By Amanda Rose Adams
Recently I brought my children, who are eleven and twelve, to the dermatologist too, in hope that she could educate them about proper sun care.
It began as a small white spot above my lip, beneath my nose, less noticeable than my adult acne. The acne far was more frustrating and what drove me to the dermatologist. During my visit I did ask her about the spot. She shrugged and told me if it started to bleed to come back. The spot never went away but grew so slowly that when it finally started bleeding I didn’t realize how large or deep it had grown.
My dermatologist barely looked at my cracking skin and said, “It’s probably cancer.” I left that appointment with a bandage over my lip, while a layer of my spot went to the pathologist. It was cancer, specifically a basal cell carcinoma. The irony was that I never spent much time in the sun compared to my siblings or peers. I’ve never seen the inside of a tanning booth, and am not an outdoorsy person. Being so pale, I usually wore sunblock and hats on the rare occasions I was outdoors as an adult, but that was too little too late. As a parent, I’ve always stressed sun block and hats. My kids are both pale too, and neither has ever had a tan or serious sunburn. The burns they’ve had are extremely rare and relatively mild, but we live at high altitude and with every mild burn damage is done.
According to the US Centers for Disease Control, “The two most common types of skin cancer—basal cell and squamous cell carcinomas—are highly curable, but can be disfiguring and costly.”
For several days after the nurse called to confirm my diagnosis, I was conflicted. I felt angry at myself for being upset about a cancer that wouldn’t kill me. Basal cell carcinomas can spread to the bone but are far more disfiguring than dangerous. My mother-in-law is a breast cancer survivor, and I lost my father to esophageal cancer. I felt like I was being a baby about my minor cancer.
Still, it was a cancerous growth and it was on my face. The Internet was not reassuring. Every photo I found of basal cell carcinoma or the Mohs surgical procedure to remove it, presented an extreme case of a “Carcinomas gone wild.” Nothing resembled my little white spot.
The day of my surgery, I learned that the little white spot was fairly deep, not to the bone, but deep enough that the doctor sent my cells to the lab three times before they came back clean and he could close my incision. This small spot left a hole that required over forty stitches to close inside and outside of my skin. The seemingly innocuous white spot was gone but I looked like I’d been mauled by a dog or gone through a windshield, and it took months for me to get any feeling back on the left side of my upper lip.
At the pharmacy, even with bandages covering my stitches I felt strangers stare and knew what they were thinking, “What happened to her?” The answer was too simple, too much sun.
Since my diagnosis in early 2013, I have an annual skin cancer check. This year, I’ve had three. The first was with my old dermatologist whose treatment of two suspicious growths failed to take. The second was with my new dermatologist who successfully removed what turned out to be a wart on my thumb and identified a scar tissue growth on my ankle. On my third visit she froze two suspicious white spots from the tip of my nose and on the side of my face near my ear. She called them “precancerous.”
The one on my nose seems to have disappeared, but the spot at my hairline is still bumpy. If it bleeds again, I’ll be back for my fourth visit and another biopsy. As a patient, this journey has been relatively minor compared to other medical issues in our family.
Recently I brought my children, who are eleven and twelve, to the dermatologist too, in hope that she could educate them about proper sun care. I’ve bought them daily moisturizer with SPF that the dermatologist recommended, but I’m usually at work before they are dressed and at their age I cannot be sure they’re using it. Forcing them to wear a hat is about as effective as it was when they were babies and dropped them out of their double stroller.
When I had my surgery in 2013, I rested a lot and kept the wound covered. By the time the stitches came out it wasn’t nearly as frightening. After two years and regular use of a silicone gel the scar isn’t any more noticeable than the little white spot that caused it. So, my kids don’t seem to even remember my surgery or the wound.
As I struggle to get my adolescent children to take their sun protection seriously, I wonder if I should show them my after photos since they don’t seem to remember what Mom’s face looked like. Maybe I should show them the before photo of the little white spot to show them how minor the carcinoma looks.
I can’t bring myself to show them the over the top photos of people whose basal cell carcinomas went unchecked until they were genuinely disfiguring, but part of me is tempted. As if the outrageousness of it would unsettle them like a driving school video of a car accident. It would probably be as effective. Thinking these things will never happen to you, even if they are heredity, is a right of passage for kids. So, I keep buying the sun protection, nagging, and taking them to the dermatologist. Maybe the knowledge will soak in before too much sun damage is done.
Amanda Rose Adams is the author of Heart Warriors, A Family Faces Congenital Heart Disease, and her work has been featured in the New York Times Well Family, The American Academy of Pediatrics Section on Bioethics and various literary journals. You can follow her on Twitter @amandaroseadams or visit her blog at www.amandaroseadams.com.
This essay was originally published on Brain Child in May 2015
Photo: Alexander Shustov