Thursday, May 24, 2012

Is the Sun Your Best Friend? Set Some Boundaries!

Did you know May is Melanoma Awareness Month?  Yep.

Did you know that breast cancer survivors are at higher risk for melanoma?  Neither did I, until I was diagnosed with melanoma two years after being diagnosed with breast cancer and started researching it!  The reverse is also true - melanoma survivors have a greater risk of being diagnosed with breast cancer.  Some breast cancer treatments, such as radiation and certain drugs, can increase your sensitivity to sunlight.  This makes protecting yourself from the sun even more important.

Who else is at risk for melanoma?  People who have fair skin, tend to sunburn easily, have ever had even one blistering sunburn, or have had multiple sunburns in childhood or adolescence, have more than 50 moles, use tanning beds, ETC. ETC.!!

 Dear 16-year-old me is a video that really hit me hard - it's a bunch of melanoma survivors telling their 16-year-old selves (and today's teenagers) to be more careful in the sun, and all the things they wish they knew when they were 16.  I would bet my whole bank account that the melanoma I was diagnosed with last year was directly related to my childhood and adolescence (and exacerbated by radiation and Tamoxifen) - I was your stereotypical Cape Cod beach bum.  I lived in my bathing suit, lived at the beach, didn't care much for sunblock, and got numerous sunburns.  Sunburns before age 18 hugely increase your risk for melanoma.

None of us can turn back the hands of time and slather sunblock on our teenaged selves!!  So let's encourage the teenagers we know and love to watch that video, and let's start protecting ourselves from the sunlight now, to whatever extent we can.  While it's true that sunburns during our youth are the biggest contributors to melanoma risk, it's never too late to start sun protective measures and it really does matter.

Melanoma is one of the deadliest cancers.  Thankfully, it also seems to be the most preventable!!!  That's such a blessing!  Having breast cancer can feel so overwhelming, confusing, and devastating, because while there are risk reduction strategies we can engage in in an attempt to prevent a recurrence, it often just feels like a crapshoot.  Why did I get breast cancer in the first place, when I was young, healthy, fit, had no family history, never smoked or drank, exercised regularly, and ate lots of organic vegetables?  I will never know.  And there's no guarantee that my risk reduction strategies (exercise, lots of cruciferous vegetables, green tea, turmeric, various supplements) will really prevent a recurrence.

But we know what causes melanoma: too much exposure to UV rays from sunlight and tanning beds!  And we know how to prevent it: reduce exposure to the sun's UV rays and don't use tanning beds!  This is great news.  Cancer has a way of making you feel so powerless, but when it comes to melanoma, we have a greater degree of power over it than we do with other types of cancer.  By consciously and consistently protecting ourselves from sunlight, we can greatly reduce our chances of getting melanoma.  It's impossible to prevent it totally, of course, and I would never suggest that someone's melanoma diagnosis is a result of them "not trying hard enough" with the sun protection - because like I said, none of us can turn back the hands of time and un-do the sun damage of our youth.  In addition to conscious and consistent sun protection, it's also important to get annual full-body skin/mole checks from a dermatologist.  By doing so, we greatly increase our chances that even if we have melanoma, it's caught at an early stage.  When caught at stage 0 - in situ - it's fully curable with surgery!

I won't deny it - protecting yourself from the sun can feel like a total pain in the ass.  Most humans, myself included, love the sun.  We're gray and gloomy when the sky is, and then when the sun comes blazing through the clouds, we're happy and relieved and love to bask in its warmth.  Some people hate the sun, and I guess they're the lucky ones in this sense...

I read the typical sun protection guidelines - "Avoid being in the sun from 10 AM to 3 PM, wear long pants and long sleeves and a wide-brimmed hat, re-apply sunscreen every two hours" - and I want to yell back, "Oh, like it's REALLY THAT EASY??"  I instinctively gravitate to the sunlight - being immersed in a sunbeam feels so warm, bright, and happy.  But this is why I got melanoma.  I eschewed sun protective measures, partially because I guess I didn't believe it was that big of a deal, and also because all of the recommendations seemed SO unrealistic and unachievable.

Of course now I'm changing my tune!!!  I've been learning a lot, and I've discovered that sun protection is neither as horrible nor as impossible as I had believed.

Do you hate sunscreen as much as I do?  There are many alternatives!!

I won't spend too much time talking about sunscreen, because that's the main sun protective measure we all know about and are probably sick of hearing about.  I don't think it's so great.  Most sunscreens actually contain carcinogenic chemicals - how stupid is that?  And most people don't apply nearly enough sunscreen for it to be effective anyway.  If sunscreen is your thing, though, get a good kind - check out the Environmental Working Group's Sunscreen Guide (the best and the worst!).  My favorite is Badger Balm, especially the new Damascus Rose SPF 16 facial sunscreen.  It's expensive but worth it.  It's completely healthy and safe, and smells nice, and best of all, it's the only facial sunscreen I've found that doesn't make me white as Casper!

Other sun protection methods:

UPF Clothing
You can buy UPF 50 clothes that block 99% of the harmful UV rays!  This works even better than sunscreen, giving you more complete and reliable coverage, and it's much less of a hassle.  The only downside is that it's pretty expensive - at least up front.  Over time, you'll probably save money by relying on UPF clothing more than sunblock, because you don't have to keep buying tube after tube.  My favorite UPF clothes are from Coolibar.  I can't afford to buy entire UPF 50 outfits (e.g. pants, shirts, dresses), so I prioritized and just bought a few items.  I bought a Coolibar wrap that I can throw on over whatever outfit I'm wearing, and a bathing suit on sale (the kind that's a short-sleeved shirt and skort!), since the beach is where my sunburns are most likely to happen.  Since a lot of my sun exposure comes from my 1-hour RT commute in the car each day, I also bought a pair of UPF 50 sleeves from Sunny Sleevez.  No, they're not so fashionable, but they're great for wearing in the car.  They get the job done, you know?  And they don't make a mess like sunscreen.  (And you don't have to shower every night to get the sunscreen off of you!  Ugh!).  If UPF clothes are too expensive for you, wait for sales (check the websites frequently), or just buy one or two versatile, key items.  e.g. this UPF 20 "buff" that can be a headband, scarf, etc.; or sun sleeves; or a jacket/hoodie/cover-up; or a UPF 50 sarong to cover up with on the beach no matter what bathing suit you're wearing.  If you just buy, say, one dress or one shirt, you're only protected from the sun that one day of the week when you wear the shirt or dress, whereas if you buy one accessory or outer layer, you can pair it with any outfit at all.  

Wide-brimmed Hats
These can actually be fun!  I think they're coming back into fashion.  Look around and see which hat(s) appeal to you.  There are the usual boring classic hats, like this ,but there are also fun hats like this and this.  Of course I will tell you that the wider the brim and the higher the UPF, the better, but any hat is better than no hat!  Check out the Village Hat Shop, Hats in the Belfry, or go to Etsy and search for "summer hat."  And don't forget thrift stores!  Buy as many hats as you can, in a wide variety, so that when you're leaving the house, you're likely to have a hat that matches your outfit.  And/or buy one or two hats either in neutral colors (black, white, beige) or in a color most likely to match a lot of your outfits.  I made the mistake of first buying a blue hat that was on sale and seemed nice, not thinking about the fact that I hardly have any clothing in that color!!  A hat that has a brim wide enough to put your whole face in the shade may prevent your need for facial sunblock.  (I know dermatologists would say you should wear the sunscreen even with a hat... but I'm trying to make the sun protection methods more manageable for real people!!)

SunGuard Laundry Product
Okay, I haven't tried this one.  But the idea is, you add this product to your laundry and it makes your normal clothes UPF 30.  (A white tee-shirt is about UPF 5 on its own).  This seems like an easy, inexpensive thing to problem with it is that I can't find an ingredients list for this product and I worry that it contains the same carcinogenic chemicals that sunscreens do.  If anyone has more info about this, let me know!

I haven't tried this one, either.  But theoretically, you could carry a fashionable UPF 40 parasol/umbrella with you, if you didn't want to wear sunscreen or UPF clothing or a hat or anything!!  Lots of the sun protection websites sell sun-protective umbrellas, but they're not that attractive.  Sara's Parasols are colorful and fun.  And yes, expensive.  At least it's a one-time investment, unlike sunblock, which you keep using up and having to buy more of.  (And if one tube lasts you all summer, you're not using enough!!!)  A parasol would be great because you could wear anything underneath it and still be protected.  Sometimes sun-protective clothing is annoying because I either get too hot in it, or I want to be wearing my cute little sundresses like everyone else.  The downside to a parasol, of course, is that you have to continually hold it above you - hard to do if you're walking to work with a laptop in one hand and and iced coffee in the other! 

In Summary...
There are multiple methods of protecting yourself from the sun, not just sunblock, so you can find something that works for you.  Which sun protection method is best depends on your personal circumstances, and the situation.  When I'm going out to the back deck to hang laundry out to dry, I can't hold a parasol, and I can't be bothered to apply I'll thrown on a wrap and hat.  When I'm at the beach, even if I'm wearing a UPF 50 bathing suit and sometimes sitting under an umbrella, there's really no way to get through the day without sunscreen.  I also use sunscreen to spray on my feet when I'm wearing flip flops.  Figure out what you need, then do whatever you can to make using sun protection easy and convenient!  If you're using your sun sleeves mostly for driving, keep them in the car, not in your dresser in your bedroom.  Keep sunscreen in your purse or your desk at work, and in your bathroom so you can put it on your face as part of your morning routine.  Keep some hats in the car, some near your car keys or by the door.  The goal is to make sun protection as much of a habit as brushing your teeth!

Most people know that they should be doing more to protect themselves from the sun, than what they're actually doing...sometimes it's because sun protection is inconvenient and we can't be bothered.  When I get frustrated by the inconvenience of having to put on sunblock or wear a hat when I'd rather not, I try to change my perspective and instead be grateful for the fact that melanoma is so preventable!  And sometimes we do try to protect ourselves from the sun, but we're just caught unaware.  Sometimes it's raining in the morning, so I leave the house with no sun protection, and then the sun comes out in the afternoon and catches me off-guard... it happens!!  If you know you should protect yourself from the sun but really don't, it would be so helpful to at least get a full-body mole/skin exam each year at the dermatologist's office.  Remember that when melanoma is small, early-stage, and has not yet spread through the skin, it's completely curable with surgery.  Such good news!

The sun used to be my best friend, and we were so close... being diagnosed with melanoma made me so angry I considered breaking up with the sun.  But I've reconsidered, and we're still good friends - now that I've learned to set appropriate boundaries!

Tuesday, May 15, 2012


Great news - 
My new oncologist is pretty awesome and immediately agreed with me that I should NOT be on Tamoxifen right now.  She has given me her approval to take at least 3 months off, at which point we'll meet again and re-evaluate!  I was soooo happy about that!  And after a little over a week with no Tamoxifen, I felt so much more "alive" - I was happy and chatty at work like never before, and in a 24-hour period, I did 90 mins of trapeze, walked about 1.5 miles, did a circuit of the exercise machines at the YMCA, and a little bit of swimming.

Today, I had minor gynecological surgery to figure out what the Tamoxifen was doing to my uterus.  My surgeon removed "numerous" polyps, which appeared benign to her, but we won't officially have the biopsy results for a week.  I'm grateful that the surgery went so well, but I'm majorly frustrated that cancer-related stuff is once again taking up so much of my time and energy.  I'm missing two days of work plus two trapeze sessions.

The hardest part of the day, actually, was the fasting.  I was under strict orders not to eat anything past midnight last night, and not to drink anything at all other than water today.  My surgery wasn't until 3:10 PM, then I didn't get home until 7 PM, so that meant over 11 waking hours with no food or coffee.  I was quite hypoglycemic and miserable because of it.  Waiting in pre-op, they offered me TV, but I turned it off because the pizza and granola bar commercials made me want to throw the remote.

The pasta and sauteed swiss chard and mushrooms A made for me for dinner tonight tasted like the best food I've ever eaten.  I savored that bowl of pasta for a good half hour.  And I had a big mug of heavenly delicious coffee, at 7:30 PM, not giving a damn if it will keep me up tonight.  There's always ibuprofen PM, right? :) 

Oh, and more good news - my iron levels are improving.  My hemoglobin is now up to 12, instead of 9!  Today, my blood pressure was low/normal, my pulse was good, my temp was good, and my oxygen saturation was 100%.  I'm sick of hearing about the abnormal stuff, so it helps to have a whole list of normal/good things like this, even if they're little things.  It helps to remember that there's more about my body that is working wonderfully and perfectly, than there are problems with my body... even when it seems like the problems are all that get focused on.  You know?  Maybe my uterus is having problems, I'm anemic, I've had two cancers, and I have ongoing Repetitive Stress Injury pain from too much typing, mild allergies and asthma, and undiagnosed digestive problems... but besides that, I have a great heart, good liver and kidney function, excellent eyesight, all of my body parts, normal hearing and smell and taste and touch, an excellent brain, a good body to trapeze with, pretty good lungs, and lots of other well-functioning body parts and systems inside of me.  All of that stuff that most of us take for granted if it's working well.  Tonight A and I watched "Soul Surfer," the movie about the teenage girl who had her arm bitten off by a shark and still lives a wonderfully happy life and achieved her dream of being a professional surfer.  I'm grateful for my arms and all of the rest of my good, healthy body.