How skin cancer changed my life

The doctor turned patient
Elizabeth Tanzi, diagnosed with melanoma at age 37

Dr. Tanzi, 39, codirector of the Washington Institute of Dermatologic Laser Surgery in Washington, D.C., spent most of her college days cramming for exams in the dark confines of the university library. But six consecutive spring break trips to popular hot spots in Florida, Mexico and Jamaica sizzled her milky-white complexion year after year. “I’d get a large dose of sun exposure really quickly,” admits the native of Long Island, New York. “I should have paid better attention to my skin.” (Brief yet intense tanning time significantly increases one’s chance of developing melanoma, and even one blistering burn in childhood can dramatically increase the DNA damage that may lead to skin cancer.)

Postgraduation, she hung up her diploma and put away her bikini. “I became vigilant about staying out of the sun,” Dr. Tanzi says. “If I was going to be outside for several hours, I’d slather on sunscreen, hide under a hat and umbrella and wear capris to cover my legs. I was very careful not to burn.”

In 2007, while expecting her second child, a small mole on Dr. Tanzi’s right calf caught her eye. “As a doctor, I knew it wasn’t unusual for moles to darken during pregnancy because a surge in estrogen can enhance pigment,” she says. About six months later, after she’d given birth, she decided the mole had to be checked out. “It looked normal, but it had really changed in appearance,” she says. “Still, I definitely wasn’t thinking cancer.” That same week, in one of her office’s exam rooms, Dr. Tanzi performed her own biopsy, removing a tiny piece of the suspicious mole along with another larger mole on her left leg. The next night, while at home with her family, she received a voice mail from Carmen Myrie Williams, M.D., a dermatologist in Washington, D.C., who had reviewed the skin samples, urging Dr. Tanzi to return her phone call as soon as possible.

“I listened to the message, hung up the phone, looked at my husband and said, ‘I have melanoma,’” Dr. Tanzi recalls. “I just had a gut feeling. I was trembling and kept repeating, ‘I can’t believe it. I can’t believe it.’” At first, Dr. Tanzi suspected the worst-case scenario: advanced melanoma. And she was convinced that the second, larger mole was the culprit. To her surprise, the normal-looking growth on her right leg was an early-stage melanoma, whereas the more irregular one on her left was a basal cell carcinoma, skin cancer that is not considered life-threatening. “In an instant, I went from being a dermatologist who routinely diagnoses skin cancer to a patient with so many questions and concerns,” Dr. Tanzi says. “Having melanoma is frightening on multiple levels, because once it forms, it can spread quickly and be very difficult to treat.”

The next day, Dr. Tanzi’s colleague Martin Braun, M.D., a dermatologic surgeon in Washington, D.C., cut out her melanoma — a procedure that required a wide incision and left her with 17 stitches, a 3-inch scar and achiness for weeks. Fortunately, the lab results of the skin surrounding the tissue came back as clear of cancer. Three weeks later, she returned to Dr. Braun to have the basal cell carcinoma removed, too.

Dr. Tanzi says that her personal experience has given her a heightened sense of urgency when it comes to testing her abnormal-looking moles. “I think about dealing with a recurrence constantly. But as a mother of two toddlers, I try to be brave for my kids and move past the fear,” she says. Self-exams every three to six months (a colleague checks hard-to-see parts such as her back) and biopsies of anything that appears even remotely suspicious are now standard practice. To date, she has taken off a total of 18 lesions, mostly from her legs and back.

“I tell patients to get to know their moles,” Dr. Tanzi says. “Being able to see your body every day is an advantage that your derm doesn’t have.” She also preaches a proactive yet stern antiaging message to her young clientele. “I have thirtysomethings come in for Botox or other skin treatments, but they still tan, whether at the beach or in tanning beds,” she says. “I explain that there’s no point in targeting lines now if they’re just going to end up with a scar on their face from having skin cancer removed.” If they still don’t seem to be listening, she shares her own ordeal to make the consequences of lifestyle choices clear. And when it comes to being the bearer of potentially devastating news, such as a diagnosis of skin cancer, she believes her experience with the disease has made her more empathetic. “I spend a lot of time talking to patients about long-term prognosis,” she says. “Because I know firsthand that fear of the unknown can be unbelievably overwhelming.”

Healthy skin how-to
Schedule regular checkups — with your doctor and yourself. Ongoing dermatologist visits (every 6 to 12 months if you’ve never had skin cancer) plus monthly self-exams are key. Look for growths that have changed shape, color or size and for ones that bleed or itch. (See the A-through-E guidelines, page 56.)

If you’ve had precancers or skin cancer, your doc will most likely increase the frequency of in-office visits to every three months. “The number-one risk for melanoma is a prior melanoma,” says Kenneth Beer, M.D., a derm in West Palm Beach, Florida. “It could occur much later — 5, 10 or 15 years in the future.” When a mole on the right side of your body mirrors in location one on your left (or vice versa), the growths might be abnormal, says Neal Schultz, M.D., a dermatologist in NYC. (For example, you could have growths that reside in the same spot on both sides of your stomach.) Skin cells with a great deal of DNA damage send a signal to other cells via the bloodstream, indicating that something isn’t right; the result can be “twin” abnormal moles.

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