can either pay privately for a Mole Mapping Clinic in your area or invest in a melanoma detection app such as Skin Vision so you can monitor your moles every month. If you then find another suspicious mole go back to your GP for referral. If you find another suspicious mole whilst still under the hospital, ring them for an earlier check up appointment.

I don't have any knowledge about natural sun screen but most melanoma patients (including myself) use Altruist which was created by a UK dermatologist. It can be found online, in at least one supermarket and at least one well known high street chemist. I have used it for the last few years & I find it's easily absorbed & I've never even changed colour, let alone burned.

Vitamin D is important to melanoma patients. NICE guidelines state that all newly diagnosed melanoma patients must have their Vitamin D level tested, so either the hospital or your GP need to do a blood test. If you've recently had a blood test, ask them for your Vitamin D result. Non melanoma patients need an optimal level of 50 for their health whilst melanoma patients need between 80 - 100. This is because we don't get enough sun & diet alone can't raise it to that level so we need supplements. Research is also being undertaken to see if a higher Vit D level helps to guard against a recurrence of melanoma. Patients shouldn't take supplements without knowing their level as having too much Vit D can have as many serious health issues as having a low, deficient level. When you get your results, if your level is below 20 - 30 your GP should prescribe you a short term, high dose supplement & then test you again after that. If your level has then raised or it was above 30 at the first blood test, you will then be advised to use over the counter supplements that you will need for life. As an example, if your first test was like mine, 42, I was told to take a Vit D daily dose of 400iu supplement. When tested again 2 years later it had only raised to 65 so I was advised to higher the dose to 1000iu which has kept my level around the 85 mark. I use an oral spray as it absorbs into the body better. 

I hope this helps. If you want to chat or ask about anything else you can also send me a friend request & I'm happy to chat by private message. Good luck & I'm sure you'll be fine,

Angie (Stage 3 melanoma patient since 2009)

You are very welcome and all the best x

Hello, and thank you for your post.

I am sorry that you are waiting to have further surgery. I can imagine this is a worrying time for you.

As Angie T has mentioned, cancer does come under the disability act. This means you cannot be treated less favourably than people who do not have cancer because you have cancer. Macmillan Cancer Support has further information on the website.

We cannot recommend a specific sun cream, but you may find our information on skin care after melanoma useful.

It might also be worth having a chat with your GP about your concerns about getting your moles checked, as they may be able to advise you further or also have recommendations on when you can go to get mole mapping.

If you do have any moles you are concerned about, then it's always best to be safe and get checked by your GP. Please feel free to get back to us if you have any further questions or if you would like to speak with one of our nurses on the helpline. We are available between 9 am and 5 pm, Monday to Friday.

Take care,

Jemma