“How long have you had that freckle on your nose?” the nurse practitioner asked, after removing a cyst from my shoulder. I responded that I’d had it for a long time – years, probably – and I hadn’t noticed much of a change … except, maybe, for a darkening in recent months.
She whipped out a syringe of something to numb the area. “I’m afraid it might be a melanoma,” she said.
My heart skipped. Melanoma? Not possible. A reformed sun-worshiper, I was aware my habits of years ago could easily come back to haunt me. For years, I’d visited my dermatologist for skin checks, and he’d removed several borderline-worrisome spots.
But wait, I thought as she scraped off the spot. I’d been vigilant for a while … but hadn’t I stopped going? My doctor likely had not even seen the nose freckle.
A few days later, the pathology was back, showing severe abnormalities. I followed up with my dermatologist, whose acknowledgement that we had “a situation” made me cry.
“I understand why you’re scared; this is serious,” he said. “The good news is it’s early – but the pathology isn’t complete. When all is said and done, I think we’re going to see a melanoma. We’ll send you to a reconstructive surgeon for next steps.”
I’d been through cancer; 20 years ago, I’d had a malignant nodule removed from my thyroid. Thankfully, the cure had been easy and complete. This was different; in recent years, melanoma has taken at least three people I know. My mind ran to the worst-case scenario: What if the cells had burrowed deep into my flesh, to the point where treatments might buy me some time, but wouldn’t work in the end?
My fear was not without reason; the American Cancer Society says more than 96,000 new melanomas will be diagnosed in 2019, and 7,230 people will die from melanoma before this year is over. Of the three skin cancers — basal cell, squamous cell, and melanoma – melanoma accounts for only 1 percent, but it causes the majority of deaths from skin cancer.
Its rates have been rising steadily the past 30 years, and it’s believed that 95 percent of melanomas are related to too much UV radiation. So my diagnosis, while startling, wasn’t a surprise. During high-school summers in the early ‘80s, I’d slathered myself with baby oil and iodine and tanned nearly every day. I’d typically burn once per summer, then cook my olive skin to a deep brown.
I never used sunblock. Ever. And in my 20s, I kept my glow year-long with the help of tanning beds a few times a week. “You’re brown as a berry,” my grandma would say. “You look so healthy.”
It’s a good thing Grandma can’t see me now. Two weeks ago, I met my reconstructive surgeon. Last week, I visited him again, and then again. He removed the lesion, then took margins – and then more margins – of healthy tissue.
I received a diagnosis of melanoma, stage 0 – the melanoma lottery, so to speak – but the “prize” for that lottery was a dime-sized hole in the tip of my nose, followed by reconstruction using a flap of my skin.
Other “prizes”: a chance of recurrence, and an increased incidence of other cancers.
As I write this, my swollen nose is a patchwork of stitches. My eyes and cheeks are bruised. My 16-month-old grandson points at my face and says, “Uh-oh.” I’ll likely be OK, but this was a close call – one of those defining moments that will change you, even if you’re not immediately sure how.
I decided I’d start, though, by taking a stand, albeit a small one. The fitness club I’d belonged to for years promotes and offers tanning packages, so I called the other day to cancel my membership. My $30 monthly fee won’t make or break the place, but the club’s owners needed to know that perhaps a rethinking of the word “health” is in order.
Take your own stand, won’t you? May is Melanoma Awareness Month. To observe it: If you lie in the sun or use tanning beds, stop. Purchase sunscreen with an SPF of at least 30, and apply it as part of your morning routine. And schedule an appointment with a dermatologist for a baseline skin check. Visit him or her at least annually, and check your skin monthly.
And be smarter. “There’s nothing healthy about a tan – a tan represents damage,” my dermatologist says.
He’s always said it, though. I just never listened.