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Malignant melanoma is one of the most dangerous neoplasms. Jadwiga, whose illness took her husband, learned about it painfully. On the other hand, Magda can talk about great happiness – she is slowly winning over cancer.
The end of September is always a difficult time for Jadzia. He doesn’t like raking his garden, smoking leaves, seeing mushrooms in the town square. She doesn’t even like the smell of plum jam, because she always associates it with that autumn. Eight years have passed and she still can’t handle her emotions. At least that’s what her psychiatrist told her.
Jadwiga went to her at the urging of her daughter. She had had enough of these reproaches on the phone, stamping her feet at each visit and instructions on what to do with her life, where to return Zygmunt’s belongings and how to empty wardrobes. After all, she knew very well about cleaning. She did it for several years and took a salary for it. She just didn’t want to empty the closets, and her daughter obviously didn’t understand. So she went to this psychiatrist for the sake of peace.
She made an appointment in another city so that people wouldn’t talk about what a crazy old woman she is. The doctor was probably even younger than her daughter, a nice, pretty girl. Of those who still know little about life. She treated Jadwiga like a child. She said that she should not bake her husband’s favorite cake every Sunday, cook two soups for dinner, including broth, which she hates, call a plumber to the broken faucet behind the house, and, above all, go to the cemetery. – Let your husband go, let him stop living in the past. It will be easier, healthier. We will work on it – she assured.
Only Jadzia didn’t want to work on anything. She nodded in respect for the doctor. She wasn’t sad or confused as she thought. She knew what she was doing. She was angry, even furious sometimes. How could Zygmunt do this to her? To leave her alone with a stupid spot on her back? Any mole he scratched after returning from vacation?
Detect as soon as possible
Malignant melanoma (Latin – melanoma malignum) is usually located on the skin. It occurs most often in middle-aged people. It is characterized by early metastases, e.g. to bones, lungs or brain, therefore quick diagnosis plays a very important role in its treatment. It is curable when detected early. This type of cancer arises from melanocytes (i.e., pigment cells that produce and contain melanin) and are transformed. Melanoma can therefore occur wherever there are melanocytes: on the mucous membranes (in the mouth, rectum), in the retina of the eye.
The risk factors include: frequent and long-term exposure to the sun, sunburn, burns before the age of 12 and complications after them, light skin complexion, genetic predisposition as well as constant irritation and injuries of dysplastic moles. Natural hormonal changes may also play a role. Melanoma was observed more frequently during puberty, pregnancy and puerperium. Therefore, slightly more women than men suffer from melanoma, but the course of the disease is usually more severe in men.
Cigarettes, stress and light strands
Magda has always been considered a pretty girl. Her intelligence and wisdom took a back seat. The tall, well-built blonde was immediately noticeable and made men turn their heads in the street. That’s why she looked for her first job with a woman. She wanted to prove that apart from beauty, she has something to say, she can formulate thoughts and is ambitious.
Fortunately, the editor of the internet portal knew people. Magda got a job, and after six months she was promoted – she edited almost all the texts on the Polonia website. She stayed at work until late, on weekends and on holidays. The authors sent her texts from all over the world, and she tried to correct them as soon as possible and put them on the website on the Internet. She worked at home, at breakfast and before going to bed. She was fast, efficient, better and better. Her co-workers liked her, her boss appreciated her with prizes. Magda felt that her life was beginning to prosper. And only for private matters, she had less and less time: for friends, family and looking for the love of her life.
She went on vacation with a laptop in hand and a few cartons of cigarettes. Sitting at the computer, she smoked more and more and ate less and less. I don’t have time, she explained when her mother asked her about meals. “Child, you don’t care about yourself at all,” she heard in return and she had to admit in her soul that her mother was right. Cup soups, cigarettes, coffee, short sleep, little entertainment and rest.
She rarely went to the hairdresser, she forgot about the beautician. I have neglected myself, I have to make up for the shortcomings, she promised herself. A beautician noticed a birthmark on her leg and instead of a massage she gave Magda a speech about the risk of complications. The next day, the girl was already sitting in the waiting room at the dermatologist’s. No stress, laptop on your lap. – Look at it, doctor – she said at the beginning – because I have to be at work right now. “You’re not going anywhere,” she heard the doctor’s serious tone. – At least not right away.
Look carefully!
Last November, a report was published at the 34th annual meeting of the American Society of Surgical Dermatology (ASDS) which found that most melanoma cases are undetectable in the early stages without detailed skin examination. Unfortunately, patients rarely pay attention to viewing existing moles and forming new ones. The author of the report, Jonathan Kantor, a dermatologist in Jacksonville, Florida, detected changes earlier in 68% of his patients than they did themselves. What is the conclusion of this? Watch your body closely and go to a dermatologist with any doubts. It’s not just about your psychological comfort, but about your life. Pay attention to:
• asymy of nevi – if one half differs from the other;
• uneven edges;
• color differentiation of birthmarks;
• its size and length – notice if it has increased or exceeded the level of the skin;
• itching, swelling, redness around the mole, or bleeding or oozing fluid;
• pain.
Holidays in Jurata
Jadzia was a loving and devoted woman. Her life was filled with family. She only accepted school cleaning because she was five minutes away from home. She could always drop by, heat dinner, take the clothes off the strings in the garden. When my daughter went to college and moved out of the house, Jadzia was swollen with pride. The child will cope with life, and they and Zygmunt will help her in this. For now, they will renovate the attic, then they will go on vacation to the seaside.
Zygmunt planned the trip much earlier. – We deserve a rest, my dear, we are beginning a second youth. The child flew out of the nest – he laughed when she protested that it was a waste of money for such expenses. However, Zygmunt was stubborn. – We will save on renovation, you know that I can do it myself – he argued. And indeed, when Jadzia came home from work, he was already cutting boards in the yard, sanding and painting. He looked younger than men his age with tanned hair, no shirt, and tousled hair. Always on the move, active, laughing. Jadzia felt that she was still in love with her first love.
She came back happy from Jurata. The weather was good for them, they spent all days on the beach. On July 16 in the morning she entered the bathroom and the first thing that caught her eye was Zygmunt’s back. The birthmark under the shoulder blade looked different. Big, dark, and swollen with blood. – Something’s bitten you, you scratched? She asked. In response, she got a disrespectful movement of her arms. “It’s nothing, it will hurt and it will stop,” she heard. – Or maybe it’s from the sun, I’m telling you enough to get some oil on your back. Zygmunt, however, never used women’s cosmetics. “It’s not for me,” he repeated. A week later, however, he allowed himself to be taken to a doctor. Jadzia entered the office with him.
He doesn’t remember much of that day. Everything was happening fast. The same day they went to Warsaw for a private visit to the oncologist. A dermatologist friend made it clear. – It could be cancer, there is nothing to wait for. You have to cut a birthmark, take a clipping. Every moment counts, it looks bad.
She gave them a phone number, they called from her office, they left. In three days, Zygmunt was already in the Cancer Center in Warsaw, waiting for an operation. Jadzia was happy then that they were so lucky that they managed to get to the hospital. The lines at the clinic terrified her more than the visit to the oncologist. “God, so many people are sick,” she repeated, because somewhere inside, she realized that THIS could also apply to her husband.
A clipping under a microscope
Each time there is a risk of melanoma, the doctor will cut the birthmark along with a margin of healthy skin. A section of diseased tissue is subjected to a histopathological examination, during which the nature of the tissue and the degree of malignancy are determined. Usually, the sample is taken without the need for hospitalization, under local anesthesia. In extreme cases, however, the doctor may keep the patient in the hospital for the skin to be cut.
If it turns out that the lesions are cancerous, the lymph nodes are examined and the stage of the melanoma is determined. The next stage is the excision of the surrounding lymph nodes. Chemotherapy and radiation therapy are not used routinely. However, in advanced lesions and metastases, treatment with cytostatics is used. After treatment, patients are subject to further observation for about 10 years. Survival largely depends on the severity of the disease.
To the hospital for a minute
Before Magda was hospitalized, she sat down on the internet. She must have read all the pages on melanoma, letters from sick people, internet diaries. In the bookstore, she bought books by Kofta and Durczok – people who won with cancer. She was looking for hope, she got doubts.
While waiting for the results of histopathological examinations, for two weeks she learned a foreign vocabulary. She wanted to know as much as possible, to understand what the doctors were talking about. She learned the scale of the assessment of malignancy of melanoma according to Clark (it is made depending on the type of cancer and the depth of skin infiltration – grade 1 is the mildest, grade 5 the most severe). She waited. In fear, alone. She didn’t tell anyone in her family or at work. She only excused herself by being tired and asked her boss for help. In fact, she couldn’t think of anything else. She was scared like never before. Diagnosis, death, pain, suffering of loved ones. She spread that fear down to its prime factors. Did not help.
She had moments of escape. She got up in the morning and instead of going to work, she wanted to go to the airport. Take the plane, go to the Australia she has always dreamed of, and then go what she wants. Common sense kept her in place. – Or maybe it was the will to fight – recalls Magda.
Her melanoma was rated 3 on the Clark scale. She had to undergo surgery, excision of lymph nodes, and several series of chemotherapy. She understood everything from the doctor’s words, perhaps because he was speaking simply and bluntly. Learning medical terminology was useless, because Magda even forgot her date of birth due to stress. Instead, she immediately trusted the doctor and clung to his words like a razor. She did as she was told, notified her boss at work, called her parents, made an appointment at a psychological clinic. She began to tame fear. She came to the hospital smiling, with a set of new, colorful pajamas and bathrobes. She felt as if she had dropped in by accident. After the operation to remove the knots, she will go home, work less, calmly wait for the results, and the psychologist will teach her how to deal with fear. “Everything will be fine,” she told herself. – The disease begins in the head and ends here.
Numbers and letters
Jadzia does not remember much from the doctors’ words. Anyway, so much time has passed. In her head, there were only some letters, numbers and the professor’s decision that Zygmunt would not be operated on, because there were already metastases to the bones and brain.
– We came home, waiting for death. Incredible. Nobody wanted to take care of us. How can that be? – says Jadzia and she is angry again. So they went to the Fathers of the Brothers for herbs, and then to a bioenergy therapist. Their daughter did not give up. She found an oncologist in Bydgoszcz, then in Gliwice. After another trip, Zygmunt said enough. He started to get tired of driving around Poland. He needed rest, Jadzin’s broth, sleep. – Tomorrow I will repair the tap, honey, today I will sleep – he said, and Jadzia saw how he was wasting away in his eyes.
After a month, they were back in the hospital. Zygmunt needed stronger painkillers, he stopped eating at all. Two weeks later, on Sunday, Jadzia was woken up by the phone. The doctor asked her to come earlier that day because it was very bad with her husband. By the time she reached the hospital in Warsaw, Zygmunt was already dead. Only a crying daughter was sitting in front of the door of his room. Jadzia wanted to kick the door in anger. “What you did to us, what you did to us,” she kept repeating in her mind.
Local and distant metastases
Malignant melanoma has a great ability to metastasize through the lymph and blood vessels. They are divided into local and distant metastases. Local metastases include satellite metastases (in the immediate vicinity of the tumor), transit metastases (located in the course of the lymphatic vessels) and metastases to the lymph nodes in the immediate vicinity of the tumor. Distant metastases may be located, inter alia, in in the lungs, liver, bones and brain. Unfortunately, the first metastases may appear in the internal organs immediately.
The course of the disease is most often chronic and progressive. The peak of metastases usually occurs after the first and second year after diagnosis, although late metastases also occur (5-10 years after diagnosis).
The girl in the hat
Magda cut light strands before chemotherapy. Just a short time to reduce stress. She did not delude herself that she would be the only one with eyebrows and eyelashes. Yet the expressionless face she saw in the mirror after the last drip surprised her a little. She couldn’t recognize herself, so she bought herself a big hat with a brim and a black wig to defiantly. She looked like a different girl, as if the disease had given her a different face. She only went to the hospital for a few hours, got chemotherapy, rested, went home. There, her mother was waiting for her, preparing meals and washing her clothes. As a sign of solidarity, my father shaved an American soldier.
Contrary to what she read on the Internet, Magda did not vomit after chemotherapy, she only felt weak as if she had suffered a terrible flu. “Now we have new drugs, they make life easier,” the doctor consoled her.
At home, Magda was catching up with her books and films, she started to draw. She hadn’t even touched the computer for several weeks. Then slowly she returned to normal life, contacted her boss at work, wrote short texts. One in three days, sometimes one a week. She used to do so much in an hour.
– The psychologist and my environment helped me – he recalls. – I felt that I was not alone, I had someone to fight for. I was assured that my job would be waiting for me, I felt needed. I was talking to people more and more often, I tried not to cut myself off from the world. I did not fall into the trap of emotions that those who do not have cancer are worse, others do not understand me, so it is not worth talking to them, because and for what. A great merit in this is Dr. Agnieszka, my psychologist. The greatest happiness? The moment when hair grows back and the body no longer resembles the scaly skin of a snake. It’s not about beauty, but about the subconscious belief that you’re getting better. My body came back to life.
Remember, it was fall
Jadzia is sitting in front of the psychiatrist’s office. I feel safer with my daughter by my side. This is the eighth visit. After the third, she emptied her husband’s clothes from the wardrobes, and after the fourth, she went to the cemetery for the first time since the funeral. She felt a little dull at the time, but the doctor said even mild mood-boosting medications work that way. The grave of Zygmunt was clean, there were flowers in the vase. Jadzia immediately threw them away, because Zygmunt hated yellow after all. She bought new white shirts that made him look so good. The next day she went there again to have a serious talk with her husband. This is what he will talk to a psychiatrist about today.
“She’s a nice girl,” she tells her daughter. – If you want, you can come in with me. You don’t have to be afraid of her. Doctors are sometimes right. You have to act before it’s too late. Look, there will be something else for me – he says with a smile. The first, unforced for a long time.
I am here and now
– What did my illness teach me? Humility and joy in life and the fact that more than just work counts. I was on my way to missing out on my life. Cancer made me stop, verify my views. Man cannot cope alone. It’s good to have others around you – says Magda, and then talks about short-term fear during check-up visits. – Sometimes I forget that I had cancer. I pretend the groin scars don’t exist… And then I sit in the waiting room line with other people and have goose bumps on my back with fear. Melanoma may still come back, because too little time has passed to talk about complete recovery. I have to be careful. I can’t waste my second chance.
See photo galleries of skin diseases!
Anna Niewiadomska
Source: Let’s live longer,
There are drugs and cosmetics that create an explosive mixture with the sun. What to avoid – you will learn in health.TvoiLokony