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.

  • http://kalisah.blogspot.com kalisa

    That tiny little discoloration?? How did you even SEE that? I have all sorts of discolorations on my face. But that’s because I’m 42. I think old ladies like us call them “liver spots.”

  • Anonymous

    Thank you for this post.

  • http://mommaruthsays.blogspot.com mommaruthsays

    I was just wondering what kind of sun exposure you had as a kid/teen? I didn’t know if you went to the beach repeatedly and didn’t wear sunscreen or sun-bathed in the backyard without any protection covering your skin, or if this is just the result of prolonged daily exposure to the sun while you grew up in TN? I’m not that far from your homeplace and I’ve never thought the sun was so bad here it could mess me up like that.

    I really don’t want any “Robertas” on my forehead later in life.

  • http://www.pineslakeredhead.blogspot.com/ Pines Lake Redhead

    I’m in the same club as you. Only I haven’t started naming my cancerous spots. Interesting idea though.

    I’m a redhead currently living in Florida. A family history of melanoma. I grew up in NJ but vacationed in FL and the Caribbean. I was even a lifeguard for 6 summers. All without a lick of sunscreen.

    My dad was in his 60′s when his first spot appeared. I was in my 30′s. I can’t go to the dermatologist without getting SOMETHING scraped, cut, excised, or cauterized.

    When my kids were younger and screamed about putting sunscreen on I reminded them to think of Grandfather’s face. He had to have reconstructive surgery on his nose due to melanoma. That gets the kids lathered up real quick.

    Thank you for discussing this. The people that make me want to scream are the ones who tell me that sunscreen causes skin cancer!

  • http://www.outtajo.com Jo

    I just sent a link to this post to my husband. His family has a history of skin cancer, I’m 18 weeks pregnant, and he has a suspicious mole or two that I’ve been begging him for WEEKS to go get checked out. Unfortunately, he’s very doctor-averse so it’s a bit like pulling teeth without any painkillers. But I’m not ready to be a single parent, much less a single first-time parent. Dramatic? Yes. Effective guilt tripping? Hopefully.

    Hopefully your post will finally give him the kick in the ass he needs. Either that or my incessant nagging will finally wear on his last nerve.

  • http://www.pineslakeredhead.blogspot.com/ Pines Lake Redhead

    PS – Did you know that Aldara’s primary use is to treat genitals herpes? I had no clue when I picked up my script the first time and the pharmacy tech was eyeing me funny.

  • Dana N

    While I should be checking my Roberta’s, Nancy’s, Lisa’s, Norma,’s, etc. (there are just way too many to count!)I do have to share that my dog, Mike, just had a tumor removed from his back right leg. I don’t know how or why he got this but all of a sudden, there it was. And now he’s limping around with a lamp shade on his head so that he won’t lick the incision to death. Hopefully he is now cancer free! What does that say about me that I will take my dog in for emergency surgery but I keep putting off my own check up?

  • http://cronereport.com cd

    If you think your moles are bad now, wait’ll you hit 50. At that point they start popping up all over the place like mushrooms after a rainstorm.

    Lubriderm and Aveeno both make daily moisturizers that are 15spf. Not the thing for a day at the beach, but I slather them on any exposed skin no matter what time of day or year.

  • dk

    How is it that John has no hair on his back?

  • http://www.allconsuming.blogspot.com kim at allconsuming

    You know, your very first post about your very first basal cell carcinoma?

    I sat there reading it and went, oh my GOD, that’s what’s on MY arm.

    My mum’s dermatologist (who’s now my dermatologist) initially prescribed Aldara, but you MUST apply it at the same time every day, five days a week for six weeks (well, that’s the dosage etc in Australia) and well, I decided to do this at the same time as going back to work after having our FOURTH child, my husband being scheduled for SKIN GRAFT surgery and my mum having just had a HIP REPLACEMENT.

    Yeah, I got me some good crazies back then. Needless to say, as I spiralled into a pit of anxiety and depression I kept forgetting to apply it each night so it wasn’t successful.

    Needless to say she dug it out with a scalpel for me and now I have quite the scar to warn my children every time they fight me about putting on sunscreen.

    So yeah, that was a very convoluted way of saying thank you.

  • Anonymous

    I just read an article about Aldara in Family Circle (I think). The woman’s spots got more than just a little red, so be prepared. But she did say it worked wonders and provided her with new, undamaged skin.

  • Heidi

    Thanks for writing more about this, Heather. I understand your paranoia. My 76 year old father had some skin cancer removed from his ear in December. They told him to be diligent in checking his skin, since what they removed was a “traveller.” Scary!

  • dk

    Sorry, I do know how to spell Jon’s name.

  • http://kristisetzer.blogspot.com Kristi

    Thank you for sharing!

    I’m 26, and was diagnosed with melanoma in situ (stage 0, basically) in August. (The day before I started law school, actually…talk about stressful!) THANK GOD I had it biopsied so early, because even though it was real-deal melanoma it was so small that it didn’t spread, and after surgery (and a nasty FOUR INCH scar) it’s considered 100% cured.

    But this is an excellent reminder that I need to go back to the doctor and get a couple more spots looked at.

    AND as a good reminder that I need to be more consistent wearing sunscreen EVERYDAY. I have to admit that I’ve gotten lazy about it lately, and living in AZ, just my regular daily exposure is doing tons of unseen damage. :(

    Thank you, again, and good luck with Roberta!

  • Kristen

    Heather, I’ve had a weird-looking mole on my forearm for a long time now, and I just NOW called and made an appointment with a dermatologist to check it out. I think about it every now and then, have a day or two of certainty that I’m going to die because of it, but always rationalize my way out of getting it checked out. Thank you for lighting the fire under my ass.

  • http://www.thefabulousmisss.com Stacy

    I think it is so awesome that you posted a picture of Jon’s mole and your suspicious spot. So many people don’t take sun-protection as seriously as they should and you posting these photos will definitely make some people think about their own skin issues.

    I, too, have had skin cancer. At the ripe age of 26 I had a basal cell. That was several years ago and now I have a small barely noticable scar on my right cheek. I’m super careful in the sun. But I could stand to be even more careful.

    Thanks for the reminder. You have brought some reality to this issue that so many feel invincible about.

  • http://anywayiwasjustthinking.blogspot.com Liz C

    Your timing is amazing. Today we go back to the Large-Highly Regarded Medical Institution (can you say cluster-f*ck?) to find out how much they want to cut off the top of my boyfriend’s head. This time. A year ago he had a wide area excision for melanoma on his scalp and we found another Nasty Spot about two weeks ago that came back melanoma too.

    I’m not happy.

    I have to go get checked too. I’ve felt a couple of baby Robertas on my person. When I was a kid we didn’t have sunscreen (I’m old) and I have a feeling I’m going to pay for all those horrid sunburns I earned in the cornfields of Indiana at a youth.

  • http://ruleroftheelves.com Anonymous

    Yikes! How scary. I’ve always been one of those people who are stupidly reluctant to go and get them checked out. At least you noticed it early and can take care of it before it progresses.

  • http://misstraceynolan.blogspot.com misstraceynolan

    Thank you Heather. I’m now getting Ralph, my friend on my forearm checked out.

  • http://houpley.blogspot.com/ houpley

    thanks! after i read a few of your skin-related entries, it did occur to me how simple it would be to just get checked out. i went for a whole body scan. awkward but needed, considering my fair, freckleness, age and sunburn history (we’re talking spring-break-at-gulf-shores-burns). turns out i had three areas of conern. i have removed two moles and am waiting on the other. thanks for spreading the word.

  • http://www.ivoryandmoss.blogspot.com bianca

    I really appreciate this story Heather, as cancer is currently a big worry in my family, with my dad waiting to hear back on his bone cancer test.:(
    I actually have two suspicious spots Im thinking of getting checked. thanks for reminding me. I better get it done!:)
    Bianca
    ivoryandmoss.blogspot.com

  • http://www.sleepynewmommy.wordpress.com Meg

    I had to laugh when I started reading this because I’ve heard so many people bitch about when you blog about your skin cancer. They seem to think you’re glorifying something that isn’t a big deal. But…um…hello? CANCER! That’s a huge deal.

    I’m so glad you posted this. I was always one to soak up the sun. My daughter is the most fair-skinned little thing, so we’ve become sunscreen Nazis around here and I hope I didn’t do damage to myself in the past that will cause future problems.

    Good luck to Jon with his appointment!

  • http://rhiinpink.com Rhi

    I’ve had to have several moles removed from my body – thank goodness none of them were cancerous. But, one was removed from my breast and I just have to say that any career I may have had as a topless model is now over. Sheesh.

  • http://jfoell.blogspot.com Jessi

    This is so timely because my husband went back for his followup visit yesterday. And they removed two more moles (3 were removed and deemed cancerous 4 months ago). So now he’s on a 4-6 month follow-up with the dermatologist from now until who knows. And I’m sure each time, they’ll remove more and more.

    I’m glad I finally suggested his dermatologist MOM look at him!

  • http://www.anextendedvacation.blogspot.com Anonymous

    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.

  • http://csquaredplus3.typepad.com Chris

    We live in Utah and my husband has seen a couple of dermatologists here. He’s had several basal cell carcinomas removed and a handful of squamous cells as well.

    RESEARCH Aldara before applying it to your head. My husband used it on a spot (much larger than yours, so he was using more of the medication) and endured unexpected side effects… mood swings, depression, mental stuff in general. We couldn’t figure out what was happening. It’s a long story, but we finally linked it to his use of Aldara. Many people use the drug with no side effects, but if you’re prone to depression and anxiety… you might want to consider having your precancer (or future ones) removed via the burn or scrape method. A little scabby, but quick and definitely doesn’t mess with brain chemistry.

    Just something to consider… Google Aldara side effects… really.

  • Michelle BB

    Heather, thanks for the reminder. I actually scheduled my own appointment with the dermatologist after reading your post. I’d been meaning to get a spot checked for a while….

  • Jessica

    Glad you are talking about this. I’m 25 and just has a 3″ mass of my back removed … Melanoma is a bitch!

  • birdie

    Thank you for this! Great post and you’ve definitely reminded me that I need to get a couple of moles checked out by a dermatologist. No time like the present :)

  • http://fearealized.com/ NaysWay

    I have a girlfriend with a few Robertas and the sun/skin cancer problem. I think she’s up to SPF 60 now, and she goes in every six months to have something removed. I wish I could give her some of my melanin, then she wouldn’t have to worry.

  • QoB

    another anecdotal data point re: Aldara. i had to use it for warts on my hands (and one on my face), and had no problems with it at all, over the 4-month treatment period. freezing them off didn’t work – multiple times – which my dermatologist speculated was due to a slightly dodgy immune reaction to the virus. in any case, all the warts disappeared, no side effects whatsoever, and i no longer resemble the Wicked Warty Witch of the West.

    best of luck with the treatment.

  • bohica

    Time to have my husband checked out. He has a fingernail-sized spot on the back of his thigh that is exactly as you described: feels and looks like sand-paper and has been exposed to the sun (when he was a kid and spent all his time in the sun in California). He’ll hate that I’ve found something new to obsess about. Oh well!

  • http://amommystory.blogspot.com Christina

    I’m as neurotic as you at checking every change in moles. Unfortunately, I’m covered in them, so it’s a lot of checking.

    I’ve had seven moles removed, four of which turned out to be the very early stages of skin cancer. I need to go back for a follow-up, especially since I’ve seen changes in other moles. Unfortunately, my husband lost his job last year, and we’ve had no insurance, and well, dermatologists aren’t cheap and are about the least likely doctors to work out a deal with you. (I’ve tried.)

    I finish nursing school next month, and hope to get a job in a hurry just so I have insurance to get to the dermatologist again. I hate playing with my life by waiting for insurance. (Hear that, Obama? We need health care reform!)

    I’d encourage everyone to get their skin checked at least once a year by a dermatologist. Even more than that if you’re Whitey McPale like me and didn’t listen to your mother about wearing sunscreen as a kid.

  • http://thebigtradeoff.blogspot.com Karen

    Ugh.

    Yes, I’m making an appointment soon.

  • http://www.katherineemmons.com Katherine

    Dammit Heather – you have made it impossible for me to go another second without making the call to my dermatologist for the annual skin-scan – thank you :)

  • dooce

    # 22. mommaruthsays, we took family vacations to the beach every year, but I blame daily sun exposure. I never wore sunscreen, and I’ve been badly sunburned more than two or three dozen times. And then in high school I routinely visited a tanning bed. It’s a miracle I haven’t turned into one giant multiplying skin cell.

  • http://serenitydays.blogspot.com/ Amber Star

    It is a very good thing about getting Jon to the dermatologist, and I do understand the careful way you inspect each and every strange growth. Thanks also about the “feels sort of like sandpaper…” part. I do have a place like that on the back of my leg and forgot to have it looked at last year during my physical and skin check with the dermatologist. I’ve had an actinic keratosis removed from my lip.

  • Brenda

    I went to my primary doctor yesterday and got a referal for a dermatologist. I am going to have some moles checked and a very suspicious “thing” on my forhead checked out.

  • Couponwhore

    I liked your face better with the hexagonal tile. Just sayin’.

  • http://www.becomingsarah.com Sarah @ BecomingSarah.com

    I’m glad you caught Roberta before she had a chance to become a little harder to evict. My mother had skin cancer when I was a kid and I cannot even begin to describe how much more careful I was with my skin as a result. I’m about the color of a ghost – maybe a little more white – but it’s worth it to always be able to notice the small changes in moles and freckles and take them to the dermatologist before they become a bigger problem.

    Thank you so much for this post! I hope it encourages people to take a closer look at their body.

  • Savannah

    I just had a huge chunk taken out of my leg for melanoma. Knowing family members had spots removed in the past, I called my mom to see if any were cancerous. Her response was as follows “No, we don’t have any cancer that runs in the family. You have a Great Aunt that died of breast cancer, but no one else has had any cancers that are genetic.” (note, mom knew mine was melanoma) “oh yeah, your great uncle on my side did have melanoma, he died from it.” That is my mom’s optimistic maternal instinct. Thankfully my doctor thinks she caught it in time. We are just waiting on the second pathology report.

    Good luck with yours and thank you for bringing this to the attention of others.

  • http://sugarboss.blogspot.com/ Sonnet

    *Love*

  • Anita

    I have a mole that looks a lot like Jon’s. Went to the doc and he said it was fine – i guess all the different colors of the mole were actually all the in the same hue (or shade? whateva) so even though it looks different colors it’s really all the same color but some of it has more pigment than other parts of it?

    I don’t really understand it all -but he cleared the funky mole.
    Hope Jon’s is the same.

  • Roberta

    No, please don’t call it Roberta. That’s my name and I don’t want to be associated with a precancerous mole!! ;) Also, I can’t dance, and would never sleep with my students, if I had any.

  • http://lipstickdaily.com Elaine

    Oh you HAD to remind this California girl why we need to wear sunscreen! Yes, yes, yes I will, but not happily.

  • http://nittanylion95.blogspot.com/ Angela

    I was careless in my teens and 20′s too. I have my first dermatologist appt on June 1. I have several nasty looking moles. Thanks for always being so honest.

  • Courtney

    A year ago, I went in for my yearly skin cancer screening, and saw a new doctor. The first thing he says to me, “You sure got your share of moles!” Thanks, doctor, like I hadn’t noticed. You can thank my parents for giving me these freakish genes.”

    I have so many scars on my body from having things removed, but I don’t mind them so much because none of them turned out to be cancerous. I’d rather have a small scar here and there than cancer. Plus, if someone asks, you can tell them about the bar fight you were in.

    My dad had skin cancer surgery recently which required the doctor to peel back his scalp at the hairline…this is where I start to pass out. If this isn’t a reason for me to wear a hat in the summer, I don’t know what is.

  • Candace

    Thank you for this! Needed a reminder to make my every 6 months appt with my derm – just scheduled a check for next week.

  • Ellen

    I’m very anxious about spots, too. I never liked tanning (thankfully) but I know I still got too much sun as a kid. That reapplication business was the worst.

    I’m glad everyone posting is inspired or takes this as seriously as you.

    PEOPLE, GET IT CHECKED OUT IMMEDIATELY. Nag your family. My father-in-law died from melanoma entering the blood stream and riddling his body. It’s rare but it happens.

  • http://captainlauraw.blogspot.com Laura

    Fourthing (or fifthing?) the warning about Aldara’s side effects. I used it for warts and it made me feel like shit for about a day and a half every time I applied the stuff. I experienced flu-like symptoms similar to those described by others above. My discomfort was severe enough to make me seriously consider staying home from work, which is not something I do. Just sayin’