The Determined Dermatologist

It’s no surprise that dermatologists care about skin cancer. But what happens to a dermatologist who has a family member diagnosed with the disease?

Sunny Walia, assistant professor of dermatology and director of dermatologic laser surgery at George Washington University knows everything there is to know about sun safety, but when someone in her family was diagnosed with skin cancer, she re-dedicated herself to raising awareness in her patients.

“Any time you have a person close to you experience skin cancer, it makes you more diligent than you were before,” Walia acknowledges. “You gain an internal perspective. You feel more obligated than you normally would to educate people.”

For years, Walia has been raising awareness about skin cancer. In fact, she was involved with SkinPAC, a political action group affiliated with the American Academy of Dermatology, that helped push through legislation in Maryland requiring minors to have parental consent before using tanning beds. “Maybe it’ll go nationwide,” Walia says hopefully. “It’s a wonderful law.”

Walia’s personal experience with skin cancer has doubled her efforts to educate patients and herself. “When patients come in to talk about acne or psoriasis, I always hand them a brochure so that they can have a working knowledge base,” she says. “And I continue to read dermatology journals, so I stay up-to-date on the latest research findings.”

Those findings say the numbers are rising. The National Cancer Institute estimates more than a million new skin cancer cases are diagnosed annually. Rising numbers mean many people who come to Walia’s office will face a skin cancer diagnosis.

Luckily, now Walia is even better equipped to handle their emotions. “The personal experience makes you feel more empathetic. You want to put the person’s mind at ease. Being diagnosed with cancer is not the easiest thing to hear,” she notes.

“That’s why it’s so important to protect your skin by reapplying sunscreen, wearing protective clothing and avoiding tanning beds.” Walia explains. “You can keep yourself healthy.”

Reduce your risk for skin cancer. Get more expert advice from Dr. Walia about how to protect your skin and play in the sun — safely.

I was diagnosed with melanoma about 5 years ago, when I was 35. I had a mole on my stomach that was starting to flake and looked red. I assumed that it was from my waist band rubbing the mole and irritating it. When I went to my doctor for my annual physical I asked her if I could have it removed. She referred me to a surgeon in the area who removed the mole in his office and sent it to a lab for testing. A week or so went by and I received a call that it was melanoma.

My first surgery

Unfortunately this surgeon lacked compassion. When you hear the word “cancer” you immediately assume the worst. I asked him if I could die from this and he said (with no emotion) yes. I cried the whole drive home and that evening. I didn’t want to die. I decided that I wanted to get the best possible care and immediately called Johns Hopkins Hospital’s Dermatology department. Through the grace of God I got an appointment within a couple of weeks. They scheduled me for surgery about 2 months later. That was emotional torture, all I could think about was that the cancer was growing inside me. The day of the surgery I was scared beyond words. This was my first surgery. I walked in to the operating room and 3 hours later I woke up in the recovery room to hear the good news “the cancer had not spread in to my stomach muscle.” A week later I found out that the biopsy on the lymph nodes in my groin was negative.

I went on to recover, happy that this was behind me.

Spreading the message

I shared my story with everyone at work and started my quest of educating my co-workers and friends. After hearing my story, my co-worker and friend made an appointment with a dermatologist to have her moles checked. Several weeks later she was diagnosed with melanoma. She tells everyone that if it wasn’t for me she would not have gone to the doctor and would probably be dead. Call me humble but I think she gives me too much credit. I was just sharing my story.

Bad news

Unfortunately, less than 12 months later I was diagnosed with my second melanoma on my chest. I went for my 3 month check up with my dermatologist and she removed 2 suspicious moles. She sent them out for testing and a week later I got the call that the one on my chest was melanoma. This mole was smaller than a pencil eraser, how could it be melanoma? My dermatologist referred me to plastic surgeon who specialized in head and neck cancer. She thought the scar would look better if he did the surgery. I met with the surgeon and we decided to do the surgery in his office since it would be a small excision. He removed the rest of the mole and a week later I got the good news that the cancer had not spread. 0 for 2.

Battle scars

I have 2 keloid scars that I refer to as my battle scars. A 4½ inch scar on my abdomen from my first surgery and a 2 inch scar in the very center of my chest from the second. I could be self conscious and wear shirts and dresses that hide the scar on my chest but I don’t. I also wear a bikini, the scar on my abdomen is fading but it is still noticeable. I do get stares from strangers and sometimes I forget about the scar and think “what are they staring at?” But when they ask how I got it, well that’s the conversation starter. I think they assume that I was shot, stabbed or had heart surgery, although the scar isn’t big enough for heart surgery. I always say “I’m glad you asked. I had melanoma. Wear your sunscreen and stay out of the sun. I was never a sunbather. It can happen to anyone.” Sometimes they ask how it was caught and I get to educate them more. If my scars were covered I wouldn’t have the opportunity to educate people.

Unfortunately my co-worker has been diagnosed with several melanomas since her first. But she is proactive and when she sees something suspicious she makes an appointment. Education really does work.

Good news

I am happy to say that I have been melanoma free for 3 years. I have a routine exam with my dermatologist every 5-6 months now and will for the rest of my life. And every single time I go I hold my breath and hope that nothing looks suspicious and my lymph nodes feel fine. Since I was diagnosed twice the possibility of being diagnosed again is in the back of my mind. And always will be. I am well aware that I am at risk. I use sunscreen and try to avoid the sun during the peak hours.

It has taken me 3 years but I have finally gotten my family to make appointments to be examined. You would think that they would have gone right away. I had to keep telling my brother that he as at risk since he was a sibling of someone who has had melanoma. Unfortunately the only way that got him there was some unsightly skin tags that he wanted removed. He went in August 2007. My mother is scheduled for an appointment in May 2008 and my father in August 2008. It may take a while but you eventually get people to listen.

I’m a survivor

It’s hard for me to think of myself as a cancer survivor. When I think of cancer I think of people who have it worse than me. I think that may be the stigmatism that goes with melanoma, people don’t realize that it is cancer and you can die from it if not caught early.

We need to continue to get the word out about early detection. If I could, I’d pass sunscreen out to everyone I met.

Thanks for listening to my story.

Heather Banz
Baltimore, Maryland

*Published with author’s permission

Mayor’s Message is Loud and Clear

What steps have you taken to raise awareness of skin cancer in your city?

The most important steps I have taken as Mayor are pushing to raise awareness and ensuring that residents and employees have access to screening. In 1997, I became the first mayor in America to sign an Executive Order granting City of Boston employees up to four hours off per year to use for cancer screenings. We know that early detection of cancer is critical and that many cancers can be effectively treated if detected early. And early detection means early treatment.

What steps do you personally take to reduce your risk of skin cancer?

I’m always outdoors meeting with residents, attending Little League games and enjoying Boston. And when I’m heading outside I make sure to wear sunscreen, and if I ever forget my family quickly reminds me. My busy schedule doesn’t always allow this, but it’s a good idea to schedule indoor events as much as possible during the sun’s peak hours from 11:00 am to 2:00 pm. That can also make a difference.

Any advice for people who are feeling lazy and not taking precautions against skin cancer?

I’d say the chance of getting skin cancer is worth taking a few minutes to apply sunscreen and taking a break from the sun. I was lucky. My cancer was caught early and I had a relatively minor surgery. Not everyone is that lucky and everyone should get themselves checked.

How has your experience with skin cancer affected the way you and your city approach skin cancer?

Sometimes it takes a bad thing to happen for people to pay attention. When I had my skin cancer it was all over the news, which was actually a good thing. We got the chance to promote education and urge people to get screened. The more people know about skin cancer the better chance they have to prevent it.

As an elected official and a skin cancer survivor, what role do you play in raising skin cancer awareness in Boston?

When I am asked about my priorities as mayor, I talk about education, public safety and public health. Skin cancer awareness is a subject that captures all three of those. Our goal is to make people more aware of skin cancer, talk with them about how they can prevent it, and work with our agencies to increase our tree canopy and clean our air. In the end, we are making Boston a safer and better city for everyone.

Young Woman Warns Others ‘It Can Happen to You’

Whenever a photo is snapped of Kristine Fargotstein, the 24-year-old turns her left shoulder away from the camera to hide the 3-inch scar on her upper left arm. Even two years after surgery to remove a pre-melanoma area, she can’t help herself. She’s self-conscious when her scar is showing and dreads heading into tank top season.

“I grew up in the Southwest where it’s gorgeous outside 24-7 and we were always outdoors. We didn’t always think about sun precautions,” Fargotstein explains. “I went to college in San Diego and I was a ‘beach bunny.’ I even went to tanning beds for awhile. I admit I was stupid. I wanted to be tan for graduation.”

Saved by Early Detection

After her trips to the tanning beds, Fargotstein noticed that a mole on her arm was a little darker. She wondered if it was something to worry about.  A short time later, while she was in her dermatologist’s office for an acne consultation, she hesitated to mention her concern. Thankfully, she did say something and her dermatologist took a biopsy. When the test results were back, Fargotstein got the news that it was serious — she’d have to see a plastic surgeon and have the mole removed.

“Doctors told me that it hadn’t yet developed into melanoma and they were able to ‘cut it out,’ but that I would now be susceptible to melanoma the rest of my life,” she says. Fargotstein is now adamant about wearing sunscreen, reapplying it and having annual skin exams. Every time someone asks about her red, zigzagging scar, she’s not shy about educating them about the risks of tanning beds and sun exposure.

Fargotstein, who now lives and works in the Washington D.C. area, urges others to talk to their doctors when they notice something is wrong with their skin. “Had I not said something to my dermatologist that day, I wouldn’t have seen her again for months. It could have developed into life-threatening melanoma by then.”

Skin Cancer on the Rise

Skin cancer has been on the rise for decades. Melanoma is the most lethal kind of skin cancer. One of its first signs is a change in color, shape, feel or size of a mole. While melanoma usually strikes adults in their 40s or 50s, doctors are also finding younger people with the cancer. The best way to prevent melanoma, doctors say, is to limit your sun exposure, especially during the peak hours of 10:00 a.m. to 4:00 p.m.; wear protective clothing; wear sunscreen with an SPF rating of at least 15; and avoid tanning beds and sun lamps.

Skin protection is now an issue Fargotstein is passionate about. “You’re young and think you’re invincible and then you realize at the age of 22, you could have a life-threatening cancer,” she says recalling the shock she felt after her diagnosis. “I had a 100 percent control of preventing it, but I didn’t because it was too important for me to look good in my graduation dress.”

“With skin cancer, you literally have the power in your own two hands to prevent it,” Fargotstein warns. “Be aware and realize that it can happen to you.”