The "why not" decision which could have saved my life
The Head of Brand at Bupa is counting his lucky stars, after a free work skin check uncovered a hidden ticking time bomb.
Warning: this post contains potentially confronting medical images.
Lachlan Hayman had never paid any attention to a small mole on his right leg. While he was well aware of the dangers of skin cancers, this particular spot never struck him as unusual, concerning, or even particularly interesting.
“I’ve got pretty fair skin and I am covered in moles. It looks like I’ve bathed in ‘Coco Pops’,” he says with a smile.
“I found it hard to keep track of which moles were changing, which ones were new, which ones were old. It’s just so hard to know, because there are so many,” Lachlan said.
But late last year his employer, Bupa, offered free skin checks for staff at Melbourne’s Exhibition Street building. Lach had been intending to get a proper skin check, so when he saw the program, he put his hand up.
“It was a free and easy thing, so I just thought, why not?”
It was a decision that could have saved his life.
“It’s a weird feeling looking back now and thinking: what could have happened if I waited until next year?”
Lach was given a full body scan by dermatoscopist Emma Mordu, who mapped his skin and looked at each mole under a microscope. She wasn’t worried about any of them, except one.
“Even to the eye, the lesion looked suspicious,” Emma says. “It was irregular in shape, had different colours within the lesion and was large compared to other lesions on his skin. Immediately it stood out to be what we call ‘an ugly duckling’. Once I used my dermatoscope, a piece of equipment that has high magnification, I could see in detail a number of suspicious features we are trained to identify.”
“She didn’t think it would be a melanoma, but wanted me to be referred to a dermatologist, just as a precaution,” Lachlan said.
Looking at the image now, it’s easy to see how it could have gone unnoticed. Brown, with a discolouration only visible under a microscope, and just slightly asymmetrical. But this seven-millimetre spot was, without doubt, a deadly melanoma. Lach’s GP referred him to a dermatologist, who decided to cut it out on the spot, and send if off for testing.
The tests came back positive, and Lach was diagnosed with a stage 1 melanoma.
Melanoma is the fourth most common cancer diagnosed in Australia. More than 12,500 Australians were diagnosed with new cases of melanoma in 2013, and in 2014, the disease took 1,467 Australian lives. The thing which makes the biggest difference when it comes to treating it is early detection. It’s estimated that 1 in 14 men and 1 in 24 women will be diagnosed with a melanoma before the age of 85.
“Melanoma can be very deadly,” Emma says. “Once they leave the top layer of the skin and move deeper into the lower layers of the skin, the dermis, they can enter the lymphatic system. If melanoma gets to this stage, it can spread to other sites and can also get into organs.”
With the diagnosis confirmed, Lach was sent back into hospital to have even more of the area around the mole cut out, in case any of the cancer had burrowed deeper into his leg.
What he thought would be a small procedure ended up being a little more confronting. Doctors had to cut out an oval shape measuring about 8cms long by 4cms wide, leaving a gaping hole. They then used a skin graft from his upper thigh to patch over the area.
“I was in hospital two weeks later, and I accidentally looked down just after they had removed these big metal clips. I wish I never had. It actually started hurting more when I realised what was there!” he laughs.
“It was like a Greg Norman divot in my leg!”
But the pain of the now-healing wound is nothing compared to what could have happened if Lach had never had his skin checked.
When it comes to skin cancer, prevention is key. But once a cancerous mole has developed, timing is everything.
Lach’s melanoma was caught early enough that doctors have hopefully been able to cut the whole thing out.
“I’m just so lucky and thankful that they had the skin checks at work, because it made it very simple to do,” he says
“I have a crater in my leg, but I’m just lucky that I’ve got my leg. I’ve been back in hospital 6 times since the first op. I’ve now been given the ‘all clear’ from that initial episode, but because of the sheer number of moles I have, I am now getting a mole map.”
A mole map is a photographical record of all the moles on someone’s body, helping to track any changes which may indicate a mole is dangerous. Lach will now have follow-up checks with his dermatologist every four months, and finally feels like he’s in control of the health of his skin.
“People have fitness plans, diet plans and savings plans, the great thing about a mole map is that now I have a skin plan. If anyone else has high risk skin, I can’t recommend getting a mole map enough.”
Melanoma Institute Australia (MIA) recommends people keep the ABCDE guidelines in mind, and get a skin check from a professional if you notice any of the following:
A – Asymmetry. One half of a mole or birthmark doesn’t match the other
B – Border irregularity. The edges are ragged, irregular, blurred or notched.
C – Colour. If you notice differing shades of black or brown, occasionally with patches of white, red or even blue.
D – Diameter. The area is wider than 6mm, or is growing.
E – Evolving. There are any changes in shape, size, elevation, colour, or anything else including bleeding, itching or crusting.
During a professional skin check, you may be checked for cancerous moles in places you’d never imagine. Specialists may scan your hair, between your toes, and under your arms, or under your fingernails just to name a few.
But above all else, don’t forget that prevention is key; stay safe out in the sun, and cover up.