Tuesday, May 30, 2017

Why I'm wearing hats this summer

"Prevention is better than cure." ~Desiderius Erasmus

Cindy La Ferle
While skin cancer isn't something that makes me happy, I'm grateful for the things we can do to prevent and cure it. Part of the following post was originally published in Michigan Prime (a supplement to the Sunday Detroit Free Press)....

My dermatologist spotted it immediately during a full-body check – an appointment I’d neglected to schedule for two years. I had noticed the subtle indentation in my right cheek, too, but dismissed it as a stubborn acne scar that was easily disguised with an extra swipe of powder blush.  Besides, I’d sworn off sunbathing -- years ago -- after an earlier brush with basal cell skin cancer on my shoulder. I thought I was free and clear.

But the biopsy report confirmed that a large basal cell epithelioma was spreading its roots deep beneath the surface of my cheek, just an inch below my right eye.

To avoid as much scarring as possible, my dermatologist referred me to a surgeon who specializes in the Mohs method, a microscopically controlled cancer surgery developed by Dr. Frederic Mohs in the 1930s. Typically lasting from five to seven hours, Mohs surgery involves removing and examining a patient’s cancerous skin tissue one layer at a time until only cancer-free tissue remains. Afterward, the surgeon might opt to close the wound using plastic surgery techniques or allow it to heal by itself, depending on its location.

The cure rate is high -- up to 99 percent for some cancers. And while the stellar reputation of my surgeon was equally reassuring, I’d be lying if I said I wasn’t nervous about the procedure and the new scar I’d soon acquire.

Facing up to shame  

Even if you're not terribly vain or self-conscious, a long, permanent scar on your face isn’t easy to reconcile. In our celebrity driven culture, appearance matters a lot more than we’d like to admit. Anyone who's ever tried to conceal an untimely acne outbreak -- right before a special event -- knows exactly what I mean. 

For women, especially, it’s hard to ignore the standards of beauty trumpeted by magazine editors and product advertisers. In Daring Great Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead (Gotham), sociologist Brene Brown devotes several pages to the tender topic of female self-image and shame.

“After all of the consciousness-raising and critical awareness, we still feel the most shame about not being thin, young, and beautiful enough,” she explains.

Brown’s shame research hit home the day after my first Mohs surgery. Aside from the hideous black-and-blue bruising around and below my eye, I was left with a throbbing, three-inch “Frankenstein scar” on my right cheek. I spent the following day and night clutching an ice pack and regretting every single day I'd sunbathed without wearing a strong sunscreen.

An ounce of prevention 

As I recovered, I kept reviewing a line from my surgeon’s post-op instructions: "Scars will go through a maturation process and sometimes look worse as they heal." Just as predicted, my new scar morphed from red to purple to pink as the months passed. With varying degrees of success, I tried just about every scar treatment on the market.

Ironically, a week before the cancer diagnosis, I’d been scouting local cosmetic departments for the best anti-wrinkle creams available. My crow’s feet and droopy jaw line were underscoring my impending senior status – and I was determined to fight them. But my epic skin cancer surgery quickly altered my stance in the battle against aging. Now, wrinkles and age spots aren’t such a threat to my pride -- and the health of my skin is now a top priority. 

Last fall, I had yet another Mohs surgery (on my left cheek) after a biopsy revealed early stage squamous cell skin cancer. Time and vigilant use of scar creams have softened the appearance of my surgical wounds, and I'm learning to see them as hard-earned life lessons. 

Or, as author Brene Brown advised, I've finally come to accept my scars and “imperfections” as visible reminders of my humanity. And I never, ever spend a day working in the garden or walking a beach without wearing a good sunscreen and one of the sun hats in my growing collection.  ~CL

1 comment:

  1. Yep, you've got to be vigilant since you had X-ray treatments. You must also get your thyroid checked. I go to my dermatologist every 6 months and I've had at least 25 basel cell skin cancers removed. I only have one scar that bothers me. But I simply deal with it and actually I have to point it out to people. Most people are so busy looking at your eyes and mouth they don't notice the rest of your face or they're so involved with them selves they don't care. Re Retin -A. You might ask again about it. It does leave your skin thinner and more susceptible to skin cancer. I don't use it because of that. Happy to answer any questions.