May is Skin Cancer Awareness Month.
When you think of summer, one of the first things that comes to mind is sunshine. That bright sphere of amazing warmth that allows us to enjoy the pool, weekends at the lake, and the desperately needed summer vacation. It is, after all, what we have been waiting for since winter. Growing up in Alabama, my summers were spent outside. Mom covered us in sunscreen and we were off to the community pool from morning till late afternoon. Family vacations to the Gulf are embedded in my memory bank as the sugar sands were our playground. Our biggest worry was not having enough time to play. Later as a teenager, it was not having a dark enough tan. Many friends spent their afternoons and weekends at the tanning bed. A “good base tan” before vacation . . . then, you had to keep the tan lasting through winter. A tan was THE beauty trend. The darker the better! Who knew back in the 80s and 90s what dangerous behavior this was?
In 1998, I entered college and graduated from UAB in 2003 with a Bachelor in Psychology. My goal was to be accepted into and graduate from the UAB Doctorate of Physical Therapy program. I was midway through my second year with the final few semesters before internships. Then, one evening in 2005, I remember a conversation I had with my mom — and the first time I heard the word “melanoma” in the same sentence with MY DAD. My heart sank a few inches in my chest. Soon the series of surgeries began to remove melanoma from his scalp, striving each time for clear borders. Skin grafts were needed to allow the area to heal. If clear borders were found, then they stopped, but if unclear, more surgery was needed. What we didn’t know then, was how aggressive this type of cancer is and what treatments would soon begin. Not too long after, the second spot, very close to the original, showed its ugly head. Now, we knew that it was already spreading. More surgery was ordered, then immunotherapy began. It was a brutal time period — breaking his body down. Again, the hope was to rid his body of any remaining melanoma cells.
Over, the next six years, there were periods of being healthy. Then BAM — another melanoma would appear. PET scans were ordered and a bright spot would be seen . . . further away from the original. Surgeons would remove the mass, biopsy to confirm melanoma, then decide treatment. The little mole, AKA melanoma, wasn’t just a mole. It was an aggressive group of cells that moved inside toward the lymph system, and wherever they landed, they grew . . . a groin lymph node tumor; the parotid gland tumor (the salivary gland on the side of the jaw), and then multiple lymph node tumors. By this time, we were speaking the words metastatic melanoma. It was NOT skin cancer any more . . . not a mole . . . it had become brain cancer.
Needing the latest melanoma treatment available, it was medically advised in 2009 that Dad go to MD Anderson in Houston for specific treatments that hadn’t been tried in Birmingham. You may ask, Why didn’t they do chemo before?? Well, it had not been recommended before because research hadn’t shown melanoma responding to chemo. The amazing doctors at MD Anderson began a new treatment plan that included a specific chemotherapy regime as well as a gamma knife procedure. The doctors were trying to kill the melanoma cells that were now in the brain. The risk of side effects of this procedure included brain swelling and seizures. For Dad, they weren’t just risks, they became the reality.
The physical therapist in me noticed his mobility and function changing. The daughter in me refused to see it. At the end of 2010, my dad’s condition began to change very quickly. The seizures worsened, and by May 2011, he returned to MD Anderson and was told the devastating news that his body would not be able to finish the new treatment. That little mole that started at the top of his scalp was now terminal brain cancer. The word hospice . . . then the timeline . . . three months.
July 5, 2011, my most precious dad, the greatest man to walk the earth, left us here and entered heaven. He lived a life of dignity and grace. He loved unconditionally and left a legacy for me, my family, and my children. He has already touched countless lives and his story should be heard and learned from. He didn’t tan. He worked in the yard and enjoyed being outside at sporting events and family activities. He was diagnosed with melanoma and lived the battle for seven years. He fought with strength and never lost his faith. He knew his Lord wouldn’t give him more than he could take. He believed his life was a gift and he lived it — letting others see God’s amazing love through him.
Underestimating the dangers of sun damage is apparent when you look around and see people using tanning beds and sun bathing without protection. It is not only unwise, it is irresponsible. My dad’s story is one I want people to know. He did NOT have the stereotypical melanoma that images show. His was flesh colored and would have been overlooked by many. Skin cancer is not just a mole that could lead to a scar, and it isn’t just skin deep. It can be the beginning of something far more dangerous. Melanoma can be fatal!
The American Cancer Society’s estimates for melanoma in the United States for 2019 are:
- About 96,480 new melanomas will be diagnosed.
- About 7,230 people are expected to die.
It is so vital to catch melanoma, the deadliest form of skin cancer, early that physicians have developed two specific strategies for early recognition of the disease: the ABCDEs and the Ugly Duckling sign.
ABCDE :: Asymmetry, Border irregularity, Color variations, Diameter over 6 mm, and Evolution or change
Ugly Duckling method :: Check for any mole or lesion that stands out from the “flock”. It may be larger or darker than surrounding moles, smaller and redder, or the sole mole on an area of the body.
Some melanomas may have no color at all. Physicians refer to these as amelanotic melanomas because they are conspicuously missing melanin, the dark pigment that gives most moles and melanomas their color. These unpigmented melanomas may be pinkish-looking, reddish, purple, normal skin color, or essentially clear and colorless.
Prevention is KEY! Seek the shade, especially between 10:00 a.m. and 4:00 p.m. Tips from the Skin Cancer Foundation include:
- Don’t get sunburned.
- Avoid tanning and never use UV tanning beds.
- Cover up.
- Use a broad spectrum (UVA/UVB) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/UVB) sunscreen with an SPF of 30 or higher.
- Apply 1 ounce of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours or after swimming or excessive sweating.
- Examine your skin head-to-toe every month.
- See a dermatologist at least once a year for a professional skin exam.
Should we live in fear of the sun? No! Should we not enjoy the summer months outdoors!? Not at all! What we should do is protect our skin and be vigilant with friends and family to do the same. Encourage dermatological visits annually. Find a dermatologist and have regular skin checks. Life is so precious, and it is so important to enjoy life (and sunshine) and every single moment with the ones you love!
Jessica is a born and raised Alabama girl. She lives in Hoover with her husband, Marc, and their two children, Ben (8) and Abby Grace (7). Their family loves animals and shares their house with 13 year old black lab, Slider; 11 year old golden retriever, Shea; 4 year old Maltese, Cosmo; and 1 year old guinea pig, Coco. Jessica is a graduate of UAB’s Doctorate of Physical Therapy program and has worked as an orthopedic sports medicine Physical Therapist for 13 years. She is the clinic director at Impact Sports Medicine in Calera, Alabama. Her family is everything to her and most all of their free time is spent enjoying their kid’s many fun activities and sporting events. Jessica’s hobby is refinishing furniture and creating pieces from reclaimed wood. She enjoys taking something that could be discarded and forgotten and giving it new life and purpose. She is an optimist by nature with the “glass half full” perspective.