"I've had to learn to practice what I preach."
Marcelle Kaplan, RN, accomplished nursing author and speaker regarding healthy lifestyles and summer sun protection, and full-time advanced practice nurse in breast oncology at NewYork-Presbyterian/Weill Cornell, knows the importance of healthy behaviors, self-examination, professional screening and early detection in preventing cancer better than most. Her career has taken her around the country teaching and speaking about various types of cancer prevention and the benefits of healthy lifestyles. But as a young child and teen growing up in Brooklyn, she was dangerously unaware of the role her summer fun would play in making the threat of skin cancer a part of her every day adult life.
"I'm born in July so I'm a natural sun worshipper. All summer long my identical twin and our friends would go to Brighton Beach and hang out all day. We'd slather ourselves with sun tan oil and turn over religiously to make sure we were 'cooked' on every side. There were no lotions with sun protection then; baby oil and a sun reflector were more like it. The dangers of too much sun were unknown, or at least unmentioned. At least a few times every season I'd get terrible sunburns, so painful I would be shaking and have chills. Then I'd blister and peel. Same for my sister."
Marcelle has dark hair, vibrant, warm brown eyes and fair skin covered by a dense sprinkling of freckles. While she doesn't immediately look as though she'd be susceptible to skin cancer, her underlying fairness and repeated sunburns as a teenager made her vulnerable. She's quick to point out that anyone is susceptible, even people with deeply pigmented skin, who can develop skin cancer on the soles of their feet or their palms.
"As I've gotten older, my skin is showing the effects of all that sun damage - sun spots, basal cell carcinomas, even squamous cell carcinoma. I've had to learn to practice what I preach, and I now try to be vigilant every day. The lesson I've learned the hard way is that you really need to protect yourself from the sun and you have to start with babies and young children. If at all possible, avoid direct exposure to the summer sun in the middle of the day between 10 am to 4pm when the sun's rays are the strongest; wear a sun screen with a sun protection factor (SPF) of 30 or higher, and reapply every two hours if you sweat; wear a hat with a wide brim, and protect your eyes with sunglasses that wrap around, and avoid tanning booths. Do regular skin self-exams and follow up with your doctor during your annual check-up to see if there are changes that warrant seeing a dermatologist. If you are susceptible, your dermatologist can make a 'skin map' of your entire body and take photos to keep a permanent record of any spots on your skin that should be followed."
Marcelle's vigilance has prevented many early basal and squamous cell skin cancers from becoming more serious. She holds out her arms to point out tiny scars on her arms and hands, then points to her face, neck, and legs where early cancers have been removed. Her twin's experience has been exactly the same.
"I honestly think you know your skin better than anyone else. It's important for you to identify even small changes, and then see a professional. I've become knowledgeable about what's going on with my skin and everything I've found has been very small, an area about the size of a freckle that's become a little elevated, or it might be a tiny sore that doesn't heal, or a spot that bleeds. Find small changes before they become serious. These, plus any change in a mole, which could indicate a more serious type of skin cancer, called melanoma, should be followed up quickly with a dermatologist. And don't let anyone tell you it's nothing, not even your doctor. I've identified skin cancers that even my dermatologist thought were benign. Unfortunately, I've never been wrong. All it takes is a simple biopsy."
Early detection, says Marcelle, is important both for your health and for cosmetic reasons. Even relatively minor basal cell cancers, if neglected, can penetrate deep into the skin tissue, and when removed leave behind noticeable scars, especially if they occur on the face. "I've had to learn the hard way, but you don't. Using sun protection measures, doing skin self-exams, and having your skin screened by a professional can do a lot to prevent or detect skin cancer early."
For more information, log on to the NewYork-Presbyterian Hospital Cancer Centers Web site at www.nypcancer.org or call: 1-877-NYP-WELL.
Manager, Oncology Service Line