I've been putting off writing this post.

This is a difficult post for me to write, and I've put it off 'til now because it's hard to know what to say. I found out recently that the cancer has returned. This changes quite a lot for me.

I noticed around Christmas that there was a tiny dark spot in the middle of my right thigh, about two inches away from my groin dissection scar. I didn't think too much about it, but by the start of February it had grown significantly. It was still tiny - just under 2 millimetres - but definitely bigger than it had been six weeks prior.

I phoned Dr Stewart and she immediately booked me into her surgical schedule for the next day. The spot was removed in a procedure called a punch biopsy, whereby a circular blade similar to a miniature apple corer is used to 'punch' out the skin containing the lesion. It only needs one stitch (compared with scalpel removal for larger lesions, which have needed up to 8 stitches) and it's a lot quicker to do as no cauterisation is required.

I got the results when I went for my regular check up 23 days after the procedure, and as I hadn't heard from her, I assumed everything was fine and that she'd simply forgotten to let me know the outcome. I wasn't prepared for the words "it's not good news". 

The biopsy had revealed the spot was malignant melanoma; to be specific, an in-transit metastases. Simply put, it's a met originating from the primary tumour, which means one thing: I still have cancer in my lymphatic system or my skin or both. My groin lymph nodes were removed last April and one node was shown to contain cancer. The hope was that by removing them all plus the original tumour, everything would have been caught. In some lucky people that is the case, but in other people, as with me, some cancerous cells get snared in the lymph channels as they are in transit from the primary tumour to the lymph nodes. Often they will stay hidden and quiet for months, even years, but at some point, and for some reason, they are triggered to start dividing and a tumour grows. That is what the spot was.

The reason it's a game-changer is this: we will never be able to say from now on that I am clear of cancer. As Dr Stewart told me, it's more likely than not that I will always have cancer and that melanoma will randomly appear. We will, of course, remove any mets as soon as they show up on my skin but there will always be some cancerous cells lurking in my lymphatic system, just waiting for their chance. 

So what happens now?

As long as the mets continue to grow on my skin, where they can easily be seen, then it's not too much of a problem. So long as they stay in my leg, then it's not too much of a problem. But if and when those cells leave my leg through my lymph system, if and when they start growing on my internal organs rather than on my skin...well, I don't need to spell it out, do I?

Since then I've had punch biopsies to two dark dots on my thigh and a random bump on my shin. I get the results from those soon. I suspect two will come back as fine and one will come back as melanoma. I will cross that bridge when I come to it because the thought of two recurrences inside 10 months is a grim one. No point worrying about its meaning 'til I know for sure what's what.