Written by Steve Irvin
PHOENIX - For me, skin cancer started as a small red spot on the side of my forehead.
I thought it was a zit.
Problem was, the zit never really went away. In fact, it grew, at times flaking and even bleeding. On my first trip to the dermatologist, the doctor looked at it with an affirmative look of “I’ve seen this before.” She quickly zapped it with liquid nitrogen.
A few months later, the spot was back. This time, a biopsy confirmed what the doctors had expected all along: skin cancer. The diagnosis was a basal cell carcinoma, the least serious of the multiple forms of cancer, one which makes up 80 percent of known skin cancers. Honestly, I didn’t take it that seriously.
I was about to learn the harsh reality of even the least severe form of the disease.
Doctors told me I’d have to undergo a Mohs procedure. It’s a surgical technique essentially designed to get the cancer – all of it – while doing the least amount of damage. The spot was still relatively small – only about a half inch or so. I figured, a few scrapes in the doctors office, a bandage, and I’d be on my way. The reality of the Mohs procedure is quite different. By the time Doctor Joseph Janik of the Skin and Cancer Center was finished with me, he had carved out a quarter-sized hole in the side of my forehead, removing every layer of skin down to the fatty tissue. The cancer was gone, and I would be scarred for life.
Looking at the video from the procedure now, I realize how serious this really was. I guess I knew it at the time. I kept using the word “scary,” perhaps because I was too frightened to come up with something more clever.
The next day, plastic surgeon, Dr. Anthony Admire would cut two incisions on the side of the hole, in the shape of a football, and carefully stitch up the open wound. Admire is a gifted cosmetic surgeon. The stitches would be barely visible, and the scar will eventually heal into a thin white line that will likely resemble a wrinkle.
Thankfully, it will blend right in.
Every time I look in the mirror, that line will remind me of a foolhardy denial, a refusal to take the skin irregularity seriously, or perhaps a refusal to hear the bad news I already knew was coming. It will remind me that despite what I thought was adequate precaution and care in the sun, the ritual of layering sun screen and wearing a hat may still not be enough in a place where the sun shines 300 days a year. It will remind me to remind others to take the same warning signs more seriously.
ABC15 asked Sharon McKenna of the Arizona Department of Health Services for some common facts and myths about skin cancer. McKenna directs the state's Sunwise program, which seeks to raise awareness about skin cancer. She is also a melanoma survivor and has undergone 31 procedures to treat 3 different cancers.
Did you know?
-1 in 5 Arizonans will likely develop skin cancer.
-Every minute, a person is diagnosed with skin cancer. Every hour, someone dies of skin cancer.
-Skin cancer is the most preventable cancer and accounts for half of all new cancers diagnosed each year.
-By avoiding sunburns and overexposure to ultraviolet (UV) light--from the sun and artificial sources, you can lower your risk of developing skin cancer
-Exposure to UV is associated with 90 percent of skin cancers (other causes include exposure to radon, coal tar and arsenic)
-By reducing your UV exposure and protecting your skin, you reduce your risk. When outdoors, cover skin with clothing, wear a wide-brimmed hat, wear sunscreen and lipbalm with an Sun Protection Factor of 15 or higher,
seek cover under a tree or use an umbrella, avoid midday sun when the UV is highest and most damaging.
-A majority of a person's lifetime sun exposure occurs by the age of 18, so educating children is crucial to reducing skin cancer rates.
-Children are exposed to UV often at school during peak times (10 a.m. to 3 p.m.).
-Arizona is the first state to mandate sun safety education (2004), specifically the Arizona SunWise Program which is required of all k-8 public and charter schools (about 1100 schools and 707,000 students learn sun safety).
-More than 200 private and tribal schools participate voluntarily and Arizona SunWise has over 100 partners like the Arizona Diamondbacks, Salt River Project, city of Phoenix, Grand Canyon Park, the state's school nurse and physical education organizations.
-Arizona has over 300 sunny days. Coupled with our warm temperatures, Arizonans are more likely to have exposed skin during peak UV months--May through September.
-Skin cancer is the most common cancer among young women 15-29 years old. Skin cancer in this age group has increased 50 percent nationally.
-A child of a parent with skin cancer is at higher risk for developing skin cancer. There is a genetic link in some cases.
-There are 3 types of skin cancer: basal call carcinoma (BCC) which accounts for 90% of all skin cancer cases, squamous cell carcinoma (SCC) which accounts for 6 percent of all cases and melanoma which accounts for 4 percent of all cases but is responsible for 79 percent of all skin cancer deaths.
-While melanoma is the most fatal skin cancer, skin cancer is so prevelant that states only track 1 of the 3 types of skin cancer -- melanoma. States do not track basal cell or squamous cell carcinomas. Left untreated, a basal cell or squamous cell carcinoma can cause disfigurement and even the removal of a digit if the cancer is found to need excision or removal. Fingers, ears, lips and toes have been removed as a result.
-It's important to see your doctor if you have any spot on your skin of concern. Unlike a pimple with a pointed head, skin cancers are normally flat. While melanomas normally occur in a mole, basal cell and squamous cell
carcinomas often appear pinkish. Basal cell carcinomas appear pearly pink. Squamous appear pink and scaly.
-In any skin spot, look for changes and whether the spot is Assymetrical, has Border irregularity, has variation in Color, has a Diameter larger than the head of a pencil eraser and is Evolving (ABCDE).
-Keep your skin the color you were born in. A sunburn is a sign of skin damage not a sign of health.
-Every skin color can develop skin cancer. People with light hair and light eyes are at greatest risk, but skin cancer rates in California hispanics has increased 8 percent and African-Americans diagnosed with melanoma have a 38% higher mortality rate than caucasians. Jamaican reggae singer Bob Marley died of melanoma that was found under his toenail and spread to other organs.
-Darker skin may not turn bright red and peel from sun damage but instead gets tender to the touch.
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