Here's a sobering fact: basal cell carcinoma is the number-one type of cancer in the United States right now. With summer in full swing, it’s more important than ever to have sun safety top of mind. We’ve got you covered when it comes to all things sun and skin here at Byrdie HQ, whether you’re curious about the best SPF products on the market or what it’s really like to get a skin check.
If there's one thing I've learned since educating myself on melanoma, it's that having this type of cancer removed from your body is a Very Big Deal. The process is serious even when the cancer is caught early and is still localised. (As you'll see below, in this instance a procedure is performed where the melanoma itself is removed plus up to a 1 cm border of tissue around it in order to help prevent recurrence.) When the melanoma has advanced and is metastatic, things get significantly more invasive.
Ahead, we'll show you exactly what it looks like to have a melanoma removed. Kirsten Carriol, CEO and founder of Lanolips was kind enough to share her experience with us both in pictures and her own words, as she recently had a melanoma cut out of her back. Not only in her story a lesson in the importance of undergoing regular skin checks and trusting your gut, but it's also a reminder that when it comes to melanoma, early detection is crucial. The point of this post is not to scaremonger, it's to share the reality that many young Australians are still missing—melanoma is serious.
Removing it is serious. Living with it is serious. Living after it is serious. It's not a case of simply burning off a mole and going on with your day.
If you're squeamish, be warned, the photos have been left in colour.
Keep reading for more.
Hi, my name is Kirsten Carriol.
I am 46 years old and have lived in Australia my whole life. I grew up in the ‘80s and ‘90s, and that's when I saw the sun the most. It was the era of tans, and I saw a lot of rays, but no more than most. As I matured, I became aware of skin cancer risks and of the fact I had fair, mole-y skin. I became very sensible in my thirties and it was then I began having my skin checked yearly by a dermatologist. About six years ago it was recommended I also get my moles mapped, which is a procedure where a dermatologist photographs every mole on your body and checks the changes in each against their previous photographs.
It's very detailed and takes about 4 hours. I have had it done every year since.
I take this stuff very seriously—I probably take more precautions than most people. Still, five years ago, I had a scare. I had gone to a plastic surgeon for Botox in my neck to treat nerve pain and muscle spasms. The doctor spotted a suspicious-looking mole and said, "I don't like the look of that, I'm going to take a punch biopsy." A couple of days later he called me and said, "It's a melanoma. Lucky we got it because I think it was only a few months away from entering the rest of you." At that point, I was in shock.
I didn't want to believe it was a true melanoma.
I asked for a copy of the pathology results because I wanted to show them to my dermatologist who I trusted. I had been seeing him for a long time at that stage and had had an appointment maybe eight months prior. I got them and sure enough, there was that word: Melanoma. I emailed my dermatologist for a second opinion and then called him in a state of concern, hoping for solid advice. He told me, 'It's not conclusive. I wouldn't worry, it's not as bad as you are being told', or something to that effect.
He seemed a bit annoyed by the whole thing, which confused me. I didn't know what to do. Should I be worried? The word melanoma was there, so why was he saying I shouldn’t be concerned? My common sense told me to err on the side of caution, so instead of taking my dermatologist’s word for it, I went back to the plastic surgeon. He took another chunk of flesh from the mole site and sent that away to pathology. A few days later I got a call to say the second sample had been checked and they had got everything.
There was no more sign of melanoma, which was great.
Eight months later, I went back to my very respected dermatologist for a yearly check-up. He brought up those pathology results as they had been stored across all my healthcare records. He took one look and said, ‘What is this? Melanoma?’. It was like he'd never seen them before. Then he checked the details of the removal procedure and criticised the plastic surgeon saying, 'He didn’t do it properly'. He also looked at the pathology tests and when he did, he wasn't happy. This melanoma was very nasty, so he went in again and removed even more flesh.
I was horrified. It was a frightening experience, and I have a nasty scar on my back from it, from the three cuts gone in there. But the results from pathology, again, came back clear.
I was lucky it was caught by chance despite the precautions I had been taking. That experience showed me that my dermatologist’s ego had gotten in the way of him giving me the right advice. For him to be critical of another doctor who had found something he had not, was very bad. In the eight months that had elapsed since he told I had nothing to worry about, the melanoma could have been growing.
After that, I decided to do triple tests going forward. Since then I do mole mapping, a physical look over with my dermatologist, and another visual check with my plastic surgeon every year. Doctors are human, and systems don't always work as they are meant to—cross-checking with at least two different methods and two different doctors is key. It’s the way my melanoma was caught, and I know my story isn't the only one.
Three weeks ago, I saw my plastic surgeon and he did punch biopsies of four suspicious-looking moles. He called me the day before my 46th birthday—one of my moles had come back as melanoma. I was in shock again. I thought I was just unlucky the first time. I was referred to the Sydney Diagnostic Melanoma Centre, and from there I met a new dermatologist who took a one-centimetre chunk out of my back to remove the melanoma. The night before I felt worried, I just wanted to get it out. I kept touching at the spot which was lumpy from the biopsy.
I was imagining it was already dangerous, which of course it probably isn't. I've been very lucky, but some people aren't. I now feel like my body is full of potential time bombs ready to go off any time.
Kirsten's melanoma pre-surgery.
The removed melanoma.
The surgery site post-removal.
I strongly believe in sunscreen, obviously, but clothes are the number one source of sun protection for me. I don't go bare-shouldered or bare-backed very often, and if I do, I'm wearing sunscreen or staying out of the sun. I'm a natural-skincare formulator by trade, but with sunscreen, I choose efficacy over 'natural' every time. The dangers of the sun are far more sinister, far greater and far more proven than the potentially sinister nature of non-clean sunscreen ingredients. I use zinc on my children when it's a sunny day.
Pure zinc, or 'cricket zinc', is white. You can't really get clear zinc so if I need my sunscreen to be clear, I use a reputable brand and that means non-clean chemicals.
I am on alert now. I'm living with the threat of melanoma all the time. I do feel exceptionally lucky because had I not had a nerve problem and gone to that plastic surgeon that day, I probably wouldn't be here—my plastic surgeon said that to me too. He really did save my life, and for that I am grateful. I would have left behind my kids and family and that's only been avoided through a random check. I feel concerned, but that's just something I live with now. I will continue with my three-pronged approach, spaced out through the year so that I am effectively being checked every four months.
Regarding my scars, they are part of me. They don't bother me at all. I feel lucky when I notice them. I can't imagine anyone who wouldn't choose to get as much flesh taken out as is recommended to avoid melanoma. For me there was no question of choice, I have zero regrets.
If you're spending time in the sun, we suggest keeping exposure minimal, and wearing a Matteau long sleeve swim top when swimming for extra protection.