"I never thought I would have cancer": about melanoma among moles and what the "ugly duckling" has to do with it

Moles seem like a completely normal thing. Many of us have never checked them, thinking that "if it doesn't hurt, it's not a big deal." But sometimes, this indifference can be very costly: a seemingly ordinary spot or mole on the skin turns out to be melanoma, one of the most dangerous types of cancer.

This article tells the story of Antonina Sotnikova, who accidentally learned that she had skin cancer and went through a difficult path of treatment.

And also – important advice from dermato-oncologist Svitlana Dyachuk on why moles should not be ignored, how to recognize alarming changes, and how to protect your skin in the summer.

From this article you will learn:

• Antonina talked about her diagnosis, treatment, and her life after melanoma;
• why melanoma often occurs on "clean" skin without moles;
• what is the AKORD rule and why is it no longer in effect;
• what is the principle of the "ugly duckling";
• how to protect your skin in summer;
• Can moles be removed in the summer?

The story of Antonina Sotnikova

How and when did you find out that something was wrong with your mole? Have you had a medical examination before?

Until I found out I had melanoma, I didn't attach much importance to checking my moles.

I once thought about getting them checked, but my grandmother told me not to. She said that removing moles was dangerous, that it could lead to something bad. There used to be, and still is in some places, a lot of misinformation on this topic.

I think our society is still not fully aware of this issue. So I didn't check anything until I accidentally ended up at a dermatologist's appointment with a completely different problem – a papilloma on my face.

And while we were talking to the doctor, she suggested that we check all the moles on our body at the same time. She looked at them with a dermatoscope – and suspected one, on our back, as dangerous. All the others were normal. She immediately advised us to see a surgeon.

How was the treatment?

I was referred to a dermatology center for surgery. The mole was not raised, just a smooth spot on my back. I was immediately referred to a surgeon to have it removed along with some of the surrounding tissue.

The operation was very stressful for me. I was very nervous, at one point I even cried. I had never had such an experience – being conscious and having something cut into me. Before, when I had to do something, it was only under general anesthesia. And here it was local, and it was somehow morally difficult to accept.

At that time, I didn't think it could be anything serious, let alone skin cancer. After the operation, the mole was sent for histological examination, and about a week or so later, the surgeon called me and said that it was stage 1 B melanoma (the early stage of melanoma, when the tumor is 1 to 2 mm thick and has no ulcers, ed.).

I was in shock. It was hard to believe that this was about me at all. It seemed like cancer was something very far away, something that happened somewhere, to someone, but not to me.

In addition, I didn't fully realize then that melanoma is one of the most dangerous types of cancer. It seemed to me that skin cancer was something "external", not very serious. And then I learned that melanoma can metastasize to any organ and spread very quickly throughout the body. That is, if it is not detected in time, the consequences can be very serious.

When they told me it was melanoma, the doctors immediately suggested another procedure – according to the protocol, a lymph node had to be removed. First, they had to do a special contrast study to find out where exactly the lymph outflow from the mole goes, and find the node where metastases could reach first. That was what had to be removed.

I went to several oncologists to weigh all the pros and cons. One of the most famous oncologists at the Dobrobut clinic calculated on a special calculator how likely it was that metastases were already present in the lymph node. It turned out to be only 13%.

So I decided not to have the lymph node removed. But now I have an ultrasound every three months to check my lymph nodes, and that will be the case for the rest of my life. It’s my way of keeping things under control and being able to react in time if something goes wrong.

In general, skin cancer often occurs due to excessive and dangerous exposure to the sun. I have very fair skin, and I have been constantly sunburned since childhood. Especially my back – it burned many times, and, as I understand now, it all made itself felt.

When I found out about melanoma, I decided to look at my old photos from the past 4 years – and indeed, I saw that this mole had been growing. At first it was very small, barely noticeable, but over time it became much larger, darker and looked completely different. I just didn’t notice it before because it was on my back and I couldn’t physically see it.

After the first surgery, I was left with a suture of about 7 cm. Although the mole itself was much smaller, it was necessary to cut out some of the surrounding tissue to remove as much of it as possible.

A month and a half later, a second surgery was performed – a wide excision to make sure all the cancer cells were removed.

The most unpleasant thing in the whole process was probably the suture. It is quite large, and after the first operation it healed very painfully. And as soon as it more or less healed, after 1.5 months I had to go for another operation, and everything was the same again – pain, healing, discomfort. It was especially difficult because it was all on my back, and it was difficult to reach there, and it was not always convenient to do everyday things. Even now, a year and a half later, the suture pulls from time to time, like a kind of reminder.

But psychologically, I survived it quite calmly. Yes, at first there was a shock, but after the operations went well and the lymph nodes turned out to be clean, it calmed me down, and I simply strictly followed all the doctors' recommendations.

Now I am completely healthy. I can do anything – play sports, undergo cosmetic procedures, because when melanoma is active, everything is prohibited.

But I understand that if you've had melanoma once, there's still a risk of it happening again. That's why it's important to regularly check all your moles, monitor your skin, and not ignore any changes. It can really save your life.

Who or what helped you hold on and walk the path to recovery?

I was supported, first of all, by my loved ones – family, friends. They were there, and it really helped me get through everything. And I also took on such a small "mini-mission" – to tell my story. I realized that my experience could be useful to others.

I wanted to show that melanoma is not something rare or far-fetched. It can happen to anyone, even those who, like me, have simply burned themselves in the sun many times, haven't used protection, haven't thought about SPF or prevention.

I started sharing my story with friends, writing posts about it on Instagram. I even collaborated with the Molodist clinic, where I was initially examined – we made publications together so that more people would learn about the dangers of the sun and the importance of checking moles.

And, to be honest, that's what really supported me. Because when you focus not only on your fears, but also on the fact that your experience can help someone, it gives you strength. It's not just a fight for yourself, but something more.

How has your attitude towards your body, health and life changed after everything you've been through?

My attitude towards my body, health and life in general has changed a lot. I have become much more attentive to myself, to my condition, to the little things that I simply did not pay attention to before. I have come to realize that, unfortunately, something serious can happen to anyone – even to those who look healthy or lead a healthy lifestyle. For example, I have always tried to eat normally and exercise, but this did not save me from melanoma.

I realized: cancer is not "somewhere out there," it can be right next to you. And when you're 32 and you hear the word "melanoma," it shatters all notions about age, about control over life, about guarantees.

Now I just live more mindfully – to myself, to my body, and to what really matters.

I would really like to tell all people: skin cancer is not a sentence if it is noticed in time. It can be dealt with. But the key word here is in time . That is why I urge everyone: check your moles at least once a year, and better – more often. And not only moles – do full check-ups, check the general condition of the body. Because many processes can proceed quietly, without obvious signs, and it seems that everything is fine until it is too late.

Yes, sometimes it's hard to find the time or money for it, but it's truly what our lives depend on . Prevention isn't just "for peace of mind," it's a chance to live longer and healthier.

It is important to monitor moles that change – grow, darken, become asymmetrical or just "strange". These are the ones that can turn out to be melanoma. And if you notice something – don’t put it off, don’t wait, don’t hope that it will "go away by itself". Go and get it checked.

I really want people to be attentive to themselves, to their bodies, and to take care of their health – not out of panic, but out of love for themselves. And for their loved ones too. Because we all want to be together longer.

Especially for LIGA.net, dermato-oncologist Svitlana Dyachuk told us everything you need to know about mole care and melanoma prevention.

Can ultraviolet rays from the sun cause moles to turn into cancer?

– There is a myth that ultraviolet rays cause moles to turn malignant. In fact, ultraviolet rays are very harmful, but for the skin in general. This means that you need to protect all of your skin from ultraviolet rays and sunburn. If ultraviolet rays do contribute to the development of skin cancer, it is more likely to occur on "clean" skin, not from moles, – explains the doctor.

Which moles are the most dangerous?

In fact, there are no "most dangerous moles" as such, says Svitlana Dyachuk:

– Outwardly, they can look very similar – sometimes even exactly the same – and yet one will be benign and the other malignant.

Therefore, it is practically impossible to independently determine which mole is safe and which is not. This is exactly what a dermato-oncologist is for: he examines moles using special equipment and can then tell whether they look benign, suspicious, or perhaps a malignant tumor.

So, unfortunately, self-diagnosis does not work – it is important to consult a specialist.

Can I sunbathe or go to a tanning bed if I have many moles?

– In fact, it doesn’t matter how many moles you have – many or none. Tanning beds are equally harmful to everyone, because ultraviolet rays affect all skin cells, including those that are part of moles.

Therefore, no one should sunbathe in a tanning bed – regardless of the number of moles, – explained the dermato-oncologist.

How to properly protect moles from the sun – are special products or stickers needed?

In fact, there is no separate "special" protection for moles. It's simple: you need to protect all of your skin, and then moles will be safe, says the doctor.

That is:

• use a sunscreen with a high SPF and apply it to all exposed areas of the body;
• if you spend a lot of time in the sun, especially at lunchtime – cover your skin with clothing (T-shirts, shirts, hats, etc.);
• Avoid direct sunlight during the hours when it is most active – from 11:00 a.m. to 4:00 p.m.

And that will be quite enough. Moles do not require any separate treatments – just protect the skin as a whole, and this is the best prevention.

Should you see a dermatologist before or after a summer trip to the seaside?

Svitlana Dyachuk explained that in order to check moles, you should visit a doctor once a year or twice a year if you belong to a high-risk group. But it doesn't matter at what time of year you do it.

Is it safe to remove moles in the summer?

– Removing moles in the summer is absolutely normal. That is, there is no seasonality in this procedure at all. The idea that moles cannot be removed in the summer is just an outdated myth that has been around since Soviet times, – says the expert.

How to distinguish a mole from melanoma

Unfortunately, most malignant skin tumors do not have pronounced symptoms, says the dermato-oncologist:

– They do not hurt and do not cause discomfort. Moreover, they can be perfectly smooth, round and very small. That is why it is important to undergo a dermatological check-up at least once a year. The doctor himself will assess all neoplasms on the skin and determine whether any of them are dangerous.

Let me remind you that the rule for checking moles AKORD ( A – asymmetry, K – edge, O – color, P – size, D – dynamics) is very inaccurate and practically does not work.

The only more or less effective rule for self-assessment is the so-called "ugly duckling rule": when one mole is noticeably larger, darker, or simply different from all the others. But I emphasize that a dangerous mole can look completely ordinary – the same as the rest.

What are the preventive measures to prevent the development of melanoma in the summer?

Melanoma prevention begins, first of all, with knowledge that it exists, emphasizes Svitlana Dyachuk:

– Most people don’t even suspect that melanoma is a malignant, aggressive tumor that can look like an ordinary mole. Awareness of this is the first step to prevention.

Another important aspect is protecting the skin from ultraviolet rays. This reduces the risk of not only melanoma, but also other types of skin cancer.

It is also important to undergo regular dermatological examinations with dermatoscopy. This is especially true for people who have many moles. They should do a so-called mole map every year – when all new growths on the skin are checked, analyzed and compared with last year's map.