Sunday, October 6, 2013

Please pack your hat!

Fourth term starts tomorrow and with it, compulsory hat wearing at school.

I've heard every excuse known to man for not wearing a hat. It's too hard to bowl with the hat on, I have naturally brown skin, the dog ate it, someone stole it, Mum forgot to put it in my bag, it will ruin my hair! I've had kids who will sit in the sun with their hats in their lap, put the hat on when the yard duty teacher walks by and then take it off again. I even had one mother tell me her doctor said her child should leave her hat off because it makes her head itchy. Let me tell you, if the kid gets melanoma the itching won't be a problem any more :-(

After so many years of Slip, Slop, Slap education the ignorance about sun exposure totally bewilders me. Today the temperature was unusually high for October but later in the week it may only be 15 and it might rain so I'll have kids telling me the hats aren't necessary. Rubbish! Sun damage is linked to UV exposure, not temperature and not wind. The UV will be high tomorrow and it will stay that way until at least April next year. After 10am in the morning you need to be wearing a hat. Every day. Even if it's cold and over cast.
If you need a reminder, there are great apps that will tell you whenever the UV goes over 4.

I first met melanoma when my mother contracted it. Mum was an active, vibrant woman, universally loved. She played tennis and golf (quite badly but enthusiastically) and she was devoted to me and to her new grand daughter, Jaime.

There was no visible change in any of Mum's freckles or moles, just a tiny lump under the skin on the back of her neck but by the time they biopsied that lump and provided a diagnosis the melanoma had metastasized to every part of her body. In her initial surgery they removed 94 separate surface lumps requiring 357 staples. The internal lumps were hit with radiation. Every inch of her skin and behind her eyes was searched for the offending mole with no success. Later, after traction to relieve a pain in her neck (believed to be caused by arthritis) had failed, a scan revealed that she had a primary tumour in her spinal cord. Not all melanomas are visible. Removal of that tumour caused paralysis in one arm and required her to wear a neck brace to hold her head up. No more golf or tennis, no more carrying Jaime. Metastatic melanoma is a death sentence and we were told she would likely be dead within weeks or months. Mum was 'lucky' enough to gain a place on a new Inteferon drug trial. 3 times a week I or a nursing friend would inject her with a drug that caused her to vomit, to shake uncontrollably and made her itch so badly I had to wrap her in glad wrap at night time to stop her tearing her skin off. The drug boosted her immune system and slowed the growth of the tumors. More importantly to Mum, it gave her an extra 18 months with Jaime and provided research data to help in the fight against melanoma for future sufferers. When the trial finished so did the free access to the drug so I took out a personal loan to pay for the injections. Eventually though, the disease won. In late November a scan showed massive tumours in her brain and in the early hours of Christmas morning, the black scourge stole my mother from me. She was 56. She missed seeing that precious grand daughter grow up to have babies of her own. She missed meeting two of her grandchildren, and I still miss her, every, single day.

I had inherited enough of Mum's colouring to know that I was at high risk of the disease myself but unfortunately it was a bit late for caution. The skin damage that causes melanoma begins in childhood and I lived mine in the coconut oil drenched 60s and 70s. I had literally baked myself on enough occasions to know that my fate was sealed. So despite slip, slop, slapping through the 80s and 90s and having numerous surgeries to remove less dangerous skin cancers it was no surprise when I had my first melanoma removed a couple of years ago. I was lucky that this one was a) visible and b) in the early stages. If I'm really lucky no renegade cells found their way into my bloodstream before it was removed. If they did, then sometime in the near or later future it will appear somewhere else in my body, most likely my brain or my liver. It's likely I won't know about that until it's too late. I get my skin checked every 6 months and anything odd is biopsied in between but I live in constant fear that every headache or nagging pain is a sign of my worst nightmare. Every time I suffer from vertigo or nausea, I'm rushed into an MRI- just to check.



In between Mum's illness and mine I have lost friends to melanoma and I know countless other families who have lost children and brothers and sisters and parents. Scarily, many of these people have been much younger than me. Melanoma is the most common cancer in 15 -39 year olds and it kills more 20 - 34 yr olds than ANY OTHER CANCER and yet still our young people risk their lives for the sake of a tan and their parents allow it. My Facebook feed is full of teenagers posing in bikinis with comments like 'great tan babe'. Just last week someone even told me their child had a 'genuine Noosa tan', as if it was something to be proud of!

Genuine Warrnambool tan. Not worth dying for.

If you're lucky enough to avoid a deadly melanoma then you might just get a basal cell carcinoma. That's less likely to kill you and they can cut them off fairly easily these days. I've had lots of bccs and I'm lucky that my dermatologist is also a great plastic surgeon and does very neat stitches. Once though, I sat in the waiting room and watched a woman lose her entire nose over the course of an afternoon. Because that's how facial surgery for skin cancer works. They take you into theatre and slice a bit off and send it to pathology. While that happens you sit, (with all the other poor suckers) in the waiting room with dressings and tape holding your face together till you get the all clear and go back in to get stitched up. If the pathology doesn't show clear margins then they take you back to the table and slice some more off and so on until it is clear. The fear in that room while we waited to see who got the call back was palpable.

So, to all the parents reading this blog, I hope you understand that the only reason I ask your children to put their hats on is because I care about them. I don't want them to become skin cancer statistics and until the time they are mature enough to make their own smart choices you and I have to make them for them. I also hope you understand why I feel so angry with you when you don't support the hat rule or when you turn up at a school event without a hat yourself. We need adults to role model safe sun behaviour. You wouldn't put your child in a car without a seatbelt - don't send them outside without a hat. I make no apologies to all the kids I will cajole, plead with, yell at and send inside because they aren't wearing a hat this term - I hope you live long and scar free lives because of my 'meanness'.

When I see kids actively sun baking, I feel sick. When parents tell me there's nothing wrong with a 'healthy tan' or their kids turn up at school with bright, red sunburn and peeling noses I have to bite my tongue not to accuse them of child abuse. The sun kills people and to ignore that message is disrespectful to me and my mum, to my friends Wendy and Jenny, to Nigel's brother, to Jim Stynes and the thousands of other people who have lost their lives and their loved ones to this vicious disease. Worse still, it is inviting disfigurement and risking the lives of our precious children.

When you pack the lunch boxes into the school bags this week, please make sure the hat and sunscreen are in there too.