Imagine our surprise when three months ago, on a routine office visit, the physician pointed out two areas — one just under his left breast and the other on his left arm that were highly suspicious. He recommended that Tom see a dermatologist right away. Later that day I asked my husband to remove his shirt so that I could see for myself the two areas in question. The mole just under his left breast was about the size of a quarter and had been there ever since I’ve known him — more than 25 years. I asked myself had it grown since I had last taken a good look at it? I couldn’t be sure. Did it look different now? On close inspection — yes. The margins were now ragged, and the color had changed from a uniform dark brown to a mosaic of medium and dark browns. It was also slightly raised where before it had been flat. The area on his left arm looked like scar tissue from a burn or a cut that had not healed properly. I had noticed it before, but had assumed that it was from an old injury. I asked myself — How could I have missed all the signs? Here was a man of Irish descent, with fair skin, who never gave a thought about the sun and its potentially harmful effects. The truth is neither did I. I saw my husband in the state of undress every day for more than 25 years and yet I hadn’t taken a really good look at his body or performed a skin inspection for many years. I was feeling guilty — I should have known better, I should have been more diligent.

The first appointment Tom could get with the dermatologist was four long weeks away, an agonizing four weeks during which time we imagined the worst possible outcomes. Despite our dark thoughts, the biopsy of the chest lesion came back highly atypical and precancerous, but not a melanoma. The lesion was removed two weeks ago — he now sports an eight-inch scar — a visual reminder that he had a close encounter with a potentially deadly cancer.

The patch on Tom’s left arm did turn out to be basal cell carcinoma, and he has an appointment to have it removed in the surgeon’s office next week. He also goes back to the dermatologist next week, when the physician will perform a head-to-toe visual exam, taking note of any suspicious moles or growths. He will go back to the dermatologist every six months to a year for a visual exam for the rest of his life.

I too have scheduled a dermatologist appointment, and after careful inspection, have come to question two moles I’ve had for many years that now appear to have changed in color.

We are both thankful that Tom’s lesions were caught in time and that things turned out the way they did. And I’m also thankful to Dr. Dhillon, Tom’s regular physician, for insisting that Tom remove his shirt and tee shirt before listening to his chest. How many times have I seen a physician lift up someone’s shirt or snake the stethoscope down someone’s blouse just so the patient wouldn’t have to remove his or her shirt during a routine visit? Never again will I thank a physician for this seemingly courteous gesture, and neither should you. We learned our lesson the hard way.

Janice Spillane, RN, MS; Editorial Director; NY/NJ Edition of Nursing Spectrum; jspillane@nursingspectrum.com