Skin cancer can sneak up on the most savvy

Kimberly O'Brien Sanga
"I regularly check my skin for suspicious spots to stay healthy."
— Diagnosed with basal cell carcinoma and squamous cell carcinoma; Salem, New Hampshire

As a child, Kimberly O'Brien Sanga, 31, spent an intense amount of time in the sun. Her family had a pool, and Sanga played outside almost every day. "At the time, we applied sunscreen only once a day — if that," Sanga recalls. As a result, she suffered two severe, blistering burns at the ages of 8 and 11. On top of burning, Sanga frequented tanning beds as a teenager. "Each month, I'd buy an unlimited membership to my local tanning salon, and I'd go three or four times a week year-round — winter, prom season, just before spring break, sometimes even in the summer."

Then, at 18, while showering, Sanga noticed a brown spot with a strange-looking red line running through it on the top of her left breast. She hadn't remembered seeing it before, so she made an appointment to visit a dermatologist the following day.

As soon as her doctor saw her mole during the exam, Sanga recalls, a look of concern crossed his face. He called in her father from the waiting room and explained that the unusual look of the mole suggested skin cancer. Considering her history of sun exposure, the doctor recommended that the spot be excised and biopsied immediately. Two weeks later, the results revealed Sanga had basal cell carcinoma.

The dermatologist instructed Sanga to begin monitoring her body for new moles or changes in the size, shape or color of any current moles. Soon, she discovered a change in a second mole, located a half inch from the first one; it had gotten darker and changed its shape. "Three months after the first mole was taken off, I was lying on the same table, once again, having another removed," she recalls.

Build a sun-shielding wardrobe Here's a shocker: 40 percent of Americans never wear sunscreen! But the latest formulas are more effective than ever. Use this guide to find a keeper for any situation. A day at the beach Go for a water-resistant, broad-spectrum sunscreen with SPF 30. Fill your palm with sunscreen and disperse that amount from head to toe. Reapply every two hours or after swimming; even water-resistant formulas lose potency after 80 minutes in the surf. "There's no such thing as all-day protection. I don't care if the bottle says SPF 800, you still need to reapply," Dr. Spencer says. Working up a sweat? Upgrade to an SPF 50 lotion or higher and use an aerosol of the same SPF when you reapply. The cream ensures you're evenly covered, and the spray makes touch-ups easier, notes Jeannette Graf, M.D., a dermatologist in Great Neck, New York. (A dynamic duo to try: VMV Hypoallergenics Armada Sport 70, $55, and Neutrogena Fresh Cooling Body Mist Sunblock, $10; both with SPF 70.) A home-to-work commute For short spurts outdoors, a daily lotion with SPF 15 is fine, says Henry W. Lim, M.D., chairman of dermatology at Henry Ford Hospital in Detroit. Make sure it also guards against UVA rays (check the label), which pass through windows. Coat all your exposed skin; Aveeno research notes the amount of yearly sun we get incidentally (from tasks such as running errands) is equal to a week of unprotected basking at the beach. Try Clarins Super Restorative Tinted Cream SPF 20, $75, on your face. An outside wedding, lunch, etc. To protect and prevent shine, apply an oil-free SPF 30 sunscreen and top it with a loose mineral powder (such as Jane Iredale Powder-Me SPF 30, $42), which helps you stay matte and reflects the rays. And don't forget also to put SPF 30 sunscreen on all exposed skin below the neck. — Jolene Edgar, SELF

The second mole turned out to be squamous cell carcinoma, which is not as fast-growing as melanoma but can be dangerous if caught too late. (It, too, can spread into deep layers of tissue and metastasize.) Sanga had three more moles removed during the next two years and continued to keep a close eye on her body.

For reasons not understood, Sanga had a reprieve from new or changing moles between the ages of 20 and 25. But the battle resumed in the years that followed. In the past 13 years, Sanga has had a total of 42 moles cut from her body (27 of them in the last two years alone). Most were dysplastic nevi (the technical term for atypical moles that can morph into actual cancer) and were removed as a precaution. Seven, however, were actually diagnosed as basal or squamous cell carcinomas.

"I am covered with scars from head to toe," she says. "They are on my head, my neck, my armpit, my back. I even have a huge, 2-inch-long scar on the bottom of my left foot and another on the top of my right toe. Every time I go to the doctor for a checkup, I fear what the diagnosis is going to be."

Sanga continually checks her skin for suspicious spots, and her husband takes part, too, checking hard-to-see areas such as her back. During the process, she pencils in the location of her moles as well as their descriptions and any changes on a body map, so she can keep track of their status and update her doctor, whom she sees every three months. Her doctor is currently monitoring an additional 30 spots.

Sanga shudders at the thought of her sun-worshipping and habitual indoor-tanning days, which have sentenced her to a lifetime of problems and health scares. So what gets her through the reality of more scalpels, stitches and scars? "My strong desire to be around 50 years from now," she says.

What you can learn from her
Sanga's vigilance is key to staying healthy. Follow her lead and get to know your skin every month. (Do it when you do your breast exam.) "Self checks are crucial to preventing skin cancer and detecting it at a treatable stage," Dr. Kaufman says. In fact, patients find one third of melanomas. And don't even think about basking in the sun sans sunscreen or using a tanning bed.

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