Not today, cancer

Today is the second anniversary of my breast cancer diagnosis, which is also the second cancer I've been diagnosed with. I remember dates like these, not to live in a mud puddle or focus on bad things but as a way to honor the trauma I've come through, and just as importantly to normalize having things like this happen.

There's a real tendency not to talk about what it's like to get cancer, or break a bone, or live through a flood, or survive childhood sexual abuse, or menopause or (fill in the blank). I find it comforting when I hear from someone else who's walked the path I'm on and so I do the same for others.

Breast cancer was different from the first cancer diagnosis, and not just because it involved more treatment. There was also the whole OMG BREAST CANCER response from so many people, and the huge disparity in the amount of support available compared to melanoma (which was . . . basically nothing).

Breast cancer also brought more trauma associated with my childhood abuse, which OK that makes a weird sort of sense since some nasty things were done to my breast. Going back to therapy, doing the entire Cognitive Process Therapy was hard so if you are there now, please know it's not your imagination. That stuff is hard.

And the lingering effects of radiation on my running, and the way my bones are just shit now, that's been hard too. After doing all the so-called right things in terms of food and weight bearing exercise, to have my bones just break was a real blow. So if you're there too, you're not alone. 

Today is a run day, and as I've done the last couple of weeks, I did not look at my running watch to see what my heart was doing or what my pace was. I just ran by how I felt. Frankly I didn't think today's run would be all that great since a cat woke me up at 2:30 this morning by massively throwing up on the bed. So I had to get up and deal with that and then try to get a bit more sleep.

But this run felt good and I'm getting more hopeful that my best running days aren't in the past. And that's especially meaningful today, on this second anniversary of my second cancer diagnosis.

The Heartland 30K Challenge

Or how I did a little scope creep and ran three 10K races instead of just one.

Backstory:

• Was diagnosed with melanoma in August, 2017. Got that removed and dealt with the mental side of having a really nasty cancer, mostly by running.
• Broke my pelvis May 2018 (actually ran two races on it because I thought it was a groin strain—nope, I fractured it and was on crutches for nearly 10 weeks). I was dx’d with osteopenia then. I started slowly training last fall, swam first then ditched the pool and did a walk/trot combo for a bit. Still had a lot of pain but turns out the bone I broke is notorious for that and I’ll probably always have that pain.
• OK so by March this year, I was getting my base built—still nowhere near the 30-35 miles a week I was running in 2018 but working on it. Then I got dx’d with breast cancer April 9.

After the Plaza 10K

Condense all this down: surgery in May, radiation the entire month of June (I ran all the way through radiation treatments, slowly but by golly I ran). And I signed up for the Plaza 10K race as my first race after all of that.

I’ll be honest, the race didn’t go as well as I hoped. I trained well, worked hard but when my radiology oncologist said recovery from radiation takes four to six months, she wasn’t lying. My heart rate wouldn’t stay down, the rain wasn’t pleasant and long story short, I ran 1 hour, 42 seconds.

1st in my age group

The second 10K was the following Sunday (the Great Plains 10K) and the weather was much different, cooler and sunny at first but then . . . boy oh boy the temps rose like crazy. I also didn’t realize this 10K was mostly on a trail, and while the trail was in good condition, I don’t ever run on trails. I knew I hadn’t run my best race, not even close, but since I had to wait for my husband to finish, I figured I might as well get my time. I was gobsmacked when the lady said oh you came in first for your age group.

Say WHAT?! That’s the first time ever for me—I sort of felt like a fraud because my time was slower than the week before (1:01:04) and yet somehow that was first in my age group.

This photo of Kent
really shows the rain.

Then last Sunday, I ran the third 10K (Dot to Dot). We had terrible thunderstorms forecast that morning, so I wasn’t even sure the race would happen. But it did . . . in absolute torrential rain. I’ve never run in rain like that, not ever. But it wasn’t hot, and the course wasn’t on a trail and I finally, finally broke one hour: 58:53. Still not my PR but holy cow I was ecstatic about that finish AND I won my age group again!

To top it all off, the final results for the Heartland 30K Challenge were posted on Thursday and I won my age group for the whole thing.

What’s next for me? I need to build my stamina back up and continue building my base. I’m toying with the idea of running the Kansas City Marathon’s 10K race on October 19, but not entirely positive that’s a good idea. It's an incredibly hilly race, plus I’ve just started on two new drugs, one for the cancer and one for my bones, so I need to make sure those play nice with me.

Here's how rainy it was for the Dot to Dot 10K:

No guarantees

I was poking around the Outpacing Melanoma 5K race site the other day, and ran across this link, which shares the story of why this race got started.

Long story not so long, her husband had a melanoma removed from his back in 2005, had the 6-month checkups and then five years later out of the blue, he developed a cough and had back pain that felt like sciatic nerve issues. It was metastatic melanoma, stage 4.

He went from totally fine to a nagging cough and some pain and then dead in six weeks’ time. I'm telling you, this is one nasty cancer.

Her story was sobering and the parallels for me are inescapable. I too had a melanoma removed from my back, on my spine to be specific. I too am on the 6-month checkup plan for the next five years. I too have a nagging cough (but also have reactive airway disorder . . . so is this a cough from the reactive airway disorder or something else?). And I too have been having back pain (which is almost certainly from running two half marathons a week apart). It’s probably nothing.

Still.

I’ve been thinking about how or if I would change how I live if I end up in the same situation as her husband. Never mind the memes about eating all the cake, drinking all the wine, etc. What would really matter to me if I had weeks left? And when do I start living that way, as though this is it?

I would hate to get to the end without having thought this through, figured out I would need to do or say and then done it. 

It gets in your head

Since getting that original melanoma diagnosis, I’d wondered if I would be freaking out over any new blemish or spot on my skin. See, the problem is I don’t actually know what that melanoma looked like. It was on my back, basically between my shoulder blades and centered on my spine. That’s not a spot I see every day. Plus, my dermatologist warned me that the normal A B C D E signs of melanoma wouldn’t really apply to me because of my moles, and I guess because of how the one spot looked. So I’m not at all sure of what should be flagged and what shouldn’t.

When I put on make-up in the mornings, I use a small magnifying mirror. I wear reading glasses but of course you can’t actually wear reading glasses and put on eye make-up, or if you can I haven’t figured out how that works. Two weeks ago, I noticed a small dark spot at the lash line on my right eye lid. Hmm, I thought, maybe I didn’t remove my eye make-up thoroughly enough . . . I decided to scrub harder the next morning, and check again. The spot was still there. So I thought OK, this is a little alarming—I’ll scrub harder one more morning and check again. Still there.

I called my dermatologist that morning, and they squeezed me in that day. Fortunately, the spot is benign, but until I got that news I’d been wondering how on earth it would be removed and then reconstructed if it had been melanoma? After all, the eye lid isn’t very big—seems like a wide local incision would remove the whole thing. That was not a pleasant thought.

As I told my mother yesterday in our weekly phone calls, the thing about a cancer diagnosis is that it leaves this invisible “what’s next” cloud over anything. She herself has cancer, and as she told me years ago when diagnosed, having one kind doesn’t preclude developing another kind. So there’s that bit of fun to contemplate. Plus, at least for me, this has disrupted the way I’ve always thought I’d end up going. There’s a pretty strong history of blood cancers in women on my mother’s side of the family. I figured I’d end up with one of those, and I guess I still might. But for now I have this melanoma to pay attention to, and to watch for. Only I don’t know what it looks like on me.

I go back in February for my next screening. I’m going to ask for any examples of what he removed from me. And if he needs to do any scrape biopsies, I'llask to see what it looks like before he removes it. That’s all I know to do.

Please get checked

TLDR: I had two places on my back biopsied in August during my annual screening with my dermatologist. One was diagnosed as melanoma. I don’t fit the typical profile, which goes to show even if you don’t either, you should get a skin cancer check every year. Also, while I am generally very private about my health, if my story motivates even one person to start getting checked, then it’s worth feeling a little uncomfortable about sharing this outside my immediate family.

Ever had a sunburn?

Ever?

Or do you have moles?

Then you should get an annual skin cancer screening by a dermatologist.

I’ve been getting screened every year since we moved back from Boston. Well actually, I got screened for the first time at 34 when one of my absolute favorite college professors, one who had a huge positive impact on me, died from melanoma. Because of his illness, I read up on melanoma and learned that your risk goes up for every sunburn you’ve had (it’s cumulative and there are no backsies on that kind of skin damage); you also have a higher risk if you have blue eyes, fair skin, fair hair and burn easily. I don’t fit that last bit at all, so I’ll be honest and tell you I truly never thought I would end up with melanoma. I figured it would be my red-headed husband who only burns, not me. Clearly I was wrong.

When I had my first ever scan at 34, everything looked fine. To be honest, I put the screenings on a back burner and didn’t bother again until 2013 when we moved back to Kansas. Since then, I’ve had something biopsied every single year:

• 2013—a mole on my hip (no issues)
• 2014—a spot near my collar bone (no issues)
• 2015—a spot on my left arm (no issues)
• 2016—a spot on the same arm but higher up (no issues)

On August 9 this year, my dermatologist biopsied two moles on my back. One scrape was about the size of a dime, and the other was more like a quarter. Both were above my bra line and in toward my spine. On August 17, my doctor called and let me know that the bigger biopsy came back as melanoma, stage 0 in situ. I was scheduled for outpatient surgery on August 24.

I’m lucky. Because I get these screens every year, my dermatologist is confident the change occurred in the last 12 months. And because we caught it early, he did what’s called a wide local excision and took a football shaped section of skin, then stitched me up. The incision is nearly three inches long, mostly parallel to my spine and sort of on my spine. I think this incision is going to end up as less of a scar than the original scrape biopsy was. If you're curious, the reason the excision is football shaped is so that when the edges are pulled together, the incision lies flat rather than puckering.

Last Friday, I got the pathology report; the margins of the removed tissue came back clear. This is good news and means my doctor got everything plus a bit to spare. You want clean margins because this particular cancer can be truly nasty when it grows down below the skin level. That’s when it often turns into the fast spreading killer kind of cancer, and that’s what happened to my professor.

Going forward, I will have screenings every six months for the next five years. If I don’t develop any more melanoma, then I will go back to annual screenings. But I’m realistic—since my body has done this once, I’ve got an increased risk (8 to 15 times according to this site and also my dermatologist) that it will happen again. As he pointed out, now we know my body will grow melanoma. Catching them really early will be the key to me continuing to survive this nasty cancer.

Please get checked. If I weren’t getting checked, then my diagnosis wouldn’t be nearly so positive.