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.

Jon's suspicious mole

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:

actinic keratosis

actinic keratosis

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.

  • Ninabi

    Last week, we said goodbye to a friend whose melanoma traveled to the brain. My husband sat in the pew beside me with a fresh 4″ incision on his stomach to clean up a not-so-great biopsied area.

    Our daughter went to prom with a massive scar down her back for the same reason. And no, she never used a tanning bed.

    I cannot thank you enough for bringing attention to this nastiest of cancers.

  • http://simplyblissful.blogspot.com/ tracy

    Heather ~ living in Juneau, where we have something like, 300 days of precipitation a year, it’s easy to take skin cancer for granted as something that will never happen to you. You have made me re-think my visits to the tanning salon, and I used to LIVE for my 15 minutes of sun a few times a week come summer time. Now I actually look at all those little moles & bumps on my body & wonder…what did that thing used to look like?? And you can bet I will always, always put sunscreen on Ellis.

  • http://simplyblissful.blogspot.com/ tracy

    and PS, this is ironic given the subject of your post, but you have really gorgeous skin!

  • Laurie

    I think it’s fabulous that you are writing about this but also that the American Cancer Society is a sponsor. I know two people who have died because of melanoma and even I need the reminder to slap the sunscreen on me and my kids. Gone are the days of slathering on the baby oil!

  • http://www.fleuris.ca fleuris.ca

    …and cool eyes too!

    My dad died of skin cancer when I was 6, so I’m pretty vigilant too. Consider yourself lucky that you can get your husband to the dr on-demand. I have to beg my boyfriend for a year to get an appointment before he agrees to go!

  • bobbiboe

    Just like #42 I am also a Roberta but I don’t mind too much if you choose the name for your mole.
    I have been called an alien but never a mole!

    I do have to get the courage to check some of my not so beauty spots, specially one that is getting a bit rough on my forehead.

    Thanks for the incentive.
    I do like the title of the post!

    PS: Your book is GREAT.
    I just finished it two days ago, and even if I was never able to have kids I still think the book is a great gift you gave women in general. Keep writing, here, there and everywhere, you do have a gift.

  • http://kcrules.wordpress.com Jennie

    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!

  • http://hopelds.blogspot.com Hope

    Thank you so much for sharing your experience. My daughter has had skin cancer already at age 29 (weren’t we told that tanning beds were healthier?), and I’ve had three biopsies so far.

  • skndeep

    Heather, I’m a dermatologist in Richmond, Va.
    Relax about your husband. From your picture, it looks like a BENIGN seborrheic keratosis. These are harmless warty growths that occur universally in humans…it’s more a sign of advancing decrepitude than incipient death.

    Of course you should have a local derm look at it (my legal disclaimer). They’re 100% benign, he will get more, if he hates it, it can be easily peeled off with liquid nitrogen freezing, but insurance doesn’t cover cosmetic procedures.
    If it’s symptomatic, your derm may be sympathetic and take it off for ‘biopsy’ (wink-wink).

    RELAX.

    Feel free to email me privately if you have any other skin related questions. I’m a pretty damned great dermatologist!

    PS- I saw you on Oprah and spent 2 weeks of my life reading 8 years of your blog beginning at timeline zero. It made me very grateful to be entering the shriveled ovary stage of my life.

  • http://www.kitchenwitchcookie.wordpress.com Casey

    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.

  • http://iloveyoutopieces.blogspot.com Kristen

    I couldn’t have said it better myself. I was 22 (I’m 23 now) when I was diagnosed with melanoma (non-invasive but still melanoma) and now I am all the time worrying about any little spot on my body…

    Glad you caught your new friend in time!

    Like you I hope anything I say on my blog about skin cancer will lead someone to a dermatologist if they are concerned about a lesion… We both are proof (and everyone else too) that it can happen to anyone, at any age!

    Have a great day@

  • http://www.wix.com/hturner/strawberrygoldie HMFT

    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.

  • http://gagliardislife.blogspot.com Felicia

    I had a pre-cancerous mole removed about four years ago and just had another checked. It actually turned out to be something called a dermatofibroma, not cancerous. But now I have another suspicious marking on the back of my hand. It sounds terrible, but the reason I don’t go in is because my insurance is incredibly terrible and I’m your typical poor working-class person. I know it sounds so dumb but if it turns out to be nothing, like it did last time, I’m out the $$ for the appointment. I also guess I’m not sure if I should seek out a dermatologist or stick with my regular doctor. It seems like the insurance companies make it extra difficult for people to seek treatment for anything.

  • http://annamariajunus.blogspot.com/ Anna

    You managed to even make a post like this funny.

    I have a mole on my chin that started off in my teen years as a beauty mark. Now it has a life of it’s own.

  • Dana

    Question for the Dermatologists here. I have many, many moles which always change and itch and act weird. Is there a good reason my Dr. backed waaay of on what he is willing to remove? We actually had a little “discussion” regarding a strange changing mole that I felt he should take off. He declined and brushed me off. He previously would take off 3-5 moles on an annual visit. Some are mild to moderate. Should I be searching for a new guy?

  • Jen

    i NEVER comment…. but my dad died of melanoma almost 2 years ago and if this post saves even one life, you are a hero. no one should have to go through that.

  • http://www.jodianderson.com Jodi Anderson :: so NOT cool

    Aw, shit.

    I mean … thank you.

    I have really fair skin and although I wear a lot of SPF (this decade), so much so that it looks like I am wearing head-to-toe Spanx, I have noticed various spots on my skin over the last few years. I looked at the colored ones and they seem *round*, so I haven’t been concerned.

    More importantly, I have totally ignored THE SANDPAPER ONES that have been appearing more and more frequently. While I am cautiously optimistic, I will definitely be getting those suckers checked out. Thanks for the info on actinic keratosis.

  • Barb

    Thanks for the reminder. I’m calling the dermatologist tomorrow! (It’s so easy to put it off, but this time I mean it!)

    p.s. I love your blog – thank you for writing it! and sharing it with the rest of us!

  • Dana

    http://images.search.yahoo.com/images/view?back=http%3A%2F%2Fimages.search.yahoo.com%2Fsearch%2Fimages%3Fp%3Dmelanoma%26b%3D21%26ni%3D20%26ei%3Dutf-8%26pstart%3D1%26fr%3Dyfp-t-106&w=600&h=457&imgurl=www.dermatology.org%2Fmolemelanoma%2Fimages2%2Fmelanomaimage15-medium.jpg&rurl=http%3A%2F%2Fwww.dermatology.org%2Fmolemelanoma%2Fmelanomaimage15-medium.html&size=26k&name=melanomaimage15+…&p=melanoma&oid=8975dc66716303ba&fr2=&no=29&tt=62243&b=21&ni=20&sigr=123qugh8p&sigi=123c4r3v2&sigb=131n97aec

    check out the image i linked:

    yeah, it looks like a melanoma to my associate and i but the biopsy will be able to confirm the stage and prognosis.

    get it checked out so it can be removed ASAP (it may take a few cuttings to remove the entire cancer) and speak with the oncologist about chemo (to ensure that if it spread, it wont attack a vital organ)

  • Megan

    Just thought you’d wanna know that Aldara cream was originally put on the market to get rid of genital herpes. Sorry, I’m a pharmacy tech and I think that kinda stuff is funny in a weird way….

  • http://northwestladybug.blogspot.com/ Carol

    I have nowhere near your readership but like you, I have been yelling it from the rooftops for a while now — especially since my brother-in-law started Interferon treatments last year. I’ve blogged about the numerous moles I’ve had removed (just search “melanoma” on my blog) and believe me, the untrained eye can NOT distinguish cancerous moles from non-cancerous moles most of the time.

    Glad Jon is being checked out.

    Carol

  • http://gagliardislife.blogspot.com Felicia

    By the way, has anyone ever told you that you look a lot like Emily Haines from Metric?

  • Amy@UWM

    I work for the American Cancer Society and want to thank you for bringing attention to such an important issue. This is a great post and so timely because May is Skin Cancer Awareness Month!

    Here’s some ACS info that might be helpful to your readers about skin checks http://tinyurl.com/qd4cmb and another page about protecting yourself from UV rays http://tinyurl.com/plda4f.

    We’re so thrilled to be sponsoring your site. It’s clear from reading your post and your readers’ comments that so many of us have been deeply affected by cancer. Speaking of sponsors, the Society’s new “Official Sponsor of Birthdays” campaign is all about creating a world with less cancer and more birthdays. We hope you all will join the movement for more birthdays by declaring ACS the official sponsor of your bday at http://www.morebirthdays.com.

  • Jen up north

    Red hair, skim milk white skin, and tanned like it was a job during my teen years. (I live in Utah too)
    The derm says more than five sunburns in your lifetime substantially increases your risk. I thought, “I get more than five sunburns a YEAR, not even on purpose!”
    I am 36 now and am getting three basal cell carcinomas removed from my back next week. My understanding is that they remove a “cube” in order to get clear margins and then do layers of stitches.
    Did they even HAVE real sunblock in the seventies/eighties?
    This sucks.
    Good luck to you and Jon!

  • Anonymous

    My friend lost her 18 year old brother to melanoma. Thanks for spreading the awareness.

  • http://www.themerrills.blogspot.com Kristy

    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?

  • http://www.ourlifewithlucy.blogspot.com Lori

    I think we are long lost identical brain twins.

  • izze

    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.

  • Brittany Fowler

    I don’t know if yo read the comments or not, but I just want to warn you about using Aldara. I was put on it for a type of HPV that could be cured with the cream. I had a very bad reaction to the cream, and while I was using it I also noticed that I had a very hard time swallowing, almost like my throat was closing up. Since stopping it, the skin that had become really irritated to the point of it bleeding and becoming pussy, has since grown back, but for about three weeks I couldn’t use the bathroom without it burning and fighting the urge to cry. I suggest you google Aldara before you start using it, because most of the time a doctor will prescribe something but will overlook the side effects, and believe me when I say this because my parents are both in the drug industry. Plus, I have great insurance through my work, and after it all, the cream cost me $45 to fill. I don’t know if you have insurance, but it’s a pretty expensive drug.

  • Katie

    I’ve recently given up pretending I’m olive skinned and supposed to be tan. Thanks to my brother’s lovely EX girlfriend who told me I was going to get skin cancer and die (on my birthday!), I’ve made spf 70 part of my daily routine. I’m only 19, but I’ve already have had friends with skin cancer.

  • Jenn

    Well, I’ve never commented before but now I feel compelled to.

    Why? I spent 2 months exactly a year ago afraid that I had skin cancer. I had a nasty (DISGUSTING) scabby, ooozy mess on my face that no amount of biopsies and scrapings could diagnose. Turned out to be a bacterial infection, thanks to the spa that gave me a facial with some contaminated cream or something. Ugh. I walked around Italy for 2 weeks with bandaids on my face feeling like a leper. Now I have a scar to remind me of the whole crappy experience and I too, am a reformed sun worshipper who does her best not to lecture those who refuse to wear sunscreen.

    Anyhow… you get a billion comments and I’m just another stranger telling you her story, but my fingers and toes are crossed for ya cuz cancer can bite my ass. Good luck :)

  • http://main.acsevents.org/site/TR/RelayForLife/RFLFY09OH?px=6301979&pg=personal&fr_id=16444&et=gZp_Z7qSq9Ej-e_bfLG56g..&s_tafId=279222 Amber

    I noticed the American Cancer Society logo earlier this week. It was just a little sign of the universe coming together for me…my husband is a cancer survivor and we’re gearing up for our community’s Relay for Life this weekend. I’ve been fighting nerves about my impending speech as part of the opening ceremony (see, I turn a bit flaming red when I speak in front of more than 10 people). But, I keep seeing the logo and it is a confirmation that we are fighting cancer *together* – and it gives me courage. Thank you, Heather, for sharing your story.

  • http://www.gregandlori.com Lori

    I had a 10 month old daughter when I got the call that the mole I had removed for cosmetic reasons (sounds funny to me now) was melanoma. Hello? Wha?

    3 years later, following a billion biopsies, another daughter, and facing the realization that I am “uninsurable”, I am grateful to be alive. Every single blessed messy day.

    Good for you Heather. Had I let it go 6 months, I may not even be here to raise my gorgeous children. Scream it non-stop: catch it before it catches you.

    In Indianapolis and Chicago we have “Outrun the Sun”…a great Race for the Cure-style walk to raise money and awareness for Melanoma. Honestly? I don’t like walking as a survivor; there just aren’t many of us. It’s like walking with a spotlight on you. But I’ll walk again if it means someone goes to the dermatologist.

    Indiana Lori

  • http://www.coffeenomad.com Nomad

    as long as you’ve got insurance, you’ve got nothing to lose, best to check it out

  • Tina

    I have also had too many moles to count removed in the past 20 years. That’s a lot of biopsies. I always think that “this time” it will be melanoma and I am not a happy person the entire time I wait for the call. So far, all of mine have been “atypical” yet benign. I have hundreds of moles. It’s hard to spot changes, and new ones show up all the time. So my dermatologist and I are VERY well acquainted. Thanks for the post and hopefully all the people who are really in denial about the sun and the risks may get checked.

  • http://joshmarcieandbattlestar.blogspot.com Marcie

    Has someone already said that your eyes are gorgeous?

  • Mandy

    Thank you for the post. Just this week I noticed a new spot on my nose, scaley like the description and everything. I’ll get it checked out now. Melanoma runs in my family, but I was all “it can’t happen to me.” Better safe than sorry.

  • MizzM

    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.

  • http://joshmarcieandbattlestar.blogspot.com Marcie

    And can skndeep #213 please come to Georgia and remove some moles for me? I have not been able to find a dermatologist that will *wink, wink* take them off for biopsy. Guess I’m just going to have to save up…

  • http://outofthebasement.wordpress.com Leah

    That’s really scary because your description of actinic keratosis sounds a lot like what my patches of eczema feel like. How would I tell the difference???

  • http://spitsgiggles.blogspot.com/ Anonymous

    So, did you have to go run and put makeup on before you took this pic?

  • Beth

    My best friend died of melanoma at age 32. (20 years ago) We used to lie out on black tar roofs, spraying ourselves with baby oil at noon to get a great tan. Many regrets about that. And now my skin is ugly. USE SUNSCREEN!

  • http://www.rebmnmny.blogspot.com Becky

    OMG…WE ARE ALL GOING TO DIE OF CANCER!!!

    (I couldn’t resist)

  • Susan

    My mother had (and survived) malignant melanoma years ago. I put off getting my skin checked over and over and over again. Because of your blog, I finally did get it done, and had two suspicious moles removed. They were, this time, benign.

    Thank you, thank you, thank you. You may well be the person who saves my life every six months.

  • http://www.momsinneedofus.com/ Lucy

    Heather thank you for this post. I had no idea that May was Cancer Awareness month. Heather as many of us I learned from you on Oprah and fell in love with your oh so smart & witty posts about your life. I don’t know how you do it. I’m Latina and I use a dictionary to read your posts. :o )

    I fell in love with it so much that I decided to make one as well. I’m alone a lot with 3 girls under 7 plus a stinky male lab because of my husbands deployments. I’m not nearly as close to writing like you but I’m trying A LOT. Thank you! for being so honest and to the point! Gracias & Mahalo!

  • shannon

    An annual “mole check” should be on everyone’s agenda. I grew up in Seattle for Christ’s sake, not exactly the sunbathing capital of the world, and just had my 2nd basal cell removed from my face. My mother is blonde and blue just like me, and tanned for years with no ill effects- the ozone is different now folks, so don’t be fooled if your parents never had any skin cancers. Thank you Heather for continuing to talk about this issue.

  • Christy Wood

    Thanks for the reminder….I really need to get on this. I have finally gotten around to going back to my OB/GYN…2 years after my 2nd daughter… :-o , I’ll make the dermatologist appointment next.

    And you’re eyes are so beautiful. Ugh…I’m the only one in my house with brown eyes in a family of 5. Well, me and the dog. :-(

  • Meg

    Well your third wish came true. I’ve had a number of moles and other spots that my husband has bugged me about for years that I’ve happily ignored. Recently a new spot showed up on my forehead (much like yours actually) and I was all prepared to ignore it too, but since I’m only 26 and I now have a 1 yr old son, I’ve made an appointment with a dermatologist to get the new spot and all the old spots checked out. So thanks for scaring me into getting checked out. Although now my husband is miffed that I listened to a stranger over the internet and now him!

  • Anonymous

    Skin cancer is a horrible type of cancer if not caught early, with most fatal results. Please be like Dooce, layer on the sunscreen and protect your kids!!! Having a blistering sun burn in childhood increases one’s risk of developing skin cancer. Remember to check your moles for any changes and go to a doctor immediately. Rest in Peace Sarah http://que-sarah-sarah.blogspot.com/ and John http://overcode.yak.net/3, just two of the bloggers I found have documented their fights against skin cancer. Thank you Dooce for reminding people!

  • kimca

    Good post. I know I should be better sunscreening even though it makes me feel claustrophobic. All sticky and icky and oppressed- especially when its hot out. I wish there was a great lotion that already had the sunscreen in it. Or that there was a good sunscreen that didn’t feel oily and goopy and/or didn’t turn to a chalky powder when I put it on. But still, I know I need to use it. I had a mole checked once years ago that turned out to be a warning to take care and I still don’t use sunscreen daily because it makes my skin feel all crawly. Anyone have a great suggestion for a fabulous screen? Like I said before, good post. Thank you. I’ll start using regularly.