wear sunscreen, people

My favorite quote is "If I can't be a good example, let me be a horrible warning."  It turns out that once again, I get to be the bearer of good news AND cautionary advice, simultaneously.

The good news: "the result of the biopsy was consistent with a benign mole. No sign of any skin cancer..."

The other news: Wear sunscreen, people.

. . .

Last Friday, I got a new scar. It's where a mole above my lips and to the right of my nose used to be. I say 'used to be' because there really isn't a tidy way to biopsy a beauty mark -- the whole thing was removed a week ago. My dad was in the back of my mind as I sat with the dermatologist. He had numerous small skin cancers excised from his face and ears after spending years in the sun without a thought of wearing a hat or anything with SPF in it.

. . .

It's interesting because I've considered my radical nephrectomy scar my 'beauty mark' for nearly sixteen years now. At 7 inches long, it is silvery white and runs from just above my right hip around my flank to my back, stopping a few inches before by spine. It is dotted with staple marks and is a reminder of when surgeons carved my diseased kidney out of my body to save my life. The scar has faded and is now also joined by more beauty marks: stretch marks from two pregnancies. The surgery that created the scar was a success, removing a few malignant tumors which would have killed me by now. Within my kidney were the slow-growing seeds of death -- the largest tumor was a scant 2.3 cm by 4 cm; the smallest was only 1.1 cm by 2.1 cm.  There was no metastasis and no lymph node involvement,  so my diagnosis was stage-1 clear cell renal cell carcinoma.

The 'typical' kidney cancer patient is male, of African American or Scandinavian American decent, has been a heavy smoker all his life, or worked in an industry with a high exposure to certain chemicals. He also is diagnosed at stage 3 or 4, when there's little to be done for him.  I met none of these criteria. I was (and still am) a medical outlier. Every healthcare professional who takes my medical history puts down her pen or pushes away from the keyboard and asks me how my cancer was found at age 28. They remind me that my diagnosis 'doesn't happen to 28-year-old women' and that I am lucky to be alive.  I nod and remind them that cancer can happen to anyone, that there is a lot science still doesn't understand about epigenetic changes and our environment, and that I was fortunate to have a physician who took me seriously when I said I had an odd, lower right quadrant nagging pain when doing yoga.

. . .

I'm not a terribly vain person (I wear makeup maybe a few times a year, mostly at important work meetings), but I was pretty upset about needing to remove a mole that is connected to my identity in a lot of ways.  My children were both fascinated by it and constantly reached for it as infants and toddlers, grabbing and pinching it until their curiosity was sated / they were old enough to understand what it was.  My daughter has the same mole, in the same spot (but mirror image and --like mine was at her age -- still only a pin point on her face).  She has often asked if her face will look like mine and if her mole will be like mine when she's an adult. I've told her the truth -- I'm not sure.

When I got home from the procedure, Leo and I explained to the kids why I was wearing a bandaid and couldn't smile or open my mouth very wide. We never said the word "cancer" to them.  Seba couldn't take his eyes off my stitches when I had the bandaid off. Lucia asked me hundred questions over the weekend about it, finally admitting that she had been scared that she might have to have her mole removed eventually, too. I promised her that I was doing everything I could to make sure it would not happen to her -- and that it why I insist on putting sunscreen on them before every soccer game and that she and her brother wear hats when feasible.

. . .

Tomorrow, I will return to the doctor's office and the last 3 stitches will come out. I'll ask him if he thinks the 1 cm scar will fade into my smile line or if he thinks I could tattoo a 'replacement' mole in its place. He's already told me to keep the scar well protected from the sun with sunscreen and a hat,  and that makeup will cover most of it. I'm sure about the sunscreen and hat but not sure if I'll start wearing makeup again. To be honest, I spent a lot of time looking in the mirror before I had kids; I often find that I've gone all day without looking in one only to discover eye crud off to the side behind my glasses hours after getting to the office. I've spent many hours looking in the mirror this week, getting used to my new face and trying not to think too much about what my biopsy results would be. I've over-thought the coincidence that my 1 cm scar is slightly smaller than my smallest malignant kidney tumor. But I've also remembered that while having kidney cancer was the Krakatoa of my life, that there's also been more joy, more adventures, and more passion in the last ~16 years than in the entire 28 years before. For now, I'm focusing on the joy -- and shopping for some more hats and sunscreen for everyone in the family.