Pre-Cancer Prevention

Pre-cancer. It’s a strange term that means something isn’t normal…but it’s not malignant, either. It’s a limbo-like term, reassuring and worrisome at the same time.

I’ve had this reddish brown spot on the left side of the bridge of my nose for several months now. It started as pimple, or so I thought. It broke, bled and then seemingly scarred. It’s aesthetically troublesome but not so bad that I can’t dull or nearly cover it with tinted moisturizer and concealer, which is what I’ve done for the last several months.

And then, it started to hurt earlier this month. It got really sensitive to touch and darker and scalier. It finally was time to get it checked, I thought, because it could be skin cancer.

It’s not an over-reaction. My mother’s mother had several basal cell carcinomas and squamous cell carcinomas on her cheeks and on her nose. When the dermatologist surgically removed a size carcinoma on her nose, Medicare wouldn’t pay for surgery to restore the tip of her nose. That flattened nose end made her very self-conscious, as did the scar from the carcinoma removed from her cheek. She really worried when my sister got married because she didn’t want to be the “snub nose lady” in the photos.

Later, my mother had surgery to remove a carcinoma on her face. The doctor did not want to delay removal because it was so near her eye and growing. She, too, worried about the photos. The photos were lovely but I understood their disappointment with the way they looked. Sure, we say, “Thank God you’re alive to attend the wedding. You should be grateful for that,” and they were. The thing is, they didn’t want the photos of such a happy occasion also to include  reminders of their mortality.

I am now the same as as my mother was when she had that first skin cancer removed, hence my heightened concern. She had others after that, too, and she ultimately succumbed to cancer and end-stage emphysema at only sixty-eight. She smoked for fifty years, so, really, cigarettes killed her.

Earlier this week, my mind tangled the doctor’s words as she explained the thing on the bridge of my nose and another thing on the tip of my nose was–is–actinic keratosis, or AK. “It’s a pre-cancer, the result of severe sun damage,” she said. Given the location on my nose, she explained she wouldn’t biopsy them right now, but, instead would zap them with liquid nitrogen because it’s less scarring and non-invasive. If they don’t go away after a month, or if they start changing, getting worse, she said, I need to come back and she would treat them as squamous cell carcinoma, which is what about ten percent of AKs become if left untreated. AK can turn into other cancers, too. The Skin Cancer Foundation has wonderfully readable information that really helped me.

AKI walked out with two spots on my nose, thanks to the liquid nitrogen. The treatment is prudent, given my genetic risk factors: multiple family members with skin cancer and being fair skinned with green eyes. I also have a history of severe sunburns (peeling skin and burning the new skin beneath) from childhood through early adulthood. When I was a kid, I was so eager to get a suntan I would skimp on the sunscreen and maximize the sun exposure. It never failed: I got badly burned and had to wear a tshirt plus SPF50 Sea n Ski for weeks while my skin peeled and bled. You’d think I’d learn but the next summer, I’d do the same stupid thing all over again. My poor nose suffered worst. Dozens of times it burned so badly it bled and then I’d have to slather it with zinc oxide and then walk around with what the locals called lifeguard nose. The summer I actually was a lifeguard allowed me to wear the zinc oxide nose coat with professional pride.

For years now, I’ve only used face makeup and moisturizers with SPF 15-30 sunscreen. If I’m going to be out in the sun for any period of time, I slather on the sunscreen with SPF 30 and reapply often. I’ve never gone to a tanning salon and I don’t use fluorescent lights in my house (though I’ve worked in many offices with fluorescent lights). All of that helps and I’ll continue to do the same or more. I wear a hat with a wide brim when I’m walking around at festivals or hiking or paddling. Still, I long to get a suntan and I frequently let myself get a slowly developing tan because I thought it looked healthy. Now I know better.

For the first few days I felt extremely self conscious about those red spots on my nose. I wanted to cover them up AK Postbut they had to be left alone to do what they were supposed to do: die and fall off. I had to remind myself they weren’t as noticeable as carcinomas or melanomas would be, and I had to lecture myself because vanity can be deadly. I’m doing good to get them treated now and to practice sun safety. If I don’t, I could end up with a carved up nose or no nose at all. It’s all about looking on the positive side, doing the next right thing, and then moving on with the serious job of living a good life without freaking out about silly things like blemishes.

Today the spots are much less noticeable. They dried up and fell off like they were supposed to. I’m thrilled! The doctor was right: we got them early before they became something worse. Yay!

Pass the sunscreen and wide-brim hat. I’m going out.