Choose You Blog

I have a weird mole located in a weird place.  And that’s about as specific as I’ll get on the subject.  What I will tell you is that one doctor suggested I remove it, but he was a specialist for another matter, so I went to my regular doctor to see what he thought. He said it looked like a “healthy mole” and that I should keep an eye on it but as long as it was a regular shape and didn’t change size or color it was fine.

I’m fortunate in that I haven’t had any issues with skin cancer (my father, on the other hand, was always having something removed) so I did a little research to see exactly what I should be looking for and I found some easy to remember advice on the American Cancer Society’s website.  It’s called the “ABCD rule” for uncovering common signs of melanoma and here’s what we should all be looking out for:

• Asymmetry: One side of a mole or birthmark doesn’t match the other.
• Border: The edges are irregular, ragged, notched, or blurred.
• Color: The color is not uniform and may include shades of brown or black, with patches of pink, red, white, or blue.
• Diameter: The spot is larger than ¼ inch across – about the size of a pencil eraser.

Also be aware that not all melanomas fit those conditions, so point out anything suspicious to your doctor.  Things that you might want to mention include:

• Any new spots
• A spot that doesn’t look like others on your body
• A sore that doesn’t heal
• Redness or swelling around a mole
• Itching, pain or tenderness
• Scaliness or discharge

As part of a routine cancer-related checkup, your doctor should examine your skin, but it’s also important that you check yourself on a regular basis.

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Lynn Lamousin is a Choose You subscriber from Atlanta, GA who signed up to Eat Right, Get Active, Get Regular Health Checks, and Protect My Skin. (She quit smoking many years ago, but still dreams about cigarettes.) Her mother and brother both lost battles with cancer.

Even though he lives at the North Pole, have you noticed that Santa always has rosy cheeks?  It’s probably because you can get burned even when it’s snowing outside.

Ultraviolet (UV) rays don’t disappear when the temperatures drop, and they can be reflected off snow just like they can off sand. So a day of skiing or sledding can leave your nose and cheeks redder than Santa’s.

Avoid getting burned by following the same rules you do when you hit the beach. Apply sunscreen with an SPF of 15 or more to any exposed skin. Put it on before you go out, and reapply it every 2 hours. And don’t skip it just because it looks overcast outside; UV light still comes through on hazy days. Protect your lips by using a lip balm with SPF, and invest in wrap-around sunglasses with at least 99% UV absorption.

Remember, protecting yourself from UV rays is the most important way to reduce your risk of skin cancer.

Click to share this tip on Facebook. Each time you “share” Choose You with your friends on Facebook, Sprite Zero donates $1 toward cancer prevention awareness – up to $450,000!

I just entered into a shady deal. Don’t worry, it’s not shady as in dishonorable – I simply made a pledge to start wearing sunglasses.

I’m not sure why, but I’ve never been a sunglass wearer. Part of the reason may be that I continually lose them and then I forget to replace them.  But since reading that wearing sunglasses can reduce the risk of developing melanoma, I’ve decided it’s now an accessory I can’t do without.

Here’s what I kept in mind when buying my latest pair… Wrap-around sunglasses with at least 99% UV absorption provide the best protection for your eyes and the skin around the eyes. Labels that say “UV absorption up to 400 nm” or “Meets ANSI UV Requirements” mean the glasses block at least 99% of UV rays. I also looked for sunglasses labeled as blocking UVA and UVB light. If there is no label, don’t assume the sunglasses will give any protection (so, don’t buy them no matter how cute they are!).

Not all melanomas can be prevented, but wearing sunglasses is one simple thing you can do to reduce your risk.

So, what do your favorite pair of sun-blocking lenses look like?  And, how do you keep track of your sunglasses?  (I think all the sunglasses I’ve lost are hanging out with my misplaced umbrellas.)

Click to share this skin protection tip on Facebook. Each time you “share” Choose You with friends Sprite Zero donates $1 toward cancer prevention awareness — and your friends learn about putting their health first!  Remember, sharing is caring!

Lynn Lamousin is a Choose You subscriber from Atlanta, GA who signed up to Eat Right, Get Active, Get Regular Health Checks, and Protect My Skin. (She quit smoking many years ago, but still dreams about cigarettes.) Her mother and brother both lost battles with cancer.

Even though it leaves me with hat head, I do love wearing my wide-brimmed felt fedora. I must admit that I bought it because it seemed stylish, but I was glad to learn that it also serves a dual purpose of reducing my risk of developing melanoma.

Wearing a hat protects areas often exposed to intense sun, such as the ears, eyes, forehead, nose, and scalp. Since buying the fedora, I’ve learned that a style with at least a 2- to 3-inch brim all around is best because it provides the most protection. A baseball cap can protect the front and top of the head but not the neck or the ears, where skin cancers commonly develop. And, sadly, straw hats are not as protective as ones made of tightly woven fabric.  (I love straw hats, but I’m glad I now realize that I should opt for more sun-protective materials.)

Of course, not all melanomas can be prevented, but wearing a hat is one simple thing you can do to reduce your risk.

So, what’s your favorite hat?  (And don’t tell me that after all the royal wedding coverage earlier this year you still don’t own a big-brimmed chapeau!)

He may have been a little off kilter, but the Mad Hatter from the Lewis Carroll classic, “Alice’s Adventures in Wonderland,” was on the mark with his hat selection. This style is large enough to shield him – and everyone at the tea party – from the sun.

Click to share this skin protection tip on Facebook. Each time you “share” Choose You with your friends on Facebook, Sprite Zero donates $1 toward cancer prevention awareness – up to $450,000!

Lynn Lamousin is a Choose You subscriber from Atlanta, GA who signed up to Eat Right, Get Active, Get Regular Health Checks, and Protect My Skin. (She quit smoking many years ago, but still dreams about cigarettes.) Her mother and brother both lost battles with cancer.

I remembered that sunscreen isn’t truly waterproof or sweat proof when I read this from HHS HealthBeat:

“Even if sunscreens say they’re waterproof, they’re not. Sunscreens can wash off with sweat, or just being in the water. When this happens, their sun protection washes off, too, leaving users at greater risk for burns, premature skin aging and possibly even skin cancer. So the Food and Drug Administration has set new rules to help people know what they’re getting and when to use it.”

I specifically buy sunscreens that say waterproof or sweatproof because if we’re outdoors, we’re likely either in the water or sweating! Sometimes those sunscreens even cost more. I can’t seem to wean myself away from those; my mind feels sure they are more effective. They must have some basis for saying it, right?

That’s a little true, but not quite accurate, as FDA dermatologist Jill Lindstrom explains, “Sunscreens may only use the term `water resistant,’ and must clearly indicate how long water resistance actually lasts.’”

So the sunscreen currently marked “waterproof” and “sweat proof” are actually only able to withstand water and sweat a little better than regular sunscreen. How much is a little? Well the new FDA guidelines only approved two lengths of time for water resistance claims: 40 minutes and 80 minutes.

That means you really ought to reapply sunscreen every half hour or so, especially if you are in full sun during the main hours of maximum sun exposure: 10 a.m. to 4 p.m.

How can you tell whether your sunscreen can resist water and sweat for 40 or 80 minutes? You might not know until the new label requirements take effect next summer, June 2012.

As you probably know, the FDA recently issued new guidelines for sunscreen. Those new requirements are to improve clarity and honesty in labeling:

• You should be able to read any sunscreen label and clearly know the depth of its protectiveness (5 versus 15 versus 50) and the breadth of its protection (e.g., broad spectrum).
• Sun screens cannot claim to work longer than two hours without special FDA approval.
• The new requirements also stipulated truth and straightforward information about how it works in the water or with sweat: “Water resistance claims on the product’s front label must tell how much time a user can expect to get the declared SPF level of protection while swimming or sweating, based on standard testing.”
• Most importantly, the new FDA guidelines state that manufacturers cannot make claims that sunscreens are “waterproof” or “sweatproof, or identify their products as “sunblocks.”

You can check manufacturers sites to see if they offer any more detail about claims of time they work in water or with sweat.

Err on the side of caution to best prevent skin damage, premature aging, and skin cancer.

Anyone can get skin cancer…young, old, light, dark, people in the sun often, people not…anyone. Check out this video: Minorities and Skin Cancer Awareness In it, Irene Ekwede, a dermatology nurse at the NIH Clinical Center, talks about skin cancer risks for minorities and people with darker skin. Nurse Ekwede also introduces a brand-new NCI brochure, “Anyone Can Get Skin Cancer,” that can be obtained free by calling the Cancer Information Service (1-800-4-CANCER) or by visiting the Web site.

My daughters invited friends to come play for a Water Day at our house. The first thing I said was, “Sun protection first!” I handed over a couple of bottles of sunscreen. My girls groaned but grabbed the bottles. One of the other little girls said she didn’t usually wear any, and that another of the little girls didn’t need any. I asked,”Why do you think you two don’t need it?” The first girl said, “I’ll stay in the shade, and she’s already black,” indicating the second girl. “Shade or sun, light or dark…color doesn’t matter,” I said, “Everybody needs sunscreen. I’m sure her mother puts sunscreen on her, right, doesn’t she?” I asked the little girl. The little girl told me no, she didn’t wear any, her skin didn’t need protecting. I don’t like to gainsay other parents, especially to their child. Actually, I had no idea what the parents really thought or did — all parents know things get muddled from kids sometimes. But I had care of these kids while they were at my house. And, hard choice as it was, it was easy to make the choice to put sunscreen on all the kids. I knew it was the right thing to do. However, I framed it as a “this is how we do things at our house,” and these kids know me well enough to know that while I respect differences among houses and their rules, House Rules rule. I had to protect them.

When I was a kid, sunscreen was basically unknown. My mother knew her kids, and that our skin burned easily. We were smart enough to figure that wasn’t a good thing. She made us wear t-shirts over swim suits to protect us, but that did little good. Anyway, nobody took sun protection very seriously back then. Nobody really understood the long-term potential problems, other than maybe aging, and when you’re 15, who can imagine aging? Still, I had learned I had two shades: white and red. I began to prefer to just stay out of the sun. For a while, my pale “whiter than white, you’re blinding me” shade was mocked, loudly and often. I spent a good part of my later youth and early 20s feeling sorry for myself and wishing I could be just a wee little bit tan, but the cost wasn’t worth it. I learned to embrace my natural shade and demanded others respect it, too.

But that choice came too late, really, and I’ll pay for the early years of sunning without protection, however innocent it was, for the rest of my life. Each visit to my dermatologist uncovers more suspicious areas, leads to more biopsies, and luckily, so far, more early detection before dysplastic areas turn into melanoma. I don’t want to be the friend someone else thinks was taken too soon, the mother who has to unwillingly leave her kids, the person others feel they must honor through action and advocacy. None of us do, of course.

What I do want to be is the person who helps spread the word than anyone can get skin cancer. Even very good people. Even lovely people who add value to the world. Friends can, moms can, dads can, people of every race, creed and color can.

Those risk charts? The ones that say freckled, fair, burns easily folk, folk who are in the sun often, etc. are at highest risk for skin cancer? Those are guidelines–these folks tend to be who has the highest incidence of skin cancer. It doesn’t mean they are the only people. The National Cancer Institute’s new brochure, “Anyone Can Get Skin Cancer,” begins:

Is it true that only people with light skin get skin cancer?

No. Anyone can get skin cancer. It’s more common among people with a light (fair) skin tone, but skin cancer can affect anyone. Skin cancer can affect both men and women.

How can people with dark skin get skin cancer?

Although dark skin does not burn in the sun as easily as fair skin, everyone is at risk for skin cancer. Even people who don’t burn are at risk for skin cancer. It doesn’t matter whether you consider your skin light, dark, or somewhere in between. You are at risk for skin cancer. Being in the sun can damage your skin. Sunlight causes damage through ultraviolet, or UV rays, (they make up just one part of sunlight). Two parts of UV, UVA and UVB, can both cause damage to skin. Also, the sun isn’t the only cause of skin cancer. There are other causes. That’s why skin cancer may be found in places on the body never exposed to the sun.

As summer nears the end, most of the PSAs about sunscreen begin to fade away and we start thinking we’re safe, not out in the sun much, don’t need protection. Or we think we never really needed it in the first places. But we do, all of us, and sunscreen is such an easy preventive step we can take. Take care, Choose You.

For more skin cancer facts and prevention steps, read the ACS Skin Cancer Facts page.

Have you ever read Dr. Len’s blog?

Dr. Len is actually J. Leonard Lichtenfeld, MD, MACP – Dr. Lichtenfeld is Deputy Chief Medical Officer for the national office of the American Cancer Society. And I really like his blog. He shares really good insights and thoughts from an expert perspective about cancer, cancer treatment, cancer causes, and cancer prevention.

Back in May he posted some really good guidelines for Don’t Fry Day. We usually put a lot of emphasis on sunscreen (make sure to read the new sunscreen guidelines and understand the new labels), but Dr. Len reminded us that sunscreen isn’t really sunblock and it isn’t failsafe:

Sunscreen is definitely an important part of sun-safe behavior.  But you may note that I have left it to last on this list.  Why?  Because too many people have too much faith in sunscreen.  Yes, it can prevent sunburns when used properly.  But it is the “used properly” part that has many of us concerned.  ”Used properly” means an SPF of at least 15 (some experts recommend an SPF of 30 or higher).  ”Used properly” also means putting on lots and lots and lots of the goopy stuff–all over your body.  ”Used properly” means putting it on every 2 hours–come sun or clouds.  ”Used properly” means putting it on frequently if you go swimming or become sweaty after playing beach volleyball or another sport.

Sunscreen doesn’t last forever, yet some people believe it does. And high SPFs really don’t make you immune from the sun’s rays for a longer time, nor do they add as much protection as some people think they do.

Survey after survey shows that people who rely solely on sunscreen to protect them from the damaging effects of the sun apply too little, and believe that high SPFs mean they can stay in the sun for much longer periods of time..

You might want to say, “Say it isn’t so…”, but sunscreen although safe and effective when used as directed more often than not is not used as directed.

The sad result is that some research shows that people who rely on sunscreen may in fact have higher rates of skin cancer, in part due to the fact that they probably didn’t follow the sunscreen rules outlined above about how to use sunscreen properly

Another sunscreen tip: use a broad spectrum (UVA and UVB) to prevent damage from both kinds of harmful rays of the sun.

And yes, although there is chatter about possible problems with some of the chemicals in sunscreen, most agree that based on currently available scientific evidence the benefits of sunscreen outweigh the risks. Research continues to answer concerns regarding sunscreen formulas, but for now they are a much better bet than taking the risk of getting burned in the sun.

Getting a burn is a bad thing folks. So is a tan. Everyone knows that sunburn is bad, and a sign of toxic effects of the sun on the skin. But tanning is also a sign of sun damage.  Forget the thought that a healthy tan is a sign of good health. It isn’t. And there is no such thing as a healthy tan. It isn’t healthy. Period.

Dr. Len says he isn’t a spoilsport and neither am I, so here are a few hints for how to stay safe but have fun in the sun:

• Watch this video: Sun Safety
• Learn about the UV index. Between 10 am and 4 pm the sun’s rays are the strongest (read: most dangerous) so try to get some shade and remember to re-apply the sunscreen. Check that UV index like you check the weather report. You can find out how strong the sun’s rays really are that day.
• Use rashguards and hats and lots of sunscreen on kids. Their skin is very sensitive, and if you protect them, you really lessen their chances of skin cancer or melanoma. You can also use those lightweight beach and pool coverups. There are some light, loose linen and t-shirt styles for both men and women that are comfortable even in the coastal Texas heat (and trust me — it doesn’t get hotter than that). Sun hats are cool. No, really, they are. Check out this hat — how cool are you in an Uncle Sam hat that also protects your head? (You might bring a bandana too, to protect your neck and ears.)
• Speaking of protecting heads…don’t forget sunscreen for your scalp!
• Wear shades. Yep, sunglasses. They are a fashion statement and also protect your eyes. Did you know that exposure of the eyes to the sun causes premature aging of the cornea, just like it causes premature aging of the skin?

All this? I learned from Dr. Len!

As you’ve hopefully heard, the FDA has changed the rules for over-the-counter sunscreens. According to fda.gov:

he Food and Drug Administration (FDA) is taking steps to help protect consumers from skin damage caused by excessive sun exposure.

The new measures include the following:

• final regulations that establish standards for testing the effectiveness of sunscreen products and require labeling that accurately reflects test results
• a proposed regulation that would limit the maximum SPF value on sunscreen labeling to “SPF 50+”
• a data request for safety and effectiveness information for sunscreen products formulated in certain dosage forms (e.g., sprays)
• a draft guidance for sunscreen manufacturers on how to test and label their products in light of these new measures.

These measures are necessary, says Lydia Velazquez, PharmD, in FDA’s Division of Nonprescription Regulation Development, because “our scientific understanding has grown. We want consumers to understand that not all sunscreens are created equal.”

“This new information will help consumers know which products offer the best protection from the harmful rays of the sun,” Velazquez says. “It is important for consumers to read the entire label, both front and back, in order to choose the appropriate sunscreen for their needs.”

Everyone is potentially susceptible to sunburn and the other detrimental effects of exposure to UV radiation.

In short, if a sunscreen is labeled Broad Spectrum it means that the product protects against sunburn, skin damage, skin cancer and early aging. It also means it has an SPF of 15 or greater and greater overall protection. Products that do not meet these criteria will carry warnings about the dangers of spending time in the sun and lack of skin protection.

Sunscreens in the form of oils, creams, lotions, gels, butters, pastes, ointments, sticks, and sprays are eligible for the label and marketing “broad spectrum” if they qualify, but wipes, towelettes, powders, body washes, and shampoo are not eligible. The FDA is further evaluating sprays for other concerns, such as dangers of inhalation.

The FDA is also requiring that labels be clearer for consumers regarding application, and water and sweat “proof” claims:

• Water resistance claims on the product’s front label must tell how much time a user can expect to get the declared SPF level of protection while swimming or sweating, based on standard testing. Two times will be permitted on labels: 40 minutes or 80 minutes.
• Manufacturers cannot make claims that sunscreens are “waterproof” or “sweatproof, or identify their products as “sunblocks.”   Also, sunscreens cannot claim protection immediately on application (for example, “instant protection”) or protection for more than two hours without reapplication, unless they submit data and get approval from FDA.

These rules are effective June 2012.

For more information, check the sunscreen label detail PDF.

An amazing, and inspiring, woman, Christine Green, shared her melanoma story, and that same week a friend said her early twenty-something niece was headed to a tanning bed to prepare for a vacation. Later that same day, I drove past a care bear (Funshine Bear, for the record) standing on the street corner advertising a tanning salon, offering a special for a package of “bed tans.” A couple of days later, at a pool party, a friend eschewed sun screen, “I’ll just catch some Vitamin D and perk up my winter skin.”

I’m thinking people aren’t taking this skin cancer risk very seriously. So I decided to ask the experts, help everyone become better informed about the real risks, real benefits, and real things to be concerned about.

• Skin cancer is the most common form of cancer in the United States.
• Melanoma, the third most common type of skin cancer, can be deadly. 75% of skin cancer deaths are from malignant melanoma, and 15% of malignant melanoma patients die.
• About 65%–90% of melanomas are caused by exposure to ultraviolet (UV) light.

Here’s a few more numbers:

• One in five people and among them one in three Caucasians in the course of their lifetime will develop some form of skin cancer.
• Over 250,000 cases of squamous cell skin cancer are being diagnosed every year, resulting in ca. 2,500 deaths yearly.
• Sun exposure causes more than ninety percent of all skin cancers
• If a person has suffered from sunburn five or more times then they stand a very strong chance of contracting skin cancer.
• The percentage of women under the age of forty with basal cell carcinoma has tripled in the last thirty years, while their rate of squamous cell cancer has increased four-fold.

So…okay. Skin cancer? Very, very real, very real risk.

Prevention and early detection matter greatly in keeping us healthy. The American Cancer Society has some great tips and explanations about how to be safe in the sun.

So do experts…the very same dermatologists who help detect and treat skin cancer:

According to Dr. Amy Derick:

The American Academy of Dermatology has issued a position statement that there is no safe threshold levels for UV exposure for maximum Vitamin D synthesis without increasing the risk of skin cancer. I recommend that my patients supplement their diets with Vitamin D pills. You can have adequate vitamin D levels and practice sun safety . The IOM suggested range (based on age): 400-800 IU/d.

Sunscreens should be broad-spectrum (UVA and UVB protection), with a SPF of at least 30. I like physical or mineral blocker sunscreens, such as those that contain zinc or titanium dioxide.

Melanoma typically presents as a new or changing brown to black spot on the skin. Non-melanoma skin cancer (basal cell and squamous cell carcinomas) typically present as sores that won’t heal or a pink scaly patches that doesn’t go away.

The frequency of skin checks depends on your risk for skin cancer. Dermatologists diagnose skin cancer in earlier stages than non-dermatologists. Dermatologists are experts in skin cancer screenings, and therefore, are the provider of choice.

The treatment for skin cancer depends on the type of skin cancer and the stage. You can make a decision about the treatment of your skin cancer based on the personalized advice of your dermatologist.

Dr. Amy Derick, board-certified dermatologist practicing in Barrington, IL, is a frequently-quoted media resource for the American Academy of Dermatology and Women’s Dermatologic Society. She would be happy to answer any questions you have about skin protection, weighing benefits and risks, and understanding the Vitamin D issue.

Please visit: www.derickdermatology.com to learn more about Dr. Derick. On this site you can view her web-based educational videos, including ” Sun Protection All Over,” “Say No to Melanoma” and “Watch out For Suspicious Spots.”

According to Dr. James Compton:

Look for sunscreens that protect against both UVA and UVB rays. Also, be aware that PABA (para-aminobenzoic acid), found in many sunscreens, triggers allergies in some people, resulting in a contact dermatitis. Non-PABA sunscreen is just as effective. And, of course, use a sunscreen with at least SPF 15 or greater year-round

Avoid midday sun. Enjoy the sun in the early morning or early evening. Be sure to choose a sunscreen with the help of a dermatologist; ensure that it is SPF 15 or higher. If you have particularly sensitive skin, or are particularly light complected, consider investing in clothing with SPF benefits and UV ray-blocking properties.

Also, it is important that people understand what the SPF numbers mean. 30 SPF means that if you are in the sun for 30 minutes, it is like being in the sun 1 minute without protection; 45 SPF means that if you are in the sun for 45 minutes, the effect on your body is as if you were in the sun unprotected for 1 minute, and so on and so forth.

Yes, the average person is Vitamin D deficient. According to the American Academy of Dermatology Association, the recommended intakes of vitamin D by age group are 200 International Units per day (IU/d) for young adults, 400 IU/d for those aged 51 to 70 years, and 600 IU/d for those over age 70. There is evidence however that these recommended levels are too low for optimum health. I recommend 2000 units of vitamin D per day for my patients delivered via a vitamin D pill, because people are not outside as much as they used to be and there are several studies linking Vit D deficiencies to a myriad of health problems. And, vitamin D deficiency does vary by region. In regions where the peoples spend more time in the sun (like agri-communities), their Vit D deficiency is not as severe.

Dr. James S. Compton is a board-certified internist who founded South St. Louis Medical Associates in 2011. Prior to founding a practice based in premium patient care, he practiced at another St. Louis-based medical center for almost two decades. He currently teaches at St. Louis University, where he is a Full Clinical Professor of Internal Medicine.

Slip, slap, slop. There are so many great quality sunscreens out there, if you need to, look on it as anti-aging and moisturizing. Whatever it takes, as long as you protect!

Shortly after the birth of my daughter my sister came from California to visit the baby and I in Virginia. One afternoon, as we stood outside a snow cone shack, she exclaimed, “What is THAT?”

I glanced at the crook of my left arm and stared for a minute at the mole I’d had ever since I could remember. But something was different.

Wrong.

It was black.

“It’s nothing,” I quickly said and tried to change the subject.

“Are you kidding me? That thing looks bizarre! You need to go get it checked it out. Please.”

But I ignored her. Caring for my two month old baby and preparing for a move to another state simply took precedent in my mind. I had no time to see a doctor about my skin. After all, I thought, it is just a mole.

The weeks passed by in a blur as I packed and nursed and packed some more. The world seemed to revolve around by newborn and her care and our upcoming move. But there was a little voice in the back of my head about the mole. I knew that my sister was right and that something was wrong, but every time the worry seeped to the forefront of my mind I brushed it away like a nagging fly.

The move went as well as it could go, and we settled into our home in New York. My sister asked again when I planned to see a doctor about the mole, and I decided it was time.

The dermatologist was kind and gentle and carefully removed the mole for testing. He didn’t act terribly worried or upset, and I took that as a good sign. But a couple of weeks later I found myself sitting in his office again waiting for my lab results. When I walked in alone he recommended that I bring my husband in from the waiting room to be with me when he revealed the news.

Alarm bells rang, loud and clear, in my head.

“You have malignant melanoma. The good news is that we caught it early. Your sister saved your life.”

I came back a couple of weeks later for surgery to completely remove the cancerous tissue.

It was September 11, 2001.

The highways were empty and the skies ominously quiet. The earth had shifted under my feet, but I had no choice but to right myself, gather my daughter in my arms, and do what I had to do to rid my body of its invader.

I’ve been cancer free for ten years.

I’ve learned a few things about skin cancer and life that I’d like to share with you…

1. My sister is pretty darn smart. Really, she saved my life. My doctor mentions this every single time I go for a check up.
2. There is no such thing as a cancer that is “no big deal.” Unfortunately, many people still think of skin cancer this way. Malignant melanoma can be fatal, and we’d all be wise to take it very seriously.
3. Know your body and listen to it. I knew something was wrong, but I put off getting checked out. Pay attention to your moles and freckles from head to toe. If you have several, go to your doctor, and he or she will “map” your body and take photos to help you get to know your skin and notice any changes.
4. Wear your sunscreen and skip the tanning bed. Seriously, it is not worth it.
5. Parents: Putting off self-care, “because I have to focus on the kids,” does not do anyone any good. Your children need a parent who is healthy and able to care for them. If I had put off that trip to the dermatologist any longer, I might not be here today to care for my children.
6. Everyone: Get checked. Do if for yourself and do it for the ones you love and for those who love you. Don’t put your health on the back burner. Nothing is more important than your life.

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About Christine Green: Christine Green is a freelance writer who also runs a personal assistant business in Brockport, NY.  She has been published in Story Bleed (Blog Nosh), Genesee Valley Parent, and has essays in Mother Muse: A Collection of Poetry & Prose Celebrating the Joys & Challenges of Motherhood. She has essays, non-fiction, and fiction pieces forthcoming in the June issue of the literary journal aaduna as well as the book, Motherly Musings, which is scheduled for publication this summer.  She always wears her sunscreen and routinely slathers it on her children, a daughter, 10, and a son, 6.  She blogs at Grown Ups are Like That.