It started as a familiar whisper in Sara Plehal’s ear. She remembered it well – she had first heard the “voice” warn her to see a doctor about a potential breast lump seven years ago. Although she couldn’t feel anything unusual and had no family history of breast cancer, she immediately consulted her doctor. Test results showed three tiny, seemingly harmless spots that, upon biopsy, indicated an aggressive earlystage breast cancer. At age 30, Plehal underwent a bilateral mastectomy and chemotherapy.

This new whisper, three years later, warned Plehal that a small freckle on the back of her thigh might be cause for concern. B ecause seeing a dermatologist would require a referral and a six-month wait, she went back to her physician, who immediately took a biopsy. T his time test results indicated melanoma, the most deadly of all skin cancers.

Luckily, Plehal’s melanoma was detected early. H er dermatologist was able to remove the cancerous spot and, since then, two other melanomas on the back of her legs. Plehal’s new reality includes trips to the  dermatologist every threeto- four months for full-body checks to look for any new growths, since she is at increased risk for recurrence.

The American C ancer Society estimates that in 2007 there will be 59,940 new cases of melanoma in the U nited States , and more than 8,000 will die of the disease. M elanoma begins in melanocytes, the skin cells that produce melanin, the dark protective pigment that makes the skin tan and can spread to other parts of the body. Fairskinned people like Plehal who sunburn easily are at highest risk for developing skin cancer.

If detected and treated early, melanoma is almost always curable. The American Cancer Society suggests you check your skin for irregularities once a month, and see a dermatologist immediately if you detect anything suspicious. To differentiate a normal mole from a melanoma, use the ABCD rule:

Assymetry – O ne half doesn’t match the other in size, shape, color or thickness. 

Border irregularity – Edges are ragged, scalloped or poorly defined. 

Color – Pigmentation is not uniform. Shades of tan, brown and black are often present, and dashes of red, white and blue also can appear. 

Diameter – Most melanomas are greater than ¼-inch in diameter – the size of a pencil eraser – when diagnosed. In cases like Plehal’s they can be even smaller. See a dermatologist if a mole appears different from others or changes size, itches or bleeds.

While she struggles with the scars left in the wake of her skin cancer, Plehal, the mother of 13-year-old Rachel and 11-year-old AJ, considers each mark a “badge of honor.” She feels she was spared so that others can learn an important lesson: there is no such thing as a safe suntan. She recommends using sunless tanning products for a safe, natural glow. 

Reflecting on her ordeal, Plehal says that her painful bouts with cancer have taught her two important lessons. “Be your own advocate” when it comes to your health, she says, and most importantly, “Live each day – don’t worry about tomorrow.  I’m very thankful to be here.”

By Nancy Pias

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