This isn’t going to be the expected recap of all the valuable insider tips and “Wow, I never knew that!” Peninsula stories you’re about to dive into—and believe me, we’re delivering some really stellar content this month. When I started to write my editor’s note, the photo that’s regularly published on this page caught my eye. It felt disingenuous to print my usual beaming smile, so instead of April highlights, I’m sharing a personal story with the hope that it inspires readers to schedule an overdue checkup or pay more attention to a health concern.
“I’m really lucky we caught it in time!” That’s a phrase I’ve heard myself repeat over and over again these past many weeks. It’s what I say in response to questioning looks about the change in my appearance. In early February, I went in for a procedure that took out a chunk of skin and flesh resulting in sutures that stretched from the bottom of my nose through my lip and into my mouth. When the stitches came out a week later, I was left with a Frankenstein-reminiscent vertical scar and a painfully tight and lopsided right upper lip. Even as I tried to process the image looking back at me in the mirror, all I could think was, “Damn, I’m lucky we caught it in time.”
But here’s the part I can’t stop thinking about. How can I be lucky to “catch something” I looked at every day? And I didn’t just look at it. I’ve been deliberately covering it up. Morning makeup routine: wash face, apply moisturizer with SPF 30, dab three dots of concealer under each eye (to lighten any dark circles) with one final tap on the mole above my lip. Dust face with a little powder. Good to go.
Most people didn’t know I had a mole above the upper right side of my lip. And in fact, I didn’t always have it. When the “How Hard Did Aging Hit You Challenge?” popped up on Facebook in January, I looked back at my first profile photo 10 years ago. Zooming in tight I can see the tiniest little fleck of discoloration above my lip. A “sunspot” is what my dermatologist called it. The term seemed ironic given that I’m the opposite of a sunseeker.
I’ve never been reckless with sun exposure and I religiously wear sunscreen. However, for some reason, my skin is prone to produce moles. My arms are speckled with them and I have several mini-constellations (one even resembles the Big Dipper) on my back. I subscribe to an annual skin check regimen, but it’s far from a perfect science. Over the years, I’ve had four suspect moles biopsied—two came back precancerous, the other two benign. Stripping to my underwear is a familiar drill now, standing patiently as my dermatologist works her way down from my scalp to the space between my toes, scrutinizing, photographing and documenting all my little dots and spots—including the mole above my lip.
I’m not really sure when it started to get bigger. Or exactly when my cover-up routine first began. Obviously, it must have grown enough for me to find it distracting. When I looked at myself in the mirror, my line of sight would be drawn to the speck above my lip, so with a dab of concealer, I made it disappear. But every year, as I checked in with my dermatologist, making polite conversation as she examined a mole under my breast, I would gesture to above my lip: “This still okay?” She’d pull out her magnifying glass and examine it closely. “Just a sunspot,” she’d confirm.
Which brings me to my annual skin check last December. I wasn’t worried about the mole, but quite frankly, the daily dab was getting a bit tiresome. And it did seem that my concealer was starting to wear off before the end of the day. “This still okay?” I asked, initiating our customary ritual. Out came the magnifying glass and a mini-measuring tool. “It’s not any bigger,” she replied. “But it looks a little bit darker. I’m sure it’s fine, but if you want, we can take it off.”
She gave me the choice. And fear of cancer wasn’t the factor that tipped my decision. I thought my “sunspot” was still fine too. For goodness sake, it had to be. I looked at it every day. I was just tired of putting the dab of cover-up on. When she described the procedure to “shave” the mole off, it sounded like short-term pain for long-term gain. A little band-aid over my lip for a few days—and the healed skin would be just slightly discolored. “Let’s do it,” I said, and the deed was done.
My dermatologist said the biopsy results would take about a week, but I wasn’t anxiously waiting. My mole removal felt like an elective procedure. Sitting at my desk in PUNCH’s office on Friday, December 21, the only thing on my mind was getting final edits wrapped up before the holiday closure. When my cell phone rang, I briefly glimpsed my doctor’s name as I picked up the call. She started to talk and since I had a notepad in front of me, I reflexively jotted down bits and pieces: “I’m sorry to have to tell you this…” “Melanoma…” I heard her say, as tears rushed into my eyes. Her words sounded fuzzy but I registered her reassurance that we had caught it early. I hung up and sat there stunned.
Over the long holiday weekend, I googled “melanoma” and encountered phrases like “the least common but most lethal form of skin cancer.” I learned that one in five Americans develops skin cancer by the age of 70—and more people are diagnosed with skin cancer each year than all other cancers combined. Even rare melanoma anticipates 192,310 cases in 2019. I mentally added myself into that count. But as I reviewed the stages—and corresponding survival rates—I felt a disconnect with my vague recollections from the phone call.
When my dermatologist’s office reopened the Wednesday after Christmas, I picked up the pathology report, which definitively stated my diagnosis: Melanoma In Situ (a term I wasn’t familiar with). In Situ is stage 0—non-invasive and not yet capable of metastasizing. Although melanoma is the deadliest skin cancer, we had indeed caught it at the earliest possible stage.
Immeasurable, indescribable sigh of relief—followed by a rush of empathy for close friends and acquaintances who received more dire, even incurable staging reports—a high school friend’s mother-in-law, another friend’s first cousin and a vibrant colleague taken before her 40th birthday. Everyone knows someone, and I’m sure reading this triggers your own heartbreaking memories of tragic losses to cancer.
In early January, I meet my surgeon for the first time. Because my melanoma is smack in the middle of my face, Mohs surgery is recommended, a procedure that removes all cancerous cells while preserving as much healthy tissue—and leaving the smallest scar—as possible. As she describes what’s going to happen, I try to process how these remarkable physicians have figured out how to precisely cut, lift and stretch adjacent skin to cover a gaping facial wound.
Next come the photos—so I’ll know what to expect. When the first shocking image pops up on the screen, I viscerally convulse and start crying. The surgeon hands me a tissue and calmly continues, showing me post-operative faces at one week, three months, six months, nine months and finally a year. The human body’s healing powers are indeed miraculous, capable of turning an incomprehensive hole in the face into a slight, almost indistinct scar. Twelve months from now, this could all be a memory as faint as a thin white line.
Next, I find myself overwhelmed by guilt. I mentally chastise myself for worrying about my appearance. Vanity is a luxury, I remind myself. Health is everything. I am so, so lucky. And then it occurs to me that my particular form of luck is intrinsically tied to my vanity. Yes, I’m lucky we caught the cancer so early but it was that annoying little dab of concealer, that little bit of vanity, that made the difference. If I didn’t care about how that mole looked, I would have left it there.
Procedure day arrives. With my husband and mother at my side, I am there for almost eight hours—two rounds of surgery, each followed by biopsies, and then the repair. I leave with clear margins. The cancer is out.
I’m well into the recovery side of things now. The first week was particularly brutal. I couldn’t talk or eat. By creasing the rim of a paper cup and tilting my head back, I dribbled liquid into the corner of my mouth. I cleaned and bandaged the wound daily, completing a round of antibiotics and slowly weaning myself off pain meds.
One week after the procedure, my surgeon removed the sutures, and I was officially cleared to go back into the office. While I was ready to embrace the distraction of stimulating work (that I love!), I clearly have a very public-facing job. I talk to people every day. Feeling oh-so-self-conscious, I taped on a bandage but it awkwardly slipped as my mouth moved. Hiding wasn’t an option for me.
As I methodically cross off the months in my year of healing, I can already see my red bumpy scar flattening, but my upper right lip remains leaden and reluctant to lift—inflicting tiny jabs of pain whenever I spontaneously laugh or smile—which I now realize is countless times in a day. Losing that ability is my biggest struggle. For now, I’m taking it on faith that I will be grinning without constraint in nine months to a year. I desperately want my Mohs surgeon to flash images of me and have another frightened patient think, “I’m going to be okay. Look, she turned out fine.”
Here’s the takeaway: Vigilance, along with mindful follow-up, is imperative—whether it’s a skin check or another form of preventative care.
In my case, I’ll be stripping down to my underwear four times a year now—keeping a close eye on my many constellations, ever watchful for any sign of another errant star.