Before you bask in the warmth of this summer’s bright sun...

Marlys BarkerTri-County
Times Editor
Before you bask in the warmth of this summer’s bright sun...

The summer season is upon us … a time to get outside and enjoy the fresh air, swimming pools and beaches, softball and baseball games, long bike rides and much more. But, as we are outdoors enjoying the warm temperatures, a silent killer is lurking. If we as individuals and parents don’t take precautions and listen to the advice of how to deal with sun exposure, we are basically playing with fire. Skin cancer — the abnormal growth of skin cells — is a real and deadly disease. Take heed.

Kyla Davis says she will be “looking over her shoulder” the rest of her life, wondering about something.

That something is skin cancer.

The 56-year-old, 1978 graduate of Nevada High School who now lives in Des Moines, is among the many people (one out of three in Iowa, she was told) who will be diagnosed with basal cell carcinoma skin cancer, the least severe type, but still something that must be addressed. Davis’ skin cancer was hard to miss, because it happened on her face, right in front of her nose, you might say.

“I noticed it in November (2015) … a red dot on the right side of my nose. It wasn’t a pimple. It wasn’t an open sore. It didn’t look like a mole. It didn’t look like anything I’d ever had before. It eventually changed and became an open sore that would scab over, but it would never heal. That’s when I knew something was wrong,” Davis said.

Davis underwent Mohs surgery, which is where doctors remove the skin growth, layer by layer, examining each layer under a microscope until no abnormal cells remain. “Since my skin was so tight, they had to take tissue from between the brows and pull it down to fill the hole where the tumor was,” Davis explained. She ended up having 40 stitches in the middle of her face, and was quite emotional about all of it. “I really debated if I wanted to share this story. I felt ashamed that I let this happen,” Davis said. But after thinking about it and realizing how important the issue is, she shared her story and photos on Facebook and was willing to speak with the newspaper, too.

Having skin cancer on her face is something Janet Stoll, 52, of rural Huxley worries about. She’s seen how people who have cancer on their face often need plastic surgery. So far, Stoll’s two cancerous episodes have been on her back, the most serious was the first, noticed during a routine exam by her primary doctor in 1995.

“I had an irregular mole on my lower left back that he said he had been monitoring for a few years. The doctor took a small biopsy of the mole and sent it in to a lab to be tested.” The sample came back as the most serious form of skin cancer — malignant melanoma. An appointment was made for Stoll to have surgery with a dermatologist.

During the outpatient procedure, layer after layer of her skin was removed and checked until they came to a layer that was cancer-free.

“My surgical site was quite large. It was approximately 6-7 inches long, several inches across and the depth went down to my muscle tissue. I was very fortunate that I did not require any further treatment, because the cancer had not spread to my lymph nodes or organs.”

Seven years later, during her annual dermatologist appointment, another suspicious mole was noticed on her back, by her right shoulder blade. “Instead of taking a sample of the mole … the dermatologist used a surgical tool that looks similar to a cookie cutter, but much smaller in diameter. The whole mole was removed, which included tissue around and under the mole.” Stoll felt lucky — the extra tissue around the mole was cancer-free.

Nevada family practitioner Alison B. Carleton, MD, said she’s not noticing that skin cancer is becoming more common to see on patients, but she is noticing more younger patients being diagnosed with the disease now. “I do have young patients with skin cancer, as well as older folks,” she said.

Scarier yet, Carleton sees her older patients more often having the “better” type of skin cancer, squamous cell or basal cell, while she is seeing some younger patients with melanoma — “the big bad type of skin cancer.”

She recalls finding that big bad type of skin cancer on a patient who had a large mole, about 1.5 cm in diameter. It had various colors in it with an irregular border. It wasn’t bumpy, but it was weeping clear fluid, she said.

The best advice Carleton can give to any person, young or old, is this: “Protect your skin from excessive sun exposure and don’t get sunburned.”

Mayoclinic.org gives lots of information about skin cancer, including tips on preventing it. Like Carleton, the site advises avoiding the sun, especially during the middle of the day when the sun’s rays are the strongest. “You absorb UV radiation year-round, and clouds offer little protection from damaging rays. Avoiding the sun at its strongest helps you avoid the sunburns and suntans that cause skin damage and increase your risk of developing skin cancer.”

Looking back, Stoll recognizes now what she didn’t understand when she was younger. “Summertime skin care was not advertised as a public concern when I was younger. My family didn’t use sunblock or sunscreen. In fact, the adults would lather up with baby oil to enhance the intensity of the sun’s rays.”

Stoll has learned now that she was at a higher risk from the sun because she has fair skin and auburn to brown hair. “These factors contribute to potentially having skin cancer if you don’t take precautions,” she said. But in her youth, she didn’t know. She detasseled corn and walked beans, unprotected, for many hours under the hot sun’s UV rays. In her early 20s, she took up another very dangerous habit — tanning beds. “My sister had her own tanning bed, which gave me easier access to the ‘golden summer glow.’”

Davis said sunscreen wasn’t an option when she was growing up. It didn’t come out until the 1980s, she said. But Davis rarely sunburned. With her dark hair, she always had a nice deep dark tan. But her light eyes, a doctor later told her, were a hint of higher risk. And even though always tan, she had fair skin.

Like Stoll, Davis also got hooked on tanning beds. “I used them the most in the 1990s … in the winter before I was going on a trip to a warm place.”

She now describes tanning beds as “a killer.”

“Whether you use them once a week or every day, the difference is today we know they are a killer. How they stay in business is beyond me. I guess they’re like cigarettes. We know they kill, but they are still available to the consumer,” Davis said.

Mayoclinic.org agrees. The site advises people to avoid tanning beds. “Lights used in tanning beds emit UV rays and can increase your risk of skin cancer.”

Stoll and Davis hope that others can learn from what they’ve been through, especially the younger generation.

Stoll’s niece used her aunt’s experience with skin cancer to do a biology assignment at her high school. “She did a project on the dangers of sun exposure, and used me and my experience as exhibits. I was still emotional from the whole process, so I did cry some during her presentation,” Stoll said. But she loves what sharing her experience did. “My niece said … several of her classmates decided to never use a tanning bed again.”

Stoll’s life today includes doing a visual check of her skin every day, because she knows that skin cancer, if not treated in its early stages, can be deadly. “If a spot changes, either in size, shape or texture, I make an appointment with my dermatologist. Not a day goes by that I don’t worry about my next spot.”

Davis is also much more diligent about protection from the sun. “I have to wear a minimum of SPF 30 sunscreen every day, even on rainy days. I don’t think I’ll be able to lay in the sun again. If I’m out in it, I will be wearing sunscreen, sunglasses and a hat. I will seek the shade whenever possible. I am terrified to be in the sun.

“When you’ve had the middle of your face cut up and had 40 stitches, it makes you rethink your future.”

The Nevada Journal and Tri-County Times are bringing our readers this story about skin cancer during May — Skin Cancer Awareness Month. May is the perfect time to start thinking about and learning more about how to protect yourself and your loved ones from skin cancer. If you are looking for more information about skin cancer, go to a trusted resource, like your own family practitioner or dermatologist.

A couple good online resources about the disease are: www.skincancer.org and www.mayoclinic.org.