LowerSacTrout.com

Hat Buttons... and Cancer ? 

For 20+ years, I’ve been a fly fishing guide.  I have ALWAYS worn a hat while on the water.  No exceptions. 

I almost always wore basic ‘baseball’ hats.  Every baseball hat I’ve ever owned has a little metal button on the very top.
 
I wear my hair pretty short to combat the Redding heat.  I also wear my hats all the way down, so that little metal button has been rubbing on the top of my scalp for two decades. And getting hot in the sun at the same time.

In 2014 the girl who cuts my hair noticed a dark spot exactly where the metal button rubs my skin.  She said she’d been keeping an eye on it and it was time to get it checked out.  So, my Dr. did a punch biopsy and it came back negative for any cancerous cells.  He mentioned it might be the constant irritation and heat of the button, and to keep an eye on it. 

I switched to a few hats I had with plastic buttons, and other buttons were covered up with a small piece of thin fly-tying foam to protect my skin from the irritation.  And then I kinda forgot about it. 

Fast forward to fall of 2016 and my wife notices that the spot is back, and a little darker.  So, my Dr. does another punch biopsy. 

It was a day I’ll remember the rest of my life.  Steelhead fishing on the Trinity River with a couple of really good friends and my phone rings. It’s the Dr. office saying I need to come in for an appointment. This time, it’s cancer.  Melanoma. 

Surgery #1 - Jan 3, 2017.  Scalp excision. Removal of scalp around original melanoma. 3-4 inch diameter down to the skull to insure clear margins.  Skin graft from inner thigh to cover bare skull to encourage cell re-growth.  Also biopsy of sentinel lymph node in neck to see if cancer had spread.  It had.  But not into major organs. We caught it at Stage 3.  

Surgery # 2 - Jan 30, 2017. UCSF Melanoma Clinic.  Radical Neck Dissection with 32 lymph nodes removed, one of which showed a tumor. Incision from behind ear to Adams Apple. This was to ‘nip it in the bud’ and prevent spreading.  I was told that I was cancer free and to return for a scan in 6 months.  Which I did.
The scan showed 3 neck masses that were not there previously.  The cancer had returned.

Surgery #3 - Sept. 22, 2017. UCSF Melanoma Clinic. More Radical Neck Dissection. This time incision from behind ear up back of head, and down to the tip of my shoulder and down to Adams apple.  25 remaining lymph nodes removed.  5 showed new cancerous tumors.

I have finished one year of Keytruda Immunotherapy and so far, so good. All scans have been clear. 
Hopefully, I’ll stay cancer free this time. Indefinitely.

I have no feeling from the tip of my shoulder up to my jaw bone to the top of my head and behind my ear. The nerve damage was extensive from two surgeries in the same area.    

Please - take precaution when in the sun.  Wear protection and get checked if something doesn't look right.