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melanoma - severe atypia?

Posts: 11
Joined: Jul 2009

My dad is currently fighting stage iv melanoma (his 3rd melanoma diagnosis). There's a strong familial occurrence for melanoma for my relatives under 40. All my life I've been educated about melanoma and seeing dermatologists regularly.

I just had two moles removed with pathology reports as "moderate atypia" and "severe atypia," and my dr had me come back to have 5 mm margins removed. This is the first time I've gotten such specific "staging" from pathology and had margins removed.

My dr explained severe atypia as "resembling melanoma" but "not cancer." Can anyone give me a little more practical information about this? Do moles go through a process of cellular change from mild to moderate to severe atypia and then progress to melanoma if untreated? Or is "severe atypia" a judgment call by a pathologist that could be interpreted by another pathologist as cancer?

I guess having severely atypical moles means I have a much greater chance of having melanoma. I just wonder if anyone here has personal or practical experience with these terms. I've been waiting my whole life for melanoma, and now I'm watching my dad die from it. Here I am with two fresh 2-inch long scars on my arm. I hate this.

yalleh's picture
Posts: 36
Joined: Jul 2009

Dear rwagner, I wish I could help but I think you may need to go to a Dr / medical or Oncologist forum and ask an expert (our limited knowledge may only make things worse if we tell you something incorrect).

Now then... I hope I can help with the rest... and I know this is hard... but stop waiting for Melanoma! Its like a dear stuck watching the headlights eventually you will get hit. Hopefully by now you know what it takes to protect yourself and if you follow that advice you will have done everything you can to prevent it. I guess what I'm saying is control your life dont let the thought of Melanoma control your life!

As far as the scars go ... always turn something like this into a positive. I for instance have dozen of these cut off of me (including an 8 inch scar on my back from my original operation to get rid of the cancer). I said all these small holes from mole removal look like bullet holes... my friend said I should become a rapper... I said that I cant sing.. he replied that it doesnt matter I just need to tell people I have been shot. It made me laugh and that (FOR ME) is the secret to life.

Posts: 11
Joined: Jul 2009

i have at least a dozen scars from bullet holes to these new ones. I think the lies about how i got them are a lot more fun than the truth, so i'll work on some new stories!

it's hard to not live in fear of this. my dad had his first melanoma when he was exactly my age in exactly the same place as my most recent biopsy. but i'm pretty inspired by what you have written here and throughout the message boards, and i have a lot of respect for what you have to say.

i'm very grateful for your wise words, and i'll try not to look too far into the future. it's all an illusion anyway. no one is guaranteed tomorrow, so let's make the best of today.

peace to you,

Posts: 2
Joined: Apr 2005

Hi RWagner,

I can really understand your confusion! Even tho I have worked in Dermatology for many years, my Mom just got a diagnosis that is similar to what your relative has. First off, I asked for the Pathology report. It stated that it was "consistent with melanoma." To me, that is basically saying that you have melanoma, or given time, it will become melanoma. You may be thinking, "Well, how long would that time period be?" That is something we don't usually know, occasionally an aggressive skin cancer can be diagnosed, but not always.

My Mom is having the area cut out surgically, and I am trying very hard to prepare her for the ugly scar that will result. And, in about a week, I will be visiting my Dermatologist for a full body check, and what I need to remember for myself, and to educate my kids. We live in So. California, and you can't tell someone to stay indoors. I know that my Dr LOVES sunscreen with zinc oxide, and has counseled me to purchase some clothes from sun precautions, as I am fair, and have other risk factors.(the sunscreen is Solbar w/ zinc oxide) As someone who has assisted in thousands of skin cancer surgeries, that has has a HUGE impact on me regarding the need to apply suncreen, find shade, and just be careful in the sun.

Please know that you aren't alone here, and although I have worked many years in Dermatology, it is downright frighening dealing with my Mom's diagnosis with melanoma. She just got over wtih breast cancer and radiation, and now this.....but you just have to deal with what comes your way. It is definitely stressful and scary tho.

All the Best,


Posts: 11
Joined: Jul 2009

I really appreciate your comment. It's terrifying to see "resembles melanoma" on the pathology report! So is it, or is it NOT melanoma? Anyway, the margins came back clear on these two (whew!. Now I know I really have to keep on my toes to stay in the game.

I'm wishing for the best for your mom. She must be one tough lady. I wish I knew why so many good people have to fight such hard battles.

And hopefully my scars will be a warning to people who don't understand the risks of tanning and skipping the sunscreen!

Take care,

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