Adventures with Roberta
One night last week as Jon and I were changing clothes and getting ready for bed I noticed a small mole on his back that sent the arrow of my skin cancer radar so far into the red that it broke in half. My radar is perhaps more sensitive than most, and if you're new to this website I should explain that I've had five suspicious moles and discolorations removed from my body in the last few years, two of which turned out to be skin cancer (you can read about my experience here, here, here, and here). So you could say I get a little jumpy when I see the tiniest skin abnormality, and for the next twenty minutes I grilled him as if he were a suspect in a gruesome homicide: how long has he known about this mole? Has it recently changed colors? Was he planning to have it checked out or was he just going to take his chances and SUDDENLY MY CHILDREN HAVE NO FATHER?
Problem is there was no one there to play good cop, so it looked less like an episode of "Law and Order" and more like a cartoon where a maniacal hen who's been left in charge of an egg accidentally pecks it into a thousand tiny pieces.
It could be absolutely nothing to worry about, but we've scheduled him an appointment with my dermatologist to be safe, and there's a part of me that wants to thank Jon's mole for reminding me that I'm due to self-treat another suspicious spot on my body, one I found on my forehead several months ago. It's tiny, not even half the size of the fingernail on my pinky, but because of its rough texture and unwillingness to go away I brought it up with my doctor who diagnosed it as a "precancer" known as actinic keratosis:
An actinic keratosis, also known as a solar keratosis, is a scaly or crusty growth (lesion). It most often appears on the bald scalp, face, ears, lips, backs of the hands and forearms, shoulders, neck or any other areas of the body frequently exposed to the sun... In the beginning, actinic keratoses are frequently so small that they are recognized by touch rather than sight. It feels as if you were running a finger over sandpaper.
If you have actinic keratoses, it indicates that you have sustained sun damage and could develop any kind of skin cancer – not just squamous cell carcinoma.
In keeping with the tradition of naming these suspicious invaders I've decided to call her Roberta. When she isn't busy disrupting the surface of my forehead she teaches salsa lessons at the local community center and routinely sleeps with her students.
Here's a picture of what she currently looks like when I haven't covered her up with make-up:
My doctor assures me that we've caught it early enough that I can successfully treat it at home with a medicine called Aldara, a topical ointment that I apply directly to the skin for a period of twelve weeks, and that I could even wait to start treatment if I was worried at all about its effects on the baby in utero. I've also put it off because of my vanity, because he said it would cause the spot in question to turn a reddish color that couldn't be concealed with make-up, and I just wanted to get through my book tour without having to keep coming up with creative answers to WHY DO YOU HAVE A HICKEY ON YOUR FOREHEAD?
I figure no one is going to notice the hickey on my forehead when my boobs are the size of nuclear warheads and leaking milk with the force of a fire hose.
I wanted to bring this up here for a few reasons:
One, The American Cancer Society recently became one of the sponsors of this website, and they asked me if I'd be willing to write about one of the ways in which cancer has affected my life.
Two, some of you have written to ask if I've found any more suspicious spots on my body. I think you could ask me that question every year from now until I die and the answer will always be yes. This is just what happens when you're as careless as I was in my teens and twenties about sun exposure, and as a result I will spend the rest of my life terrified that every skin irregularity could end up threatening my life.
And finally, maybe these details will be what finally urges someone to make an appointment with a dermatologist, maybe these images will turn up in some Google search and convince someone that they should take the discoloration on their forehead seriously. And so let me urge you, if you are at all unsettled about a strange place on your skin, please don't ignore it. And in the meantime put on some sunscreen, hug your kids, and call your mom.
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Heather talks about public tantrums (from kids) on today's Momversation.
- Bedtime, Leta lingering defiantly in the hallway. Jon: "If you want fart stories, you better get in bed RIGHT NOW."
- RIP Louis Mortimer Armstrong: http://bit.ly/1R4tv6
- Hugs and kisses to you, too! RT: @Monkey_Tree: @dooce he probably committed suicide because he was tired of LISTENING TO YOU WHINE.
302. MaL said:
Yeah, educate yourself and be prepared for Aldara's side effects, but don't let google scare you off! Cryotherapy does take care of the one spot right away but doesn't take care of developing keratoses beneath.
I used to work with the dermatology residents at the U! I imagine the ones I knew are all graduated by now.
303. jen said:
Thank you, thank you! I'm thrilled to see the ACS sponsoring your blog and to know that you'll be writing about your experiences. I can only assume that you'll lend the same hilarious yet thoughtful voice to this subject as you do all others, and that can only mean good things for the fight against cancer...a cause near and dear to me and mine.
304. Katie said:
Thank you so much for using your very popular wonderful blog for the Cancer Public Service Announcement. As someone who had to have half her nose cut off at the age of 20 (wonderfully recreated with the miracle of plastic surgery!) I'm all for getting the word out. Again, THANK YOU!
305. suenarita said:
Some Dermatologists are Mole-happy, like mine. If they don't remove anything they don't make much money...
306. Mel said:
You know how sometimes the same thing keeps coming up in many places and you finally see it as a sign that the universe is telling you something? I am massively careless with sunscreen and it filters down to the kids. I just don't think about it unless we're at the beach and that's a terrible way to treat your skin. First my friend had moles removed this week that turned out to be cancerous, then I was just at the food store behind a woman purchasing massive quantities of sunscreen, and now I come home to read this.
Third time knocked it into my thick skull?
Thank you for this. While Roberta sounds like a fun-loving girl, though a bit risky with her dalliances with students, I just don't want her showing up on my skin. Or the twins. This post just made that sink in.
307. Em said:
After reading this, I made appointments for me(lifeguard 7 years) and my husband(southern california water polo player for like 15 years!!) to have a general check up at the derm this summer. Thanks. Seriously. You do good things with this site.
308. tania said:
i hope that folks read this far down into the comments. a lot of you are commenting on how paleness equates a risk of skin cancer and while that is certainly true, i'm reminding all the folks with darker skin to take care as well. i have an olive complexion, never burn and only tan, and still had a basal cell carcinoma removed from under my eye when i was 26. i went to a plastic surgeon because of the delicate location, and the ONLY REASON that the mass was biopsied was so that i could claim the surgery on my insurance. i had no idea it could even be cancer.
because of my darker skin, i am considered "low risk" and might never have known it was cancer. we are all susceptible and need to wear sunscreen all the time!
309. Anonymous said:
going to the dr tomorrow regarding mystery place on back. don't want to. going anyway. thanks for the nudge.
310. Nicole Francois said:
One of my friends--at the tender age of 29--is currently battling skin cancer, and he may loose this battle however much it pains me to admit this fact. He had a suspicious mole for years, that he noticed and knew was potentially bad. But he did not have health insurance and waited until he found a job that provided coverage before getting it checked out. By that time, the cancer had spread so far as to leave him with only a 25% chance of survival. (At this time, he's doing "well" and I think it's more of 50/50 gamble, the odds of which will hopefully continue to improve until he's in the clear, so to speak. HA! a little skin cancer humor for you.) I applaud you for bringing this subject to light, as I don't think people realize how potentially and probably fatal a cancer this is and how completely treatable it is when caught early and completely preventable it is. Your a beautiful and funny writer and it truly makes me respect you and your life even more that you will be using your voice as a wake up call on this issue to sun worshippers, weird mole deniers, and other idiots.
311. Amy @ Dear Mazzy said:
I need to show this to my parents. My mom actually owns a tanning bed. WTF?? And they think it's ok for my daughter to play outside in Texas with no hat/sunscreen cuz she's "in the shade" most of the time. In a 1-acre yard with 8 trees. Right.
312. Pamela said:
Is it true that when the dermo does an all over skin check they look at your female stuff and in between your butt cheeks too? Because I've heard that.
313. Lacey said:
My father passed away after fighting squamous cell carcinoma and the complications from that last September, so no, I don't believe you can ever be too cautious!
314. Negar said:
I am covered with these, althought flat but dark. I heard that a person has an average of 600 on their bodies. I used to get worried now they are too many and I jsut stay away from the sun.
315. KaraMac said:
I went to the dermatologist for the first time this morning to check out a spot on my face. "That is a precancerous lesion. Do you have anywhere to be this weekend where you wouldn't want a red scab on your face? No? Good, I'll just burn that off right now." The fun all happens before 9 a.m. in my life. :)
316. Darlene said:
Thank you for this post, and especially the pictures. I had always thought, mistakenly, that the only moles to worry about were dark brown or black in color. That's what you would always see in pictures of "suspicous moles." A pinkish spot on my nose (that I orginally thought was a pimple) turned out to be a pre-cancerous growth.
317. domestikate said:
Kudos for being so proactive on this subject, and thank you for sharing! I really appreciated your posts on basal cell a few years back, it made me think hard about my own skin.
I'm a 35 year old woman and I just finished a 5 week run of Aldara for basal cell and AK on the skin along the edge of my top lip. My doctor told me very little about the drug, and prescribed it in a cavalier fashion. He even prescribed about 10 times the amount that I needed- and this is a very expensive medication.
I hope that you'll do some research on the drug and proceed slowly, it is a powerful medication, with many potential side effects. It's even been linked to the trigger of serious autoimmune conditions like lupus.
If you chose to use it- A little goes a LONG way, just the tiniest dab should cover that little spot.
I chose to use it as freezing hadn't worked and the other option (MOHS scraping) I would require some very tricky plastic surgery to my lip, and would still leave me with AK in the surrounding areas.
So I used Aldara for 5 weeks, a few times a week it in a somewhat non-recommended area (close to the soft tissue of my lips). I was sick as a DOG for the duration. I had days where I would have thought I was dying if I hadn't done the research into the side effects. And of course I was a horror show of scabs on top of scabs, which meant it was working. It's healing up nicely now and I'm glad I muscled through.
Hopefully dermatologists will come to a better understanding of the powerful nature of the drug, there's so much that mine did not tell me.
318. aliplus3 said:
Thanks for getting the message out that pale can be cool too!
It's particularly important to protect our kids - each sunburn under the age of 5 dramatically increases their lifetime risk of cancer. My derm (chief of dermatology at a renowned research and teaching hospital) said that babies can be protected with zinc oxide instead of regular suncream (most pediatricians tell parents not to apply sunscreen to babies under 6 months, but our neighbour's 8-wk-old granddaughter got 2nd degree burns after 30 minutes in the shade. And we live in Quebec - hardly equatorial!).
And don't rely on sunscreen alone - cover up with SPF clothing, a hat and sunglasses with UV protection (you can get melanomas in your eye). Like they say in Australia: Slip (on protective clothing), Slop (on sunscreen with a high SPF) and Slap (on a hat).
Also, darker-skinned people shouldn't feel immune. Remember, Bob Marley died of melanoma.
319. Amber said:
CRAP. You are making me realize that I should really get to a dermatologist ASAP. Honestly, this has reminded me that I am practically an albino and was a *lifeguard* during college, and that during my pregnancy my skin threw a party and invited tons of new moles, red spots and rough patches. My skin looks like crap. But rather than throw my hands up and accept my new, less attractive reality, I should make sure I'm in the clear with all these new spots and rashes and whatnot. Thanks for the reminder, dooce!
320. Anonymous said:
My poor future children... Every time I see an infant or toddler in the sun (even this morning at 8 am - in Chicago) I think to myself - oh gawd, I hope they've put sunblock on that baby.
I'm very fair skinned and burned to blisters several times in my life. I haven't had a full body scan in about 15 years but I started developing my first liver spots in my early 20s. so far all of my spots are non-worrisome, though there is melanoma in my family.
It would be a good idea to find a doctor to get a good baseline to work from later.
321. Nancy said:
Two things: 1) thank you, and 2) stay well :)
322. Angie said:
I have been meaning to make an appointment for a routine skin check for a long time. After reading your post I actually called and made the appointment. Thank you for the reminder.
323. Stacy said:
Not all cancerous moles follow the rules. My malignant melanoma moles were completely void of color; they were totally symetrical and they did not change.
I am so very blessed that I am in remission; several people I went through treatment with were not so fortunate and mine was further advanced, stage iv.
Don't mess with this people. It is truly a horiffic disease. Dying from it is even worse.
324. Anonymous said:
Maybe you should drop in at notesfromthetrenches.com, read today's (May 21st) post and (gently) ask Chris (the blogger) to check out your cancer history before she pooh-poohs sunblock for her kids....
325. P said:
I've often joked that I've "bought" my dermatologist a condo on the beach. That would be the cruel reality, huh? :o)
Living in Florida and being raised during a time when baby oil and iodine* were accepted sun(burn) oils has not been kind to my skin. Not to mention, I'm one step away from being a redhead. Anyway, I totally related when you said you would always be finding suspicious spots from here on out. My personal record was 23 during one visit. You know that little diagram they record them on in your patient records? Mine looked like I had chicken pox. Not pretty!
Thanks for the gentle reminder that it's time to go get spot checked (again)!
* What genius thought that one up?
326. Ali said:
I think I need to name mine too. I've had over 30 removed in the last two years - the worst being stage 1 melanoma. Paranoid doesn't even begin to describe how I feel about my skin/moles now. And like someone else said, I am all for the scars if it means I get to live.
327. Anonymous said:
By sharing this information on your blog, I am certain you saved at least one person out there who has some sun damage. Love your blog! Best wishes to you and your family.
328. Sarah said:
My husband has a mole on his chest.
He calls it 'BOB' as does our almost 2 year old son...
329. Jill said:
Hi guys,
Just a quick reminder....as well as sunscreen, don't forget to wear sunglasses!! I have had numerous basil cell carcinomas cutt off my body (mainly forehead) and of course now I use sunblock liberally. I never even thought to protect my eyes as well until yesterday I went to the eye doc and have a suspicous freckle on the back of my eyeball...YES! My eyeball!! Please wear sunglasses and put them on your kids as well!
330. tanyakristine said:
jesus. i've got a ton of those! thanks DOOCE! now i'll be paranoid till i see a dr!
331. HeatherAktie9 said:
Hey Heather,
Sorry to see you are dealing with more skin cancer issues. Hope this one is easily dealt with. Thinking of you & sending you good thoughts & vibes.
XOXO HUGS! --Heather :)
332. julie said:
i have so many effing moles and spots that i hardly notice when a new one appears or when one changes shape. however, thanks to you (and all the commenters' horror stories), i will go see a dermatologist as soon as i have health insurance again. this lack of medical care is unquestionably my favorite part of graduating from college.
333. Alissa said:
I think it is so great that you are sharing this information with people. It is so important to take care of your skin from a young age. I don't think young people generally understand that they are not invincible. Again thanks for sharing.
334. Baby Favorite said:
Okay, you convinced me. I called as soon as I read this post yesterday and got in to see a dermatologist at 1:30 today!
Interestingly enough, the stupid scaly thing on my forehead was most likely a wart (eww), but the doctor found a very suspicious mole on the back of my calf that she also biopsied. I never even thought it was a mole--figured it was a dark freckle! Who knew!
Also, thanks to that appt. (and you), I am now set up for some chemical peels and microdermabrasion. So, even if it ends up not being life-saving, it's complexion-improving. Right?
Thanks, Heather!
335. Carrie said:
Thank you, thank you, thank you. My husband and I just attended a funeral this week for a dear friend who died of melanoma, at the age of 50. Thank you for this very important public service announcement.
336. Jen said:
I am dealing with the exact same diagnosis right now. At my annual skin check, I showed the doc this spot on my nose that a different doc had passed off as nothing. This guy did two punch biopsies on my schnoz (THAT was something makeup can't cover!) and viola... solar keratosis. I'm treating with a very aggressive three-week topical cream that I'm assured will make me look like a freak who tried to use a cheese grater on her nose (makeup WON'T cover THAT). Should be a treat since 1.) I'm vain. and 2.) I'm a PR person. As in, in front of the public on a regular basis. Yeah.
Point is: good luck to you! I feel your pain.
337. Jennie said:
I'm going to make it my goal to get an appointment very soon. I've never had my skin checked and think about doing it all the time. No more putting it off! Thanks for the reminder :) BTW, I read your blog a lot, but have never commented before. I totally enjoy your writing!
338. Casey said:
Great post, thank you. I had something suspicious removed years ago (not cancerous, just odd cell "architecture"), and have been meaning to get the full body scan. I'll hug my kids and call my mom first, though.
339. HMFT said:
Funny you should post this today.
I spent yesterday scouring your site, looking for the skin cancer stuff. Found what I was looking for, and stopped at my doc's before picking Seth up from school.
I have this weird bump on my back. Thought it was a zit, but the damn thing won't go away. Or heal.
Doc says it looks like nothing. Keep an eye on it. Still there in 2 weeks? Come back to see him.
So...thank you. You lit a fire under my ass to keep an eye on this thing.
340. Kristy said:
Thank you so much for this reminder! I'm being treated for breast cancer, and like skin cancer, early detection is the best defense ... except sunscreen!
I recently read that tanning booths can increase odds of getting skin cancer by 150%. Do people still go to tanning booths?
341. izze said:
Just wanted to give another suggestion that you may want to consider to treat any precancerous lesions, especially on your face. This can even get those that aren't visible to your eye yet.
I'm an RN and have worked in dermatology for many years, and here in Los Angeles we treat AKs with a "blue light" that does in a few days what daily topical meds take weeks to achieve. It's VERY effective. You'll wait until after the baby is born, and you'll need to check compatibility with breastfeeding... but first a solution called Levulonic Acid is applied to your face and left to incubate for an hour or more. Then you will sit with goggles on, under a blue light laser, and you'll feel a tingling (can hurt a lot or a little, depending how many precancerous lesions are there) -- for 15 minutes. Then you CANNOT go in the sun all weekend, and you will have a sunburn look... but by the following week the areas will peel off and you'll be good as new. Also refreshes the skin in general. I highly recommend it over what your derm. is suggesting. He probably doesn't have the equipment, but you can search for a doctor in your area that does "Photodynamic Therapy", or PDT.
This way you'll be treating whatever could be developing quietly on your face, well before you can see most of it, and perhaps this will ease your mind. You can do these treatments regularly, depending on how much sun damage you have... or just this time if you only have the one lesion.
342. MizzM said:
Well, your blog is so damn POPULAR that you probably won't even read this comment, but my grandmother (a Breast Cancer Survivor) died from Melanoma that had absolutely NOTHING to do with weird-ish looking moles. It was completely a-typical in presentation and morphed into her lymph nodes, brain, and what-not.
Because I have good health insurance, I regularly schedule a visit with my Primary Care Physician (which is usually fulfilled by a Nurse Practitioner or a Physician's Assistant and NEVER an actual DOCTOR, because that's the best you can hope for with an HMO and/or socialized medicine.) I have LOTS of scaly, crusty, pre-cancerous "issues" floating around on my back, and the only thing I'm told is, "Oh, yeah, you have pre-cancerous crusty crap all over yourself. Use sunscreen."
Ummmm...okay...I have insurance, so what are you going to do about it?
The answer?
NOTHING.
Which is EXACTLY what they told my Grandmother with her "atypical presentation" that she died from.
People "pooh-pooh" Skin Cancer all the time because they are ignorant and clueless.
343. Becky said:
OMG...WE ARE ALL GOING TO DIE OF CANCER!!!
(I couldn't resist)
344. Mandinka said:
Thanks so much for this timely post. Just tonight I saw a suspicious spot on my Mum's skin, but she brushed it aside. Now I can use your story to convince her to get it checked...or I'll just threaten to break her fingers or something evil like that.
345. Mamasoo said:
My mom recently passed away from skin cancer, so I've become an annoying PITA to everyone I meet regarding sunscreen, tanning and self check-ups. Good luck with Roberta, and with Jon's mole.
It disturbs me, however, while reading your post that you have the American Cancer Society as a sponsor on your site. Are you actually taking money from them for their advertisments? Hope not. As a cancer survivor, that would be reprehensible.
346. Anonymous said:
Just throwing this out there bc I was shocked when my doctor prescribed me Aldara...it's a good 600 dollars with out pharmaceutical coverage... I have one of those lame insurance plans that will only do anything for me if I'm litarally dying and have to go in the ER via ambulance with my arm/leg/head cut off. It sucks.
347. Candace said:
Thank you for this! Needed a reminder to make my every 6 months appt with my derm - just scheduled a check for next week.