A photo of a woman's skin cancer scars on her nose.

Hitting the Trifecta

I’ve hit the trifecta of cancers. A trifecta in the horse racing world means horses finish in the correct order. Years ago, we attended the Kentucky Derby with its time-honored derby hat and mint julep traditions. During one race that day we actually won the trifecta.

So what does horse racing have to do with cancer?

Another definition of a trifecta is a set or combination of three things. In 2016, I was diagnosed with not one, but two types of cancer. The first was polycythemia vera or PV, a rare blood cancer. A couple of months later, I added invasive ductal carcinoma, breast cancer, to the mix. It floored me to have two cancers. Up until that time, I thought I was healthy.

The skin check that changed everything

I went through chemo and multiple surgeries for breast cancer and took medication to keep the PV in check. Things were looking good. I was feeling great. The cancer had finally taken a back seat. Well, it did until that full-body skin exam at the dermatology clinic in 2019.

Basal cell carcinoma on my nose

The dermatologist noticed a red spot on the side of my nose. I honestly thought it was a pimple. I hoped the biopsy would come back benign, but my luck up until this point hadn’t been great. Sure enough, it was a basal cell carcinoma. Seriously? Now I had three cancers to contend with. Like two wasn’t enough. This upset and frustrated me.

Fun in the sun

I wondered how did I wind up with skin cancer too? My dermatologist told me that 40% of skin damage occurs before 18 years old. I lived in Minnesota for most of my youth, so sunbathing opportunities were limited. However, that didn’t stop us. As soon as the permafrost was off the ground, my friends and I were working on our tans. We doused ourselves with baby oil while soaking up the sun’s rays. When I moved south, I continued my sun-worshiping ways for many years.

I did start to get smarter about the sun

After a rosacea diagnosis ten years ago, I started getting smarter about skin protection by always using sunscreen, wearing a hat and sunglasses. I still lived an outside life of running, biking, and swimming, but I was much more cautious.

My blood cancer and skin cancer: how they're related

Besides my sun-loving life, the medicine I take for the PV concerns me. It is known to increase the likelihood of non-melanoma skin cancers. Since I had never had an issue with skin cancer before I started taking the medication, it is possible it is also a culprit.

Adjusting my skin check routine

After my first basal cell diagnosis, I moved to the 6-month dermatology plan. Every visit resulted in a biopsy and usually some kind of cancer. In 2021, the dermatologist diagnosed me with melanoma in situ. The cancer wasn’t on my butt or in some other location nobody sees. No, of course not! It was dead center of my cheek and the Mohs procedure left an ugly five-inch scar across my face.

Frequent flier plan

I moved to the three-month (aka frequent flier) plan with my dermatologist after that. Last year, I had several biopsies. One biopsy of a dark spot, a lentigo, showed abnormal cells and resulted in my first experience with the topical cream Imiquimod. Another was a basal cell which I'll have a Mohs procedure to remove. There’s no surprise that these were all on my face. Between the massive melanoma scar and now the multiple biopsies, my face resembles a poorly sewn patchwork quilt.

I do feel lucky

Although I am a bit sad about my current state and significantly marred face, I consider myself lucky that they diagnosed these cancerous spots early. In addition, I’m also learning a whole new cancer vocabulary and am getting great at identifying skin carcinomas. Best of all, not only do I get to write for Blood-Cancer.com, I have the opportunity to write for Skin-Cancer.net now too!

My own triple crown

I’m thinking since I’ve hit the cancer trifecta, perhaps I need to get back to the horse track. I probably have a good chance with another trifecta.

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