Over 5 million people are diagnosed with skin cancer annually. In an effort to bring awareness to the disease, I have shared this long tale of my journey with skin cancer on this last day of Skin Cancer Awareness Month. Check it out, do monthly skin self-checks, see a dermatologist annually, and wear your sunscreen! It could save your life.
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It all started about 10 years ago when I noticed a red spot about the size of a dime on my scalp. At first it just kind of stood out after a day in the sun or when it was hot out, and I didn’t pay it much attention. It didn’t hurt or do much of anything really. And it would go away on and off like a rash for months.
At some point, the spot began to get red every time I took a hot shower. It also started oozing, which was a new, somewhat alarming attribute. It would split open and have a clear liquid come out of it, dry up like a scab, and then heal again each and every month.
Knowing that the skin should not ooze, I headed to the dermatologist (after getting approved to see one through my insurance, of course, which took a couple months). I made sure to tell the dermatologist that the spot was oozing and scaly and that every month it did this same process of healing. I knew that providing as much information as possible is helpful in getting a diagnosis, so I was sure to mention the oozing. My dermatologist looked me over as her scribe took notes on a tablet in the corner.
She said the spot looked like it was healing, and she wasn’t concerned about it. I stressed its oozing nature. She said it was fine because cancer doesn’t heal and that is exactly what was happening here. So, I went home. I didn’t think to question her, as she was a highly decorated dermatologist with a thriving practice. I went about my life for one and half more years with this annoying scaly spot on my head. I changed my hairstyle so that it wasn’t visible because people had started to notice it and ask me about it.
As these things tend to do, it got worse. The oozing increased and it got harder and harder to ignore everyday as I looked at myself in the mirror and there it was. So, I went back to the dermatologist, and she said immediately, upon looking at it again, “We need to do a biopsy. That looks like cancer.”
I was shocked considering how she had so quickly dismissed the same thing before. I angrily said it was doing the same thing as when I first came, and she said it was fine. Why the change now? She had her scribe read her notes which said that the “patient complained of oozing from the spot, but that it was healing.” I was angry.
One messy biopsy later that left my hairline missing a small chunk of flesh and hair, and I was out the door. A couple of days later, I found out it was a basal cell carcinoma, the most widespread type of skin cancer, generally appearing from exposure to the sun. I was shocked, as I was 37 and had limited my time in the sun for well over a decade at that point. I had suffered a few bad burns in my life and had worked to avoid them ever since my early 20s. But that is the thing—skin holds onto your past.
According to the University of Colorado Cancer Center, the overall risk of developing melanoma, the most deadly type of skin cancer, increases 80 percent with 5 blistering burns in your childhood. In the Pacific Northwest (where I live), where the sun is blocked by clouds for much of the year, skin cancer rates are higher than much of the country—likely because people underestimate the risk on cloudy days. Overall, there are more people diagnosed with skin cancer every year than any other type of cancer, making early detection and knowing what to look for all the more important.
Within in a month, I had Mohs surgery to remove the cancer, which ended up being about the size of quarter when it was all said and done. Mohs surgery is a specialized procedure that has a very high cure rate. According to the Skin Cancer Foundation, it is 99 percent curative in patients who have never been treated before.
The surgery involves removing skin slowly in layers, analyzing it in the laboratory as you wait, and then removing more and more as needed until all the cancer is gone. This was the easy part. There was lots of numbing and prodding into my head to see if I could feel it before proceeding each step of the way. I had three rounds of cutting and analyzing tissues before they got it all out and I thought I had conquered the thing. But then came the reconstruction.
Because of where the now quarter-size hole on my head was, in order to get my scalp to lay down and look “normal,” it was required to make a large incision and pull it all back together to cover the hole. I really wish this had been done when I was not awake because it was horrifying, from the sound and sensation of the scalpel cutting my scalp to the surgeon stapling my head with 35 staples, using a staple gun so similar looking to the one I had at home. She and the nurses gingerly discussed her plans to fly out of town for the weekend for a conference as she stapled my head together.
All the literature I received prior to surgery stated that this outpatient surgery was simple and that most people could go back to work in a day or two. I did not. I couldn’t bend over in any sort of way, as now that I had staples holding my scalp together, I realized acutely how much the skin stretches to accommodate any and all movement. I also couldn’t smile, laugh, or really even talk that much because all of these things pull on the skin and wow, they hurt.
After two weeks of laying around, my wound was healing, and it was time to take out my staples. I was kind of hoping that the wound would look okay once I got the staples out, but as it turned out, the staples were just holding down my hair that had already been disconnected during surgery, and most of the hair just came out, leaving a large bald spot on my head. I thought all the hair stapled down would cover the wound, but that was not so.
Weeks after my surgery, I began to have uncontrollable twitching in my eyes and face, as well as sharp shooting pains up and down my face that I can really only describe as electric. I was told this was the nerves healing. It went on for months. It was hard to talk to people because my face would twitch so much that it was really distracting. But finally, all these things subsided, and I got back to life as usual.
A couple years ago, I went back to the same dermatologist because the cancer appeared to have come back. It wasn’t oozing, but it looked the same, just like my scalp had looked many years before when the spot first appeared. It was in the exact same spot. Again, my dermatologist did not do a biopsy and instead recommended that I use a chemotherapy cream that turns out wasn’t covered by my insurance and then I lost my insurance for a while, so again it went undiagnosed and treated for months. Thankfully, that was the last time I saw that dermatologist.
When I got the situation figured with my insurance, I visited a different dermatologist, and she took one look at it and ordered a biopsy. That time it was cancer again too, but in this case, I took action much quicker and when it came time to have surgery to remove it, the area was a lot smaller and was able to just be sewn up instead of needing to rearrange my scalp to cover the gaping hole.
While basal cell carcinoma is likely not going to spread and kill you like more dangerous melanomas, please use my story as a testament to how early detection can definitely prevent a lot of pain and suffering, or in the case of melanoma, save your life. Now I visit the dermatologist annually and always wear sunscreen (and a hat) when out in the sun. It’s the easiest thing you can do to protect yourself.
Though moles are sometimes cancerous, skin cancer doesn’t always come in the shape of an irregular growing mole. Sometimes it can be just a scaly spot that never heals. Checking your body monthly for any changes is important to catch skin cancers in their early stage. Even if you have dark skin, this is important to do, as skin cancers can develop in anyone, even if you have never been burned. In people of color, skin cancers are often diagnosed in a later stage, and when its melanoma, the cancer can spread quickly and is difficult to treat, making early diagnosis the best bet.
Along with making you think about wearing that sunscreen, let this story be a cautionary tale that if a doctor tells you something and you don’t think it is right, get another opinion. All doctors are not right, and they make mistakes too. We know our bodies better than anyone, and we need to advocate for our own health.
