Melissa Garrett, 51, has none of the traditional risk factors for skin cancer. Yet for almost 15 years, she’s been dealing with an onslaught of basal cell carcinomas (BCC)—the most common type of skin cancer—and even some melanomas, which are rarer. During that time, she’s learned how to spot telltale changes in her skin and how to better balance her love of the outdoors with her need to stay sun-safe. Here’s her story, as told to writer Amy Norton.
On paper, I don’t seem like someone who needs to avoid the sun at all costs. I’m not the fair-skinned, freckled redhead who turns pink within a minute of going outside without SPF 50. I’m part Native American (my dad is Cherokee and Irish), have naturally olive-toned skin, and can remember only one bad sunburn in my entire life (in elementary school, from standing outside at some all-day event), and one or two mild sunburns as an adult. Other than that, I never burned—despite being a runner and spending a lot of time outdoors. Growing up, I used sunscreen only occasionally; it wasn’t really advocated back then like it is now, particularly if, like me, you tanned easily and almost never burned. (And I only used tanning beds a few times in high school, like before the prom.)
So I was completely unprepared for that day, almost 15 years ago, when my doctor gave me the news that would change my life: skin cancer. Skin cancer? I knew nothing about it at the time. I wasn’t the “demographic” for it. I had no history of skin cancer in my family. I was 36, just shy of my 37th birthday. How could I have skin cancer?
Little did I know I was about to start an ongoing cancer journey: I’m 51 now, and I’ve spent years having full-body skin exams where I strip down and my doctor searches every nook and cranny for anything suspicious—and routinely finds exactly that. Most of my skin cancers have been basal cell carcinomas, and I couldn’t begin to put a number on how many I’ve had. I just know that I need to be vigilant about checking my skin and seeing my dermatologist every three months. And I’m okay with that—I’ve accepted it. It’s how I stay alive and well.
Going back to my first diagnosis: I can’t remember why I originally went to see a dermatologist, but there was something going on with my skin—a rash, I think—that I wanted to check out. By sheer luck, my timing was just right. My doctor ended up spotting a small mole on my back (which was news to me, since I couldn’t see it), and didn’t like the way it looked. He took a skin biopsy, and about a week later I got the call. My doctor asked me to put him on speaker phone, get my mom and dad, and then sit down. It turned out that the mole was melanoma.
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Melanoma, a.k.a. the rarest and deadliest form of skin cancer. Luckily, my melanoma was caught at stage I, and the only treatment I needed was surgery—though it was a big one. My surgeon removed a chunk of my back that was six inches side to side, three inches up to down, and an inch deep. The recovery wasn’t fun, but what really sticks out to me now is what my surgeon told me at the time: New skin cancers might start going off like “fireworks” in my body, since having one means you are at risk for getting more.
Not the news you want to hear, but he was dead-on. Within a year, all these basal cell cancers began showing up, initially on my legs and chest. BCCs don’t necessarily look all that threatening: Mine were small, round, pinkish or reddish areas, sometimes a little raised from the skin. And they might scab up or bleed a little if they got irritated.
BCCs are way more likely than melanoma—they are the most common type of skin cancer, and cancer in general, in people—and are usually considered easy to treat. But when you have as many as I had…. Let’s just say “easy” is not the word. My treatment was topical chemotherapy, which is medication you apply to the skin yourself. Now that would usually mean “spot treating” the BCC areas twice a day for about two weeks. But because I had so many cancers firing up at once, my treatment course would ultimately stretch far beyond that.
For one, I had to do the chemo twice a day for two months. Plus, my doctor had me treat one area of my body at a time—and only during the winter. That sounded really weird to me at first. But after I began treatment, I quickly got it: Topical chemo can make you feel like you’re on fire. So there I was, in the middle of winter, wearing shorts and a tank top because my body was a furnace. In the car, I’d have to roll the window down and freeze everybody else to keep myself from roasting. I did one leg one winter, then the other the following winter, and my chest the following one. Three winters of treatment. But it didn’t end there.
Like I said, I’ve been getting regular skin exams for years. And they’ve caught a lot of additional BCCs, including ones on my arms, shoulders and upper back, and my head. In some cases, my dermatologist has done a “shave and destroy,” where they scrape the tumor off then use electrical heat to kill off any cancer cells that are still kicking around, and to seal the wound.
Amid all these BCC fireworks, I also got another diagnosis. It was a second melanoma, on my right leg. I was 48. This time, though, I’d actually spotted the melanoma myself. I mean, I didn’t know it was melanoma until my doctor biopsied it. But, having developed a keen eye by that time, I knew when something wasn’t right. This melanoma was nothing but a tiny dark dot, like the mark of a ballpoint pen, but it seemed to be getting darker over time. So I pointed it out to my doctor. Thankfully, we caught it early and, again, I only needed surgery.
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One question none of my doctors can answer is, why? Why would someone like me have all these skin cancers from such a young age? Another question no one can answer: How many times can you get “lucky” and have all your skin cancers caught early before your luck runs out? (I have lots of questions. I think I drive my doctors bonkers.)
What I do know is, I have to keep doing what I’m doing. At my most recent skin check, my doctor found about a dozen spots. Some were growths called actinic keratoses, which can sometimes turn into cancer. My doctor froze those with liquid nitrogen (which causes the AKs to “fall off” a few days later). Some other spots turned out to be BCCs. One, on the back of my knee, looked different from all my other ones—larger, and shaped like a snowflake. As of this writing, I’m scheduled for surgery on that one. A second one, on my back, is unique too: It’s a BCC, but also what they consider a “pre-melanoma.” I’ll be having surgery to remove that one as well.
So when I called it a cancer journey, I meant it. I have to constantly stay on top of things, including sun protection, which has really been a struggle. I live on the North Carolina coast, four minutes from the beach, and I love the beach. I’ve always loved to fish and be out on the water in a boat. But skin cancer has meant staying ashore, out of the intensity of the sun’s rays. It means being careful about the time of day I’m outside, and always shielding myself properly with sunscreen and clothing.
I admit it can be hard to find a balance between that vigilance and just living my life. I do try not to live in fear and always have things to look forward to. I go to a cancer support group once a month, and I’ve made great friends there and learned a lot. If I have one piece of advice to share, it’s this: Get to know your skin so you can notice any changes that should be checked out. Protect yourself in the sun. Do these things whether you think you’re “high risk” of skin cancer or not.
When I look in the mirror, I see that scar in the center of my forehead from my BCC surgery. Sometimes it’s frustrating, because it’s a reminder of the cancer. But it’s also a reminder that I’m a survivor.
An earlier version of this story stated that the subject had only ever had one sunburn in her life; it has been updated to clarify that she had one bad sunburn as a child, and a couple of mild sunburns in adulthood.
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