by Judy Fraser
Some of the things I enjoy in life are gone. Since I've had skin cancer, fear is always lurking, particularly when I'm outside. I've always been an outdoors person playing golf, bicycling, gardening and I still am. But it's not the same. I keep checking to be certain I have sunscreen all over my body and that the brim of my hat is covering enough of my face.
Though I'm blond and fair-skinned, I never thought skin cancer could happen to me. Now I can see why it did. When I was a girl, we lived on a lake in Wisconsin and went boating and water-skiing and were out in the sun a lot. In high school, my friends and I used baby oil and iodine to get a tan faster.
Then came college. I went to the University of Wisconsin where the student union was on a deck over Lake Mendota, and we lay there in the sun, talking and studying. We became beautifully bronzed, golden; we looked good and we felt good. Sunscreen: We didn't even think about it; most of us didn't even know about it. We had no idea that what we were doing could catch up with us 20 or more years later.
Twenty-eight years ago I became a television weather forecaster for WCAI-TV, and I've appeared on the air ever since. Every so often, in the course of these years, I'd find scaly patches on my skin, which turned out to be actinic keratoses, and my dermatologist took them off. I knew these were precancers, but I still never thought I'd have anything worse.
A Fine Red Line
And then, about three years ago, I noticed a very fine light red line under my left eye. It was the kind of line that a very thin pencil point might make and could barely be seen. It never got bigger or bled, so I wasn't concerned until one day I realized that the line had been there for over a year. I went to my dermatologist who took a biopsy. Even then, I was sure that it wouldn't show anything serious. However when the call came from the doctor's office, no information was given to me and I was told that he wanted me to come in to talk to him. That did worry me. I called my husband of five years, Lou Ryniek, and we went together to hear the diagnosis: cancer — a basal cell carcinoma. It was like being hit in the face. When I heard the word "cancer," I thought of the worst possible scenario.
The carcinoma was so close to my eye that the dermatologist referred me to Dr. C. William Hanke, a Mohs micrographic surgeon in Indianapolis. When he examined me, he observed that the carcinoma was so tiny as to be all-but invisible without magnification. Mohs Micrographic Surgery could remove it in just a few minutes, he said, and began the procedure right away. It was a little painful, but not unbearable.
I Am One of Them Now
After the treatment, I went into the waiting room where several people with large patches of gauze on their faces were waiting for the results of their microsurgery, and going in for additional treatments. As for me, I was sure I'd be out of there as soon as the initial microscopic study was completed. However, twenty minutes later, Dr. Hanke told me the cancer was much deeper than we had thought, and that he'd have to remove more layers of skin. That was only the beginning. I went back for additional microsurgery four times before Dr. Hanke reached a skin layer that was free of cancer cells. As I went back to the waiting room in between treatments, I looked around at the other patients and thought, I am one of them now.
A Gaping Hole
The basal cell carcinoma went so far under the skin that the surgery left a hole the size of a thumb. If it had gone any deeper, I was told, it would have gone into my eye. The terrifying thing was that this fine red line looked like nothing, but was a cancer and had spread very far. I was brought up short to recognize how I had put myself in jeopardy just to look good for four months of the year.
|Figure 1. The "gaping hole" is shown immediately after Mohs Micrographic Surgery.||Figure 2. Several months following a full-thickness skin graft, the cosmetic result is excellent.|
The diagnosis and surgery were particularly hard for me to bear. I was afraid not only about having cancer, but about my job as it demands an attractive appearance. I explained to the doctor why I could not be off the air for very long, so the decision was made to close the gaping hole that very afternoon. Dr. Hanke's colleague, Dr. Steve Klapper performed the second surgery. The hole was so large that the sides could not just be sewn together, but required a graft taken from the skin of both eyelids. In addition, what I call a "contraption" was devised to keep the lower lid tied to the eyebrow so that it would not droop later. A gauze roll was sutured to the lower lid and attached to the eyebrow.
Afterwards, I was frightened and depressed, but my husband was very supportive. Whenever I was most down, he bolstered me. He also helped to take care of the contraption, because for the first couple of days, I couldn't see well enough to do it myself.
Two Weeks Off the Air
I looked awful with my eyes swollen and bruised and I couldn't go on the air for two weeks. Even after the contraption was removed, the injuries still showed, and I wasn't able to put on makeup. But I'd been at the station for so long that everyone in charge of the programs wanted to help. They agreed to let me appear on the air wearing specially designed tinted glasses, and I did that for another two weeks.
When I appeared in these glasses for the first time, I did not start out by giving the weather forecast. First, I was up front and told exactly what had happened to me and why I was wearing tinted glasses. By now, I have a following that is extremely loyal to me. People were so kind and compassionate and sent many cards and expressions of support and sympathy. Every few days, during the weeks I was wearing the tinted lenses, I made a point of repeating that I'd had skin cancer, but it had been completely eradicated.
I stopped wearing tinted glasses when makeup and my regular glasses were enough to conceal the scar, but I was not back to normal for about six months — I had the surgery on January 21st and the scar became barely visible in June or July. There are still scars on the eyelids where the skin graft was taken, but they are almost unnoticeable.
Since then, I go to the dermatologist every six months for a total body skin examination. I've had three more actinic keratoses removed, but nothing else. The cancer has not returned.
Now that I've had a skin cancer, it's hard to believe I was so unaware of the danger for so many years. I was happy to be tan and liked the way I looked.
In the Public Eye
People who have jobs in the public eye, as I do, have a wonderful opportunity to help others. We have a lot of power to put across a message. Whenever there's a story about skin cancer in the news, I use that as the reason to tell viewers to take care in the sun. And if there isn't a news story, I bring up the topic of sun protection by talking about events in my life before starting the weather forecast. For example, I might describe plans for a trip to Florida with my husband, and say that I'm planning to bring a sunscreen with an SPF of 30 or 45. I also make it clear that I won't go outside without a hat, even though that's the toughest thing for me, as I don't look good in a hat.
I try to make people realize that anyone can get skin cancer. Dan Rather got it. I got it. Skin cancer changed my life; don't let it change yours.
Comment by C. William Hanke, MD
Judith Fraser's basal cell carcinoma on the lower eyelid is a very typical indication for Mohs Micrographic Surgery. The Mohs procedure allowed us to precisely remove the cancer cells while preserving all of the normal eyelid tissue for reconstruction. Basal cell carcinomas such as this are often larger than they appear to the naked eye. In Ms. Fraser's case a full-thickness skin graft provided an excellent functional and cosmetic result. The five-year cure rate for this type of cancer is 99%. Ms. Fraser is a high-profile professional whose position in television requires her to look her best. On a personal note, she is a very courageous and charming person.
C. William Hanke, MD, is a vice president of The Skin Cancer Foundation and Medical Director, Laser & Skin Surgery Center of Indiana.
From The Skin Cancer Foundation Journal, Vol. 22, 2004