Skin cancer, cardiac cancer possibly related

DEAR DR. GOTT: A dear friend of mine had a large black mole on his face. He asked his doctor and a surgeon to remove it by freezing it. One month later, he felt sick and had a liter and a half of fluid taken out of the sack around his heart. There was blood in the fluid, and cancer was diagnosed. Could this have been caused by not biopsying and having surgical removal of what turned out to be a melanoma? He died in one month.

DEAR READER: My guess is the “mole” was far more advanced than anyone anticipated. The fluid (pericardial effusion) could have resulted from the accumulation of blood after a surgical procedure or from an injury. The additional pressure on the heart results in poor function and can cause failure or even death. I cannot comment on whether the skin cancer was related to the cardiac cancer. It is possible, but I don’t know whether it is likely.