I don’t feel like putting sunscreen on again afterwards. Laziness is also a factor here.

Photo of a woman using a tanning bed (Stockbyte / Photos.com) Monica, 43 years old

“I’ve learned to have my skin checked regularly by a dermatologist. But also to watch my skin myself so I can react quickly enough.”

I don’t really know exactly when it was that I realized I have a higher risk of developing skin cancer. It just gradually dawned on me.

Several years ago I had a mole I thought looked unusual, so I went to see a dermatologist. She said that I should have it removed, but she didn’t want to do it herself and told me to see a surgeon as soon as possible. When I asked her opinion, the dermatologist didn’t want to say anything else about it, just that we needed to wait for the outcome of the surgery. On the referral form for the surgeon she put “suspected malignant melanoma.” I was getting mixed messages and felt very confused. She had told me that it wasn’t possible to say anything about the mole, but at the same time she had written down the suspected diagnosis and told me to see a surgeon right away. I went to see the surgeon and had the mole removed.

I went back to the dermatologist for my wound dressings. The results were supposed to be there after one week. The doctor casually mentioned that everything was alright. She must have forgotten what she had written on the referral form and what that had meant to me.

I had a mole removed after I was pregnant

In the early 1990s I noticed several new moles. They were very dark, almost black. When I was pregnant, very dark moles appeared on my torso. They had slightly ragged outlines and I thought that I should show them to my dermatologist. She said that we should keep an eye on them, but that it would not be a problem and that it could wait until after the pregnancy. Nine months after giving birth I went to see my dermatologist again. She then decided to remove one of the moles.

After the operation I called about the results. The receptionist wouldn’t tell me them over the phone and asked me to come in. I thought: “Oh my God, what does that mean?” and went there. I was expecting a death sentence, but I was wrong. The doctor told me that the mole was very close to being cancerous. There were changes in the cells, but they weren't malignant. On the whole, I felt like she should have handled things more sensitively. She must have had no idea how panicked I was the whole time - I had really been scared. After that I started going to a new dermatologist.

From then on, I had my skin checked by the dermatologist every six months.

I found a lot of information at the library

I also started reading more about skin cancer. I borrowed all the books about it from the public library to try to put my mind at ease.

There was one particular patch on my skin that I looked at a thousand times a day, and I kept on standing in front of the mirror trying to remember the pictures I had seen in the books. I can get quite worked up in situations like this, and sometimes have difficulties being objective. I watch moles for so long that I can no longer tell whether they've grown bigger or not. I sometimes manage to reassure myself, depending on how I’m feeling that day. But there are situations when I start feeling really anxious. I have to admit that I’m a bit of a hypochondriac. Whenever I find something abnormal on my skin I keep on looking at it again and again. Each time I think it's getting a bit darker and bigger.

I then find it helpul to keep busy and work or meet up with people. I hate being by myself when I feel that way. Information is helpful, but can also be confusing. There are so many pictures. Sometimes it says that a mole like this could be cancerous, and on another website there's a similar picture that's described as being non-cancerous. Sometimes I don’t see any difference between the pictures.

I go for check-ups regularly

My new dermatologist is very thorough. I go for a check-up every 12 to 18 months. I have to take all of my clothes off and lie down on an examination table. She checks my back first, and then looks at my belly and examines everything very carefully with a small magnifying glass. She looks at some moles a little more closely, and if one seems unusual, she removes it. It's been several years since I had an abnormal mole removed. None of them was as critical as the one I described before.

I had no problems with getting the moles removed. The scars are tiny and you can hardly see them. It took half an hour to have the moles removed; it was done in the doctor’s practice and wasn’t a big deal. It hurt a little, but it healed very quickly.

I never worry much about the examinations. You do feel exposed, being undressed and lying on the examination table with only your underpants on. It feels a bit strange.

I also carefully check my skin myself

Sometimes I put off having a check-up. They take quite a bit of time, especially because you have to wait for so long. But the examination itself doesn't take that long. I always feel relieved afterwards if the doctor doesn’t find anything. When I had my last mole removed I was sure it was harmless. But the day I went to get the results wasn't easy, and I still felt nervous. It’s always a bit scary when you have something removed. It could be malignant, otherwise they wouldn’t want to remove it. A combination of things makes it easier for me nowadays: I trust my dermatologist because she's always very professional and careful, and I know more about skin cancer now. That helps too.

I also check my skin very carefully myself. I think I know my body well enough to notice if something new is developing or if any moles change. I don't follow a routine or set schedule. We have a big mirror above the sink in our bathroom, and I stand in front of it and look. I also keep an eye out for new moles or any changes in the older ones when I get dressed.

In a way it’s difficult to grasp. One tiny change in our skin can turn out to be incredibly dangerous. It doesn’t really make sense. The last mole I had removed wasn't black, but rather dark, and was along my hairline. I had had it for quite a long time and it grew very slowly. At some point there was this moment in front of the mirror when I had the feeling that it was bigger than it used to be. I hadn’t paid much attention to it before that, but then it was like a switch had been flipped. From then on I thought it might be dangerous.

Sometimes I even get burned in the shade

I do protect myself from the sun. I try to stay in the shade and always take care to put enough sunscreen on my son. I once got sunburn myself because I hadn’t put sunscreen on often enough. Sometimes I don’t take it that seriously because I think that I’ll be in the shade all the time. But then I get burned despite the shade.

It’s hard for me to choose the right sun protection factor. When I’m standing in front of the sunscreen section at the drugstore, I don’t think I need the very high sun protection factors, and that they are meant for young children instead. I probably underestimate that. I also find it difficult to put sunscreen on more than once. For example, when I already have a bit of a tan, and have put sunscreen on, and then go into the water. I don’t feel like putting sunscreen on again afterwards. Laziness is also a factor here.

I make sure my son puts on enough sunscreen

I'm much more careful with my son. I make sure that I reapply his sunscreen often enough. Although he can do it himself now, he doesn’t like doing it. But I take care of that. Sometimes it’s not easy, but I put my foot down.

I also check my son's skin has changed. He has some dark moles, and last year I took him to the dermatologist. But I made a mistake there: At a prepubescnet age I took him to a female doctor. He hated taking off his clothes and refused to do it. At home we also walk around without clothes, but I had misjudged his sense of shame. He was pretty angry with me, and rightly so I think. I should have taken him to see a male doctor.

I’ve learned to have my skin checked regularly by a dermatologist. But also to watch my skin myself so I can react quickly enough.

 

Acknowledgement

Our real-life stories summarize interviews with people who are affected by the medical condition. Our interview partners have given us permission to publish their stories. We would like to express our sincere thanks to them.

The real-life stories give an insight into how other people cope and live with a medical condition. Their opinions and comments are not recommendations by IQWiG.

Please note: The names of our interview partners have been changed to protect their identity. The photos are of models.

Labels: C43, Cancer, D04, Melanoma, Prevention, Skin and hair, Z08, Z12, Z80