Hi,

I'm sorry you are going through this anxious time, especially having 3 moles that need to be biopsied.

I'm a little confused about the first one that led you to seek GP attention. You say that in July you noticed that the existing mole had changed colour and was no longer flat but was dome shaped. You then saw a dermatologist a few weeks later and they agreed to a punch biopsy but weren't overly concerned about that particular mole. You are now worried that they may not have thought about nodular melanoma? In my experience of dermatologists, and I've known many over the years, if the mole looked like you say, they would definitely have considered nodular melanoma - it would not have escaped their attention. Now, that is not to say that there isn't a very small chance it could be nodular but how it presented to them gave them no reason to believe it was. 

Unfortunately the only fool proof way to tell if a dodgy mole is malignant is a biopsy - melanoma is very sneaky! The fact that you have a punch biopsy booked for next week is good and I doubt you could get it brought forward any quicker if you raised your fears before then. I would certainly voice your fears to the surgeon though, in case they can calm them. 

If any of the moles are malignant the next step would be further surgery - a Wide Local Excision (WLE) where an extra margin of tissue is removed to ensure any stray cancer cell is mopped up. If the melanoma was more than 1mm in depth, you would also be offered a Sentinel Lymph Node Biopsy (SLNB). This is done at the same time as the WLE - dye is injected at the site of the melanoma and is tracked to the nearest lymph nodes. These are then removed for biopsy to see if any melanoma cells have spread to the nodes. This procedure is optional - some patients decide to have regular ultrasounds of the lymph node areas instead. 

Good luck with next week's punch biopsies and for clear results. Please let us know how you get on.I

Angie (Stage 3 melanoma patient since 2009)

Hi Angie,

I’ve seen a lot of your replies on other posts and they’re all very good advice and reassurance regarding melanoma and pre diagnosis. 

The flat mole I had was pigmented on one side (2 little dark ‘spots’) which alerted me to keep an eye on it (never had noticed it before June) after my holiday I had a little itch on my shoulder and realised a lump (the mole doesn’t itch), the then the flat mole was no longer flat. When I seen my GP, her concern was that it had dark pigments in, I couldn’t see the pigments any more due to the raised dome. When I seen the dermatologist she didn’t see this and didn’t think the mole was concerning. She did acknowledge my worry of how it had suddenly changed, however, didn’t seem it needed removing unless I wanted it. When I opted for removal she warned me of scarring but at this point that didn’t worry me as much as having it seen to. I know they have seen many lesions in their time and I do hope that they’d know if it looks like nodular melanoma, I just google too much and a lot of opinions of this specific type is that it’s rare and largely dismissed as “normal” :/ (as it doesn’t fit typical ABCDE).

Aside from my worry, I’m glad 1/3 has gone, and the other 2/3 will follow on Tuesday. I can only hope for good results. I’ve never been a sun lover, and used a sunbed twice in my life (as a teen!) however, I do realise that it’s not always sun related and it’s unfortunately also luck of the draw! 

I hope you’re keeping well, your stories and replies keep me sane!

Thank you :)

Sorry, I forgot to be clear on the colour change. The flat blemish was almost the same colour as my skin, with some dark pigments on one side. When it turned to a dome it was a pearly skin coloured mole (could no longer see the dark pigments due to this) since I seen the GP and derm it had turned to a darker tan colour. I failed to show this to the dermatologist last week as I had gone in there thinking the mole they were removing was a punch biopsy... until they said it'll be a excision. I'm a very anxious person and totally scared of pain and procedures! So I was a shaking mess in there and forgot to ask her to take another look at the "dome" one!! 

You've hit the nail on the head about Google. It's not up to date, it fuels worry especially as a dodgy looking mole can turn out to be innocent whilst a mole that's not dodgy looking can be malignant. So comparing Google images against your mole is only going to fuel anxiety.

The thing to focus on, which you are doing, is that they will all have been removed in 2 days time. Then get through the long wait for results by keeping busy and being kind to yourself. Hopefully the results will be clear but if not, don't panic. Melanoma treatment is progressing all the time and is showing very promising results so it's not as desperate as you think. xx