Friday, December 4, 2009

News From a Cancer Survivor

I was recently diagnosed with basel cell carcinoma.

This is considered a low key cancer, one that is not life threatening.

I'm a fair white girl who grew up worshipping the sun in an era before sunscreen. I swam all day as a toddler in Miami at our home pool, spent long summers in Israel at the beach and pool, spent summer days at the UC Berkeley Strawberry Canyon pool, crashed the Claremont Hotel pool in Berkeley (in my teens while working at Berkeley Repertory Theatre as an actress), and swam at the Stark pool in Danville in high school, among many other places. Sunbathing was our entertainment and a tan meant we were beautiful. We slathered ourselves in baby oil.

Then, the dark news: my Dad was diagnosed with Melanoma when I was in my early twenties. He told me to stay out of the sun. I didn't listen. I continued to sunbathe on the roof of my soho loft building in Manhattan, sunbathed on vacations, and I rarely used sunscreen.

Dad died eight years later from the melanoma (he developed a brain tumor which is the typical evolution of the disease when it has matistisized). I (sort of) paid attention after his death and spent less time in the sun--no longer sunbathing flat on my back, but continuing to do activities outside--often without a hat or sunscreen... pretty much until now. Okay sometimes I used sunscreen, but not not carefully or religiously.

I gave birth to a redheaded girl and have tried to keep her out of the sun. We've been a bit more relaxed in the last few years, so she's developed a face full of freckles. Still, I think she's had only one mild sunburn. I've been careful to keep her out of the strong mid-day sun, to make her wear a hat and keep her body covered as much as possible. But we're not perfect.

Two weeks ago I went to see my dermatologist for what is supposed to be my annual visit-- but I have not been in several years-- to check for melanoma. As the child of a parent with melanoma, I really should go every six months. Yet because I have so many doctor visits to make for cancer checks for various potential outbreaks every six months--more than you'd want to know--sometimes I just tune it all out and try to forget, and skip scheduling appointments. It is my way of blocking cancer from dominating my life.

The first thing the dermatologist noticed was the tiny little patch (the size of a small freckle) of what looked to me to be dry skin--maybe eczema-- on my cheek. He said, "that looks like basel cell carcinoma," and took a biopsy and explained that if it is cancerous, they would do the surgery right in his office. I ask if there would be a few stitches. He said, "Well, probably more than that." He didn't say more, and I assumed it was a minor thing.

It was not a minor thing. At least not to me. A huge circle of skin was removed from my face. But no one, not any of the doctors who worked on my face explained much to me in advance about the final result and how I will look once they are finished. The surgeon who removed the cancerous skin tissue (the MOHS surgeon) said they would do it in stages, checking with each stage if they have removed all of the cancerous cells. He looked very sad as he explained this to me, but he never said, "You need to be prepared, this may end up as a very large circle, smack in the center of your face, and sewing it up after is a little complicated and will change the shape of your cheek. There will be scarring." Instead, he told me I looked like this very glamorous actress from Gossip Girls (I had no idea who she was --I've never seen the show). He took out his iphone and showed me her picture. I was so flattered--she's young and lovely. What a nice distraction. (I'm kidding, of course.)

Then he cut into right side of my face. He cut in three stages.

After the MOHS surgeon was done, the plastic surgeon walked in. I had no idea how much had been removed-my face was numb. I assumed it was small. The plastic surgeon asked, "Have you seen your face?" I said "No." He said, "You need to see it in order for me to help you understand what I have to do." So he held up a mirror and I felt sick to my stomach. I wanted to cry. There was a very large red circle in the center of my face. I knew one day I would look back and think this was a very minor thing. My life was not threatened. I will have a scar on my face for a while--but the scar will fade. He proceeded to cut and snip and sew the big open circle into one long straight line. When the surgeon was done, he asked me if I wanted to look in the mirror. I said, "No." He covered the wound with a long bandage. I told him I would wear the bandage forever.

In that moment, in that first week, I felt as if the world had come apart.

Why? My body has been through so much worse: chemo, hair loss, physical pain, serious surgery, life threatening cancer, the loss of so many loved ones to cancer and heart disease. Why did this minor surgery for a minor cancer upset me so? It is nothing. I have/had my legs and arms and heart and mind. The things that matter remain/ed in place.

So, why was I so upset? Was it vanity? Was it something more?

This question plagued me.

Perhaps it is because--my face is me. It is what I physically identify with as my "self". It is what the world sees. It is what I see in the mirror.

Perhaps it was because the results of my surgery were completely unclear--they were not explained to me in advance.

Still, this was not the end of the world. I will be fine.

At night, as I lay under the covers, feeling the grief, I came to an understanding.
My body is on high alert. The doctors are on constant watch for the many parts of my body that are "high risk." Every six months my body is forced to go through a huge battery of tests in various areas to probe and look for potential life-threatening cancers.

Most obviously, and more importantly, my father died from melanoma--the deadly skin cancer. Now the largest organ on my body threatened to self-destruct at any moment. Now I have joined him. Now I must keep close watch on my skin. Now I must fear every freckle, every discoloration, every bump.

Now, once again, I am terribly afraid.

As a mother, I am faced with more fear. For my daughter, I want to smile and be brave. It is harder than one would think to do. For my daughter, I grieve. She does not deserve to live under the weight of knowing mom's visit here on this planet is so tenuous. I try to promise her I will be here for a very long time, but how can I promise that, especially given my history and my family history?

* * * * * *

Two weeks later--after I first wrote the above--the bandage has come off.

I touch the scar. It is hard in some places. There are small bumps. It does not hurt. Sometimes it looks prominent and upsets me, and in a different light it looks like a long cat scratch.

In the end, I know I cannot ward off these cancers. I would like to be free of this fear, and free of the chemicals that threaten to make me sick--they are in and around me. I would like to think that I can protect myself from early death, and most of all I'd like to protect my daughter from the loss of a parent, and from getting sick from cancer herself. Yet all of this is out of my control.

All that I can do is write, sign petitions, join the environmental movement, and hope others will join me. I hope and dream that the Climate Change action will take place, and that the chemical, nuclear, and other destructive industries stop abusing, exploiting and poisoning the earth. For those of us who have gone through rounds of chemotherapy, surgeries, radiation, and other painful procedures, as well those of us who have lost loved ones to the horror of cancer--I hope and dream of a better environmental future, a healthier home for us to live in.

The earth's body is our body. Her scars are our scars.

In some moments, I actually like my scar. It is a reminder of all of these things I love and care about on this earth. My scarred cheek is a river or mountainside worn down and altered throughout time--still beautiful, though ever changing.


Barbara said...

I am so sorry you have to go through this.

Anonymous said...

As difficult to read the second time as it was the first. Hadn't heard about your face... I know it's "still beautiful"!

Why our family? It seems more than other families. Yes, every freckle...