No Skin Cancer, I Am Not Going to Be Your Victim (Through a Physician's Eyes)
Last updated: February 2021
Trigger warning: The content includes mentions of suicide that might be upsetting to some people. If you or someone you know have thoughts of suicide, have attempted suicide, or experience emotional distress, contact the National Suicide Prevention Lifeline 1–800–273–TALK (8255) or Live Online Chat.
My journey with cancer started when I was only a mere 18 years old. I did not feel it on my own skin, but still, the experience was absolutely terrifying. We were having a typical family lunch at home when my dad suddenly had a convulsion-like reaction. My dad, a farmer and a primary school teacher, was the typical example of a very healthy 53-year-old male. He was not taking any meds and was healthy as can be. My body was full of adrenaline, I wanted to do something, but felt helpless. He was going to die, just like in the movies.
A forced entry into the world of cancer
When the doctors shared his test results with us, I was sick to my stomach. How could this be, he is only 53 years old, diagnosed with renal cell carcinoma (kidney cancer), the size of a grapefruit, and brain mets the size of a golf ball. They said he only had months to live. Miracles do happen, I see that every day in my practice and my dad was another prime example. He died 3 years later, in my 2nd year of medical school. The year 2000/2001 was particularly difficult, with my brother, 5 years older than me, taking his own life, 4 months before my dad passed away. He was just not able to cope with all of life’s stressors but was, unfortunately, struggling in silence and alone.
How can I do better?
Every time I lost someone close to me, I promised myself that I need to do more. I need to be better. Looking back, I am not always too sure what that meant? Being more proactive as a doctor, reading between the lines when someone is struggling, maybe more. Creating awareness on a primary care level? Maybe just doing your best?
Skin cancer: A professional perspective
What I love about skin cancer is that it’s 95% prevention and education. Unfortunately, there is a 5% category where genetics plays a role, and this is where knowing your risk is prudent. On our website’s homepage, we have access to a melanoma risk assessment tool. I recommend making use of this tool to all of my patients, family, and friends.
Even I'm at risk for skin cancer
Growing up in the very sunny Northern Cape of South Africa and not always listening to the very wise reprimands of my parents, I am at risk. When I was a teenager it was the typical misperception that my parents just don’t want me to have that much fun outside. After all, what do they know? Looking back, they actually knew quite a lot. Even though I am not fair, with blond hair, blue eyes, and tan fairly easily, I do have well over 100 nevi (moles). That puts me at very high risk for melanoma. My high nevi count and numerous blistering, peeling sunburns all add to the bottom line. HIGH RISK!
Skin cancer prevention recommendations
My recommendation: "No part of your body should be exposed to daylight. Whatever part of your skin that is not covered with clothing (preferably UPF clothing), needs sunscreen, typically lots of it." Your sunscreen needs to be broad-spectrum, SPF 40-45. This is 365 days of the year, keeping in mind it is not sunshine that is the culprit, but daylight.
My skin is in the game, we can do this!
Do you sunscreen in the fall?