It started out as the tiniest bump on the right side of my nose. A pimple, I thought, which could be easily covered with makeup. I was in my early forties but getting a zit from time to time was not unheard of. One day while looking in the mirror, it dawned on me that this zit had been on my nose for longer than usual. I reasoned that we get blemishes on our skin as we age. Even my primary care physician said it was “probably nothing to worry about.” So, life got busy and I simply put it out of my mind. When blood would appear from time to time, a vague foreboding voice told me it needed a second look. It was my Mom who bluntly told me during a visit that I needed to see a dermatologist—immediately.
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One biopsy later my Mom’s fears were confirmed. This little bump was skin cancer. Furthermore, I had let this molehill go on for so long that it had turned into a mountain and now needed something called Mohs surgery. I did get a bit of relatively good news that day, too; it was not melanoma, an aggressive and sometimes deadly skin cancer. Instead, I had a less aggressive form called basal cell carcinoma, a form that rarely metastasizes.
The name of the surgery sounded like some kind of medieval torture. In fact, it has become a standard procedure for nonmelanoma cancers. Using a local anesthetic, this specially-trained surgeon scraped a bit of the skin, sent me to the waiting room, and examined the tissue for cancer cells. Then he repeated a second time and a third until the cancer cells were gone. It was like having multiple biopsies in a single morning. Groundhog’s day in the dermatologist’s office.
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That wasn’t the end of it. Because the surgeon had needed to dig somewhat deeply to remove the cancer, I needed one more outpatient surgery. That afternoon a plastic surgeon would remove a small piece of skin from behind my ear and stitch it over the divot on my nose. Following this second surgery, as I was getting dressed in the recovery room, I glanced in the mirror and gasped. A large neon-yellow chunk of gauze was sutured to my nose. Panicking, I ran to find a nurse. “How long will this thing be on my nose?” “Oh, not long,” she replied, “only a week or two.”
Two weeks later, when I finally returned to public, I made a few important changes in my lifestyle.
1. The sun is my friend. But even good friends need boundaries. Each morning regardless of the season, I apply a face lotion with an SPF of at least 15. The drugstore shelf holds many brands; some are heavy or greasy. Neutrogena sells an oil-free SPF 15 lotion that works well for me. It provides protection during those short daily tasks outside like running errands, walking the dog or plucking some vegetables from the garden. During longer periods in the sun, like riding my bike or cross-country skiing, I use heavier armor. Dermatologists recommend a broad-spectrum sunscreen with an SPF of at least 30.
2. I bought myself a big floppy hat. The sunscreen provides one line of defense, the hat provides a second. I try to wear it as often as possible when in the direct sun for a period of time such as sitting through my son’s soccer and baseball games or recreating near the water—swimming, canoeing, hanging out at the beach.
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3. Lips can be damaged from the sun just as skin can. I use a lip balm with an SPF of 30. Anyone who has gone out in the sun with a shiny lip gloss and has ended up with burned or even swollen lips knows just what I mean.
4. I monitor my skin much more closely. Dermatologists warn to watch for new growths or moles that have changed size or shape. Also, anything that bleeds is a red flag. I may be a step or two shy of paranoid, but I do go straight to the dermatologist when I question something new on my skin. (It’s only happened once since the surgery.) Otherwise, I see the dermatologist annually for a checkup.
5. Most importantly, I am making my health a priority. Fortunately, aside from this minor incident, I have been blessed with good health. However, in the future even if one doctor tells me things are fine, but I continue to have doubts, I will take the time to get a second opinion.
One in five people will be diagnosed with skin cancer during their lifetime. We can’t reverse those childhood days in the sun without protection, but we can be smart about skin care in the present. We can pass down our wisdom to our children, too.