Friday, March 21, 2014

My Most Personal and Important Post Yet. A Plea to Fellow Sun Worshippers

I am writing this only moments after removing extensive bandaging from my leg. I look down at my shin which is covered in stitches, swollen and misshapen, and for a few minutes, I cry – I have just had surgery to remove my second skin cancer in the last year. I’m 26 years old. I was first diagnosed with Melanoma on my left forearm in February 2013.

Now that I’ve adjusted to this new reality, I’ve decided to write about it, not for sympathy or pity, but because I feel it would be selfish if I kept this experience to myself and failed to warn others. No one thinks that skin cancer will strike at twenty-five, but it does – and for me, it did.  Melanoma is now epidemic, yet relatively few people get checked for it or even think they are at risk, particularly young people. The odds of surviving Melanoma are far greater when it is caught early. If I can persuade even one person to get checked, and if that appointment results in the early detection of a skin cancer, I’ll know that sharing my story was worthwhile.

Unlike many twenty-somethings, I see a dermatologist yearly to get a full body check. Last winter, I asked my doctor about a strange-looking mole on my arm. She said it was nothing to worry about and that she would look again in a year, but something made me insist to the point of saying, “I’m not leaving here until you biopsy this mark.” Begrudgingly, she performed the procedure, and I received a phone call five days later informing me that I had Melanoma and two other forms of cancer clustered in the same place. Immediate surgery removed the tumor, as well as a great deal of surrounding tissue, leaving a large scar and a misshapen forearm that took many months to heal. Alarmed by my brush with cancer, I bought UV protective clothing and took considerable care to avoid the sun all summer. I wasn’t open about my experience then, mostly because I wasn’t ready to deal with it.  I hoped this experience was a fluke that I wouldn’t have to deal with again.

Last November, I noticed a red mark on my left shin, just above my ankle. My (new) dermatologist told me it was probably nothing at my age. Within three months, it grew rapidly, and I scheduled an emergency appointment in January. Again, I insisted on a biopsy and this time it was a very rare tumor few doctors have seen. This time, my pathology reports were sent to distant specialists to discuss, and I ended up at Dana Farber Cancer Institute in Boston.  There, a team of pathologists evaluated my cancer and with the help of an oncologist and surgeon, determined the course of treatment.  Within two weeks, I was under anesthesia on an operating table as a large portion of my shin was removed in a ‘wide excision’. Despite the work of a world-class plastic surgeon, it’s not pretty – and my condition is no longer a fluke.  According to my oncologist, I am at exceedingly high-risk of more melanoma, especially if I do not stay diligently out of the sun and see a dermatologist every three months for the rest of my life.

It’s imperative to know your body, recognize what constitutes a worrisome change, and check your skin frequently. It’s also vitally important to listen to your gut when something seems wrong.  Never ever take no for an answer when you have a ‘funny feeling’. Be persistent because your life may quite literally be at stake! If I had listened to two dermatologists, I would very likely have lost the chance to celebrate my thirtieth birthday. While insisting upon a biopsy made for some awkward moments and an irritated doctor, it was the difference between metastatic cancer and the urgent treatment I needed to save my life.

I have never used a tanning booth, but have been a lifelong sailor and beach lover. According to my oncologist, I used ‘Nature’s Tanning Bed.’ I am fair-skinned and blue-eyed, and I recall childhood sunburns, and an ever-peeling nose as a sailing instructor for many summers. I considered myself careful in the sun, pretty good about applying and re-applying sunblock and wearing sunglasses and hats. That wasn’t enough.

I hope this post convinces you to visit a dermatologist for an evaluation. I am now investing in a wardrobe full of UV protective clothing and considering designing my own. I will get past the appearance of my scars, and know I am lucky that my cancer was treated early, but the sun is not my friend – a tan is certainly not worth this pain and disfigurement.  It isn’t worth dying for.

So, if I’m on the beach this summer, it will not be between the hours of 10 a.m. and 4 p.m.  When I do go, I will be the girl covered from head to toe under the shade of an umbrella! I will be wearing sunblock every day, all year, and I’ll be hoping that you will, too.  And please, if you have not seen a dermatologist in a year or more – and especially if you never have – pick up your phone and make an appointment.  Do it now.  

I've deliberated for some time as to whether or not to include a photograph of my latest reconstruction. I've decided that although it isn't a pleasant thing to see, it may make the best impact of all. If this is what motivates you to get checked, it was worth the momentary squeamishness.  

Before Surgery - Surgeon Marked the Area to be taken off.