After another round of icing my face with a bag of frozen peas, I popped some more Tylenol. It felt as if I’d been hit in the face with a baseball bat. The next day, peeling back the compression bandage, I assessed the damage. My nose looked angry and swollen, a line of stitches, dotted with blood, snaking down its length. The bridge and under my eyes has bloomed with less-than-flattering purple bruises.
Yet, beneath the swelling and damage, I felt grateful—and triumphant.
Because I spoke up about a spot that seemed too small to matter, and that decision helped catch my skin cancer early.
Never Be Afraid to Ask
Ten months before, at the end of a routine visit, I asked my dermatologist about a tiny spot on the bridge of my nose. Nearly invisible, it felt rough and sometimes bled when I exfoliated. IIt seemed so trivial that I almost didn’t mention it.
“This is probably nothing,” I began.
As women, we’re conditioned to brush off our medical concerns, afraid of imposing on others or being perceived as ignorant, neurotic, or high maintenance. When we do speak up, our opinions are too often dismissed.
But my dermatologist paid attention. He examined the spot under a magnifying light and ran a finger over it, then told me it could be precancerous. After taking a photo for my medical record, he froze it with a spray of liquid nitrogen and said, “Let’s see if it comes back.”
It did. Six months later, at my next visit, he froze it once more.
“If it returns again, we’ll do a biopsy,” he said that time.
Three months later, I was back in his office. After numbing the area with a needle, he shaved off a sample to send to the lab. The following week, he called to tell me it tested positive for cancer.
Caught on Time
My diagnosis was squamous cell carcinoma in situ. That last part, in situ, was good news. It meant we’d caught the cancer at an early stage before it had a chance to spread past the top layer of skin. To ensure it wouldn’t, my doctor referred me to a colleague for Mohs surgery, which has up to a 99 percent success rate for untreated skin cancers and 94 percent for reoccurring cases. (Related: Stop Being So Damn Available: The Revolutionary Act of Going Quiet)
Except for a few painful hours after the anesthesia wore off, my recovery was quick and easy. The experience left me with a stunning realization. If I’d ignored my intuition and said nothing about that barely visible spot, my cancer may have gone undetected until it had reached a more advanced stage. Instead of a minor procedure, I might have faced a far more invasive surgery or worse.
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It’s on Us to Be Proactive
By a certain age, women get reminders to schedule mammograms and colonoscopies, but rarely are we pushed to proactively see a dermatologist. It’s on us to take that step. You may be thinking, “What’s the big deal? If I have a weird mole, I’ll just get it looked at.”
First, good luck booking a timely appointment if you’re not already established with a practice. Second, it’s tough to spot cancers in places you can’t easily see, like your scalp or back, and it’s not always obvious what to look for.
Most of us are fairly familiar with the warning signs of melanoma, or the ABCDEs. But melanoma, while among the deadliest, isn’t the only type of skin cancer. And the symptoms of other skin cancers can be subtle or mistaken for a wart, pimple, bug bite, or normal part of aging.
Basal cell carcinoma (BCC), the most common skin cancer, is diagnosed about 3.6 million times each year in the United States. Squamous cell carcinoma (SCC) is next, with about 1.8 million cases. Both are highly curable, but when detected too late, “BCCs can be locally destructive” and “SCCs can sometimes grow rapidly and metastasize,” according to the Skin Cancer Foundation.
The fact is, about one in five Americans will develop skin cancer by age 70. That makes it worth taking new, changing, or unusual spots seriously. And as with other cancers, early detection improves your outcome.
Prevention Is a Team Sport
It’s vitally important to do monthly self-checks and see a professional about anything new, changing, or unusual—what dermatologists call “ugly ducklings.” These include:
- Moles that grow bigger, thicker, or change color/texture
- Brown spots larger than a pencil eraser
- Spots that persistently itch, hurt, scab, ooze, or bleed
- Pearly, pink, red or irritated growths (possibly crusted in the center or with raised edges)
- Lingering sores
In addition to learning the topography of your skin (surprisingly, you can), you should ask your primary-care clinician or dermatologist how often professional skin exams make sense for your personal history and risk factors.
Having lost my dad to melanoma, I go twice a year without fail. I’m in a literal game of whack-a-mole to avoid the same fate.
While taking these measures and minimizing unprotected sun exposure can’t prevent skin cancer, it can reduce my chances of missing an early diagnosis and dying from it.
It’s Not Fun. Do It Anyway.
I know adding one more appointment to an already overflowing calendar is inconvenient. As is finding a reputable dermatologist who’s accepting new patients and doesn’t have a years-long wait list.
But I think there’s another reason women aren’t eager to strip to their skivvies for an up-close skinspection: embarrassment.
I get it! At the gynecologist’s, I modestly tuck my bra and underpants inside my clothing, lest my doctor catch a glimpse before she peers inside me. Wearing nothing but my underwear and a loose paper top while my dermatologist scrutinizes me head to toe through a magnifying light took some getting used to. But I did.
And while I’m no longer unnerved by these exams, I still prepare for them like I’m getting ready for a hot date. I shower, shave, and wear the closest thing I own to a matching bra and panty set. Bare-faced, like Pamela Anderson. Sucking in my belly, because: menopause.
The truth is dermatologists don’t care about stretch marks, extra pounds, or stray hairs. So if vanity is keeping you from scheduling a full-body check, imagine what having a portion of your face or body removed will do for your looks.
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Be Empowered, Not Embarrassed
I trust my dermatologist and appreciate his experience, compassion, and keen eye. More importantly, I trust myself. So I show up for appointments grateful for the opportunity to have a professional look me over. I bring my list of ugly ducklings and I ask about every single one. As my recent diagnosis proved, no concern is too minor or weird.
Remember that old expression, “There’s no such thing as a stupid question?” It’s still true. But there are stupid reasons to die. Like embarrassment.
The hosts of one of my favorite true-crime podcasts have long encouraged listeners to prioritize personal safety over social niceties. The principle applies here, too: Don’t let fear of awkwardness prevent you from getting care.
It means trusting your gut and removing yourself from uncomfortable situations without worrying about being rude. Like when a stranger tries to talk to you from their car or insists on buying you a drink. Forget politeness and do what you must to protect yourself.
We should never allow embarrassment or fear of awkwardness to place our health—and lives—at risk.
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