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Pregnancy is supposed to be a joyous time of anticipation. Baby showers, nurseries, and nesting all add to the fun and excitement. Even when morning sickness gets extreme, and doctors’ visits get old, it’s hard to imagine anything truly ruining that special time for soon-to-be mothers. For Cailtyn Scaggs, however, this time was abruptly interrupted when she was diagnosed with melanoma just a short time into her pregnancy. She soon found herself learning to balance fear of the unknown with her faith that everything would work out in the end.

 

Pregnancy, an Unexpected Lifesaver

“Pregnancy is all rainbows and daisies, nurseries, nesting, and cute little onesies. The idea that it could be anything other than positive was not on my radar.”

The mole was discovered during a back massage. “I was experiencing lower back pain because of the pregnancy and Adam was rubbing my back when he saw the spot. He told me, ‘It just doesn’t look right,’ but didn’t know how to describe it. At the time, I was tired of being pregnant. Of being poked, prodded, and examined. Pregnancy felt like one long continuous medical appointment. I heard him saying that I had yet another reason to go to the doctor and I was angry about it. I brushed him off and didn’t listen to him.”

This behavior might seem unreasonable, but Caitlyn’s hesitation, also known as health information avoidance, is a common phenomenon. Thankfully, her husband persisted. “I didn’t show the doctor right away. It took two more baby doctor appointments. My husband was with me and as we were walking out the door. He asked her to look at the spot on my back. I was furious. Then the doctor immediately said, ‘That needs to go,’ and I was confused. It felt like everyone was ganging up on me.”

Caitlyn didn’t know it at the time, but it has become increasingly common for women to discover melanoma before or during pregnancy and her husband’s “annoying” persistence, coupled with her doctor’s instincts, could have saved her life.

 

It Takes a Village to Beat Cancer

From biopsy, to diagnosis, and throughout treatment, Caitlyn leaned heavily on her family, coworkers, and doctors for support. She was still experiencing disbelief when she went in for that first biopsy in the winter of 2011, “I went in pregnant and angry,” Cailtyn recalls, “and I left indignant about how bad the numbing medicine hurt. All I could think was, ‘This is so silly. What are we doing here?’”

Despite her doubt, fear started to seep into her consciousness as she waited on the results. That day she confided in a colleague: “Can I just say something crazy?” She asked tentatively. “What if this really is something? What if this is melanoma? “

5 days later, that nagging fear was realized when she got the results. “I was at work when the phone rang and I saw it was my dermatologist. The actual words that came out of my mouth were, ‘hold on I have to make sure I don’t have cancer.’ I was 25. I thought everyone was being dramatic.”

When she picked up the phone it wasn’t a nurse telling her that everything was fine. It was her doctor who explained that she had melanoma. She panicked and broke down right in the middle of the police station where she worked. Her thoughts immediately went to a fellow police officer who had died from melanoma a year prior. “Whenever he said the word melanoma I thought of the special life inside me and pure fear washed over me. They can’t tell you quickly enough what diagnosis means. Your brain needs to know the bottom line ASAP. My first thought was, ‘I’m not going to see my little girl go to kindergarten. Will this hurt her? Will it affect the pregnancy?’”

That’s when her doctor, colleagues, and parents rallied around her. “The doctor let me completely lose it. He told me that he was praying for me. He knows that faith is important for me. He even gave me his personal cell phone number so I could call with any questions. I was so overwhelmed I had to lay down right on the floor, in the middle of everything, and put my feet up. I became completely unglued. My coworkers sat with me, put their hands on me, and let me know they were there.”

Caitlyn’s parents also helped by picking her up from work that day. The news made it impossible to drive. During the ride, they helped Caitlyn work up the courage to tell her husband. “The hardest part hands down was telling the people I love. Having to call my husband and say I’m going to need surgery in a week because I have cancer. I couldn’t figure out how to tell him. Do I call and casually hit him with the news? Do I do it in person?” Thankfully, once she broke the news, her husband was instrumental in calming her fears. “He’s really good at taking things as they are. He asks, ‘What can we do today? What can we do tomorrow?’ He helps me take problems one step at a time.”

 

Melanoma Treatment During Pregnancy

The next week was very busy and emotionally difficult for Caitlyn. She had several doctor appointments and lots of questions. Thankfully her dermatologist, OB-GYN, and surgeon knew what to do and communicated with each other regularly to coordinate Caitlyn’s care.

Her first meeting was with the surgeon who wanted to schedule her for surgery immediately. Caitlyn says meeting with the surgeon helped her feel empowered. “I requested a copy of my pathology and objectively looked it up online.” She also asked lots of questions. “I brought a pen and notepad and asked the surgeon to draw diagrams and explain implications. I asked about every statement. I wanted to understand the boundaries of my situation. I thought, ‘Melanoma you’re not going to get the best of me. I’m going to empower myself to the best of my ability.’”

The surgeon explained the pathology and prognosis. The cancer was not just on the skin’s surface. It had started to grow inward and was about 0.74 mm deep. Thankfully, this depth meant Caitlyn could avoid a sentinel lymph node biopsy (SLNB), but needed to have a wide excision surgery to ensure all the cancer was gone.

Next, she had an OB-GYN appointment. In an email to family, Caitlyn wrote, “I’m so looking forward to seeing our sweet girl! I think I’m going to just fall apart though, it’s just been such a trying 5-6 days, seeing her is going make me melt, I should probably prepare Adam and the ultrasound tech for that.” During that appointment, she was allowed to record the sound of the baby’s heartbeat which she used as a source of comfort when times got rough.

The surgery took place at LewisGale Hospital Montgomery (Formerly Montgomery Regional Hospital). It lasted about an hour and anesthetic was applied locally which meant Caitlyn was awake the whole time. This was to ensure Harper’s safety. In fact, the OB-GYN’s staff were in the operating room to monitor Harper the entire time.

The surgeon removed skin and tissue on the site of the mole in a football shape down to the muscle.  That’s the standard of care for Caitlyn’s pathology. “They removed a lot,” muses Caitlyn, “The scar is pretty gnarly because my belly was still growing while the scar was healing.”

She says surgery ultimately assuaged many of her fears, “Before surgery I couldn’t say ‘melanoma’ or ‘cancer.’ I called it the ‘M word.’ I felt like I couldn’t face the enormity of it being something I was dealing with it, but surgery helped me feel better. I did what I needed to do for the long term.”

 

Moving Forward with Melanoma.

As a melanoma skin cancer survivor, Caitlyn must follow the survivorship care plan that was set out by her doctor. Initially, she went to the dermatologist for screenings every three months. After three years of normal exams, her doctor extended the time between visits to six months. During this time, she had many suspicious spots removed, and says she doesn’t mind this new routine at all, “I’d rather anything questionable just go. I can deal with scars. They’re proof that I’m still living. They tell a story. Melanoma is just part of my story.”

In addition to screenings, Caitlyn works on lowering her risk of getting new skin cancers with simple lifestyle changes. She’s made sunscreen part of her daily routine (even in the winter), wears clothes that cover more of her skin in the summer, and does her best to limit her exposure to UV rays.

Most importantly, Caitlyn says she hasn’t let melanoma rob her of joy. She still has the same love of the outdoors, but uses outings as an opportunity to challenge herself. “My goal is no tan lines. I still go to the beach. I still till run outside, but now I take precautions.”

She’s also passing wisdom about skin cancer on to her children.

“My daughter Harper earned her middle name, Grace. She’s my saving Grace. When she asks about the scar I tell her what happened. I want her to know life isn’t always pretty. [My kids] need to see that I can handle life when it goes sideways because it’s going to happen for them. I want them to see what it looks like to be strong. Being strong and falling apart can exist together. It means falling apart and getting up. Confronting the thing you never wanted or think you could handle.”

2017 marks 5 years cancer free for Caitlyn. Having survived through a truly scary diagnosis she’s happy to report that her worst fear was never realized. “My first thought was, ‘I’m not going to see my little girl go to kindergarten,’ and this year I’ll be putting her on the bus.”

 

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