How skin cancer changed my life

By Nicole Catanese

updated 11:20 a.m. ET June 23, 2009

Diagnosis: Skin cancer
Come summer, the sun plays a starring role — blazing at the beach, lengthening our afternoons, luring us to exercise outside. But the truth is, that big, yellow ball is present 365 days a year, so we’re almost always in its spotlight. Stepping outside unprotected for a few measly minutes might seem harmless, but the damage adds up: UV rays are linked to 90 percent of nonmelanoma skin cancers and 65 percent of melanomas, the deadliest form of skin cancer. In fact, skin cancer is the most common cancer in the United States, with 1 million cases diagnosed annually. And melanoma is the second most common cancer among women age 25 to 29.

In spite of the scary statistics, we’re not suggesting you live in a cave. Our job is to arm you with the facts and encourage you to stay safe. Research shows that reminders do make a difference; 56 percent of people who received a text message to wear sun protection slathered it on, a study by Harvard University Medical School in Boston shows. And protecting yourself truly pays off. Skin cancer is one of the most preventable forms of cancer, according to the American Cancer Society in Atlanta; wear sunscreen with SPF 30 and you’ll be protected from up to 97 percent of UVB rays. It’s also one of the most curable: Detecting melanoma in its early stage gives you a 99 percent chance of beating the disease. Just ask these survivors; their stories will inspire you to safeguard your skin. Want a heads-up to apply sunscreen? Text SELFSKIN to 467467 for four weekly alerts.

The sports enthusiast
Nanette Bercu, diagnosed with melanoma at age 36

Growing up in Southern California, Bercu, 38, was always romping around beneath the rays. “I practically peeled myself a new nose every summer,” she says. At 16, breakouts motivated her to see a dermatologist. Along with her acne, a mole on her lower back caught the doctor’s attention. He biopsied the spot, and when the results came back as atypical (meaning it could progress into melanoma), Bercu’s doctor said her best option was to have the mole cut out. (This diagnosis — dysplastic nevus — became a familiar one for Bercu; over the next two decades, she would have more than 20 other moles removed.) Even so, Bercu wasn’t as committed to daily sun protection in college as she should have been. “I went to school in Rhode Island, where it’s mostly rainy and snowy. Sunscreen didn’t seem necessary year-round,” she says.

Meanwhile, new moles continued to pop up on her body, and by her mid-20s, Bercu finally became diligent about using sunscreen with a minimum SPF of 30, reapplying several times when outside. “There were more public warnings about skin cancer, and I was getting about three moles removed every year,” she says. By the time she reached her 30s, Bercu, now the creative director of Paul Mitchell Haircare and a mom of two, visited the doc every six months. “As my family grew, I worried about my kids being in the sun,” Bercu says. “I coated us all in sunscreen.” Bercu also began doing triathlons, her UV exposure increasing as she spent countless hours training outdoors. Her doctor started to routinely take pictures of her scalp, breasts, feet, stomach and thighs — known as total body photography — to track new and existing growths. (Bercu has copies at home to do self-exams between visits.) “Nanette is so freckled that you can’t find a patch of pigment-free skin,” says Barbara Hayden, M.D., a plastic surgeon in Santa Monica, California, who has performed all of Bercu’s mole removals since she graduated from high school.

In May 2008, another questionable mole was excised from Bercu’s back. Three weeks later, after a routine check to see how the incision was healing, Dr. Hayden noticed a fresh growth, right above the stitches, that hadn’t been there just weeks before — a major red flag for skin cancer. “It was pin-sized, the tiniest mole I’d ever had removed,” Bercu says. When the biopsy came back as malignant melanoma, “my life flashed before my eyes,” Bercu says. “I thought, I’m only 36.”

Bercu’s doctors said there was a 40 percent chance that the cancer had spread to other parts of her body, so the next step was to test her lymph nodes. (The lymphatic system acts as an internal drainage system for the body; its nodes are like drop-off zones for the “garbage” picked up along the way, including cancer cells.) As she lay on the exam table, neon-colored radioactive dye was injected directly into the melanoma, then made its way to three areas where the cancer might have migrated: both armpits and her groin. (This process is known as lymph node mapping.) “I thought, I’m doomed,” she recalls. “It’s everywhere inside of me.” Days before her 37th birthday, Bercu had a portion of each of the nine possibly affected lymph nodes taken out and tested. The mole and surrounding tissue were also removed, leaving Bercu’s lower back with a zipperlike scar running about 3 inches long and an inch deep. (See photo on previous page.)

Bercu’s lymph nodes were cancer-free, but the painful procedure and ensuing recovery meant she had to do physical therapy to regain motion in her shoulders. After months of rehabilitation, she was able to move normally, although nerve damage slowed her recuperation, and she still has difficulty fully extending her arms. Despite these setbacks, Bercu, ever the athlete, could not wait to begin training again, even though that would mean facing the sun once more. “I choose to continue the activities I enjoy but be smart about sun protection,” she says.

More from TODAY   Dad in Japan custody case: I’m dead to my kids | Video   He stands by wife accused of faking abduction | Video To win back her kids, she lost 340 pounds Makeover! She was bullied into cutting her hair From Madonna to Marge: 10 celeb hair icons

These days, Bercu works out only before 10 a.m. or after 4 p.m., when rays are weaker, and she never goes without sweat-resistant sunscreen with SPF 60. Clothing with UPF (UV protection in fabric) is a staple in her active wardrobe, and she stashes sunscreen everywhere — car, gym bag, even a little compartment mounted on her bike. “Having melanoma was a blessing in disguise,” says Bercu, who gets full-body photos taken every six months and skin checks every three. “I refuse to live like a prisoner to skin cancer.”

Healthy skin how-to
Take cover! On average, you’re exposed to a minimum of 28 hours of sunlight per month, a survey from Proctor & Gamble Beauty in Cincinnati reveals. Sun protection (at least SPF 30 plus UPF-infused clothes) is your most valuable anticancer weapon. “A white T-shirt offers less than SPF 10,” says Gervaise Gerstner, M.D., a dermatologist in New York City.

MORE FROM HEALTH

Health Section Front

Bacon pie? 13 fattiest Thanksgiving dishes To win back her kids, she lost 340 pounds New treatment improving burned triplets’ scars   Stroller company announces major safety recall     A look at places where germs lurk   How to keep your memory sharp   How to handle stress   Expert advice on health, exercise   Outrage grows over Wall Street’s flu vaccines Amid shortage, big NYC firms get swine vaccine Health Section Front   Add Health headlines to your news reader: