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What to know about melanoma
54-year-old Susan Cox is a three-time survivor of advanced melanoma. She spoke to us about her approach to sun safety before getting diagnosed, not losing hope and what she’s learned.
One morning in 2007, Susan Cox woke up to a blueberry-sized mole on her back that was, suddenly, bleeding. She hadn’t paid much attention to the mole before, but now it was making itself known—and she immediately knew that something was wrong.
“It sounds ridiculous to think that my life could be in jeopardy from a mole,” she says. But it was. After a three-month wait to see a dermatologist, Cox was diagnosed with stage three skin cancer and a 10-inch strip of skin was removed from her back.
The 54-year-old, whose cancer has recurred three times, is among the one in 73 Canadian women who will be diagnosed with melanoma in their lifetime. The deadliest form of skin cancer, melanoma accounts for 3% of all new cancer cases in Canada. It’s very treatable if caught early, but over the past 25 years, the incidence rate has increased significantly. The numbers are staggering—which is why, at five years cancer-free, Cox is still fighting the disease head on. But this time, she’s focusing on public awareness. “My mole was itchy for a couple of years before [I was diagnosed]. I should have recognized there was something different about it then, but I didn’t,” she says.
That’s why she has contributed to an e-book of photo essays by melanoma survivors published by the Save Your Skin Foundation and Novartis Pharmaceuticals Canada Inc. (See a selection of her photos throughout this story.) Many people think it’s “just skin cancer,” but Cox’s mission is to convey just how serious a diagnosis melanoma is, how much it changes your life—and how easy it is to prevent.
What was getting diagnosed like?
I had a mole on my back that popped. I thought it was just a pimple, so I called a dermatologist and ended up waiting three months to get an appointment. I didn’t realize it was serious—and then I was diagnosed stage three melanoma right out of the gate. So, that means, you are already pretty much in trouble before you’ve even known what has hit you.
“While time goes on, the physical and emotional impact of melanoma can fade, but it never really disappears. It’s something I’ll never be free of, but I can live with the scar and I can try to move on.”
When it did hit you, how did it feel?
At first, I went to the internet, which was the wrong thing to do. It freaked me out. I cried into a towel in my bathroom with the door locked. I was frozen, I actually didn’t know what I was supposed to be doing. When you’re told you have this disease and it’s going to keep coming back and keep coming back… I wanted to run away, frankly. It sounds silly, but I just wanted to go somewhere… but how do you run from your own body?
Were you cautious about sun safety before you were diagnosed?
No. Not at all. As a matter of fact, I used tanning beds, religiously. I encouraged others to use them. I took my daughter. I read the literature and it sounded safe enough, but I didn’t understand what I was doing. I didn’t understand they were carcinogenic, as a whole. And I didn’t use any sun safety product.
How did having melanoma change you?
I was so scared. I wasn’t really living. I was only living between my doctor’s appointments, truthfully. If you are told your appointment is in two months, you put everything on hold for two months. You don’t make holiday plans, you don’t buy a ticket on an airplane, you don’t book a hotel—it’s almost like you’re expecting to be told you’re dying. But after a couple of surgeries, I decided I wasn’t going to be afraid to try things anymore. Once I had survived cancer twice, I felt as though I better start getting my bucket list double-checked and so I did.
What kinds of things did you check off your bucket list?
I’m a designer and I always wanted someone to hire me to design a beach house, or decorate a beach house, and nobody ever did—so I bought one. I did it myself. I wanted to know I could do it myself, and I was very pleased with how it turned out. I had a magazine come shoot it, I took some design risks that I wouldn’t have taken before. I wasn’t afraid anymore.
“When I was diagnosed with advanced melanoma, I was in tears. It absolutely demolished me.
The stormy times and fear kept me from living my life vibrantly. I decided I needed to build my beach house and it’s now a reality. It’s a place I can go to relax and regroup, and express my passion for design. I may have never taken this risk before I fell sick.”
Melanoma is the deadliest form of skin cancer, and the incidence rate has increased significantly over the past 25 years. So why don’t we talk about it?
It’s the mentality that it won’t happen to me. People don’t want to hear about melanoma because they want to be outside in the sun. Since the ‘60s and ‘70s, we’ve had a culture of tanning the skin. We see tanned skin as attractive, sporty, athletic. I was absolutely drunk with the idea of having brown skin and looking Mediterranean. But guess what? I’m not. I’m fair-skinned, I had white hair as a kid, I should never have been in the sun, ever. But it’s a cultural thing. I get it. I feel like I look better with a tan. I wear less makeup when I’m tanned. But it’s okay to look pale and be in the skin you’re in. I wear pale skin as a badge of honour. Tanned skin is damaged skin. You might see a tan, but a dermatologist sees damaged skin at a cellular level. When you come out of the shower in January and you can still see your tan lines, that’s damage. I still have tan lines and I haven’t been in the sun in 10 years. I’m rarely in the sun in a bathing suit, but I still have my tan lines. That tells you how badly I damaged my skin.
What was treatment been like for you?
I took a targeted therapy because I had a mutation (which means the cancer mutates), and they’ve been able to look at that mutation and bind a protein to that mutation, therefore choking it out so it doesn’t multiply and doesn’t continue to grow. It’s available through an oncologist and it’s a pill. I took it twice a day. So for me, it was taking a pill twice a day and my tumours shrank immediately and completely away.
How did you keep yourself from losing hope?
It would be very easy to lose hope, [but] it would be almost impossible not to lose hope. I refuse to give up. I absolutely refuse. I refuse to lose. I don’t like to lose and if I’m going to lose this battle sooner than I should, I’m going to go out on my terms. I’m not going to go out on my knees.
After being educated about sun and skin care, what have you learned about the importance to take sun safety precautions all year round?
There was a famous skier in Whistler, Dave Murray, who died of melanoma. You actually get more sun exposure in the winter than you do in the summer because snow and ice reflect the sun.
What advice do you have with individuals with concerns about the disease?
Get educated. But not on the internet! Do not look at pictures of melanoma in the images of your Google search. I don’t know anybody’s melanoma that looks like those pictures I have seen on Google. Don’t be afraid to have something looked at. If in doubt, cut it out.
Why did you get involved with the Save Your Skin “Melanoma Through My Lens” campaign?
One word: Hope. I want patients to not be afraid to help themselves and I know it’s hard because you want to run away, but there’s no running away from it. It goes with you, where you go. You have to stay and fight. It’s not a death sentence anymore. There’s hope.
“Being honest with my family about what I was dealing with made a difference in my journey. Everyone helped me get through this. My son is a very caring boy. My daughter always shows me she cares. My husband is always by my side. What could be more hopeful than more time with my loved ones?”
Image courtesy: Susan Cox
What are three words you use to describe yourself with this disease?
Loud. Numb. Scared.
What are three words do you use to describe yourself without this disease?
Loud. Educated. Empowered.
Check out the Save Your Skin Foundation to find the Melanoma Through My Lens e-book.
Photography by Stacy Van Berkel
The kitchen probably has the most traffic in your home, which means it can also be the messiest. Keep your counters and cabinets clutter-free with these clever storage ideas.
1. Looking good
Display your pretty serving pieces on open shelves and use decorative baskets to house the less attractive and infrequently used kitchen necessities (think small appliances and tools).
2. Mix it up
Varied storage keeps items of different sizes in their place: deep drawers for medium-to-large appliances, stacked shelving for wine bottles and shallow drawers for spices.
3. Within reach
Keep the items you need most, such as cereal and snacks, between waist and eye level, and move the rest of the goods up high or down low.
4. All access
A pull-out pantry allows you to see inventory at a glance and helps keep supplies organized so that nothing gets pushed to the back and out of view.
5. Now you see it
Cabinets that are tucked behind a sliding door will provide a functional space-saving solution to a typical pantry. This storage system can be built along an unused wall in a kitchen. Use it to conceal mismatched boxes, jars and canned goods.
The biggest advantage in a kitchen is accessibility, yet the most common blind spots I see are cabinet shelves that are too high and wasted space between shelves. Whether you've just moved in or you've settled into a kitchen, it's worth the time to adjust shelving to fit the contents and to lower shelves so you can reach what you need. After adjusting the height, you can often add an extra shelf to accommodate wide narrow items, like trays.
— Marie Potter, Professional Organizers in Canada, Vancouver
The times have changed when it comes to meat consumption, according to Renelle Briand of Health Canada. “Many of us grew up in households where meat took center stage on the dinner plate. Today, there is a greater emphasis on meat alternatives, vegetables, fruit and whole grain foods,” she says.
Last week, University of Waterloo’s school of public health became the first in Canada to endorse Meatless Mondays—and if a major university in Canada can do it, so can you.
Here’s why cutting back on meat is beneficial for your health:
1. Reduce saturated fat intake
The most recent Canada’s Food Guide suggests that people choose more beans, lentils, and tofu among other meat alternatives as a way to minimize saturated fat. “Though some saturated fat in our diet shouldn't be harmful, if you're eating a lot of it, that may negatively affect your health,” says dietitian Abby Langer. Since the majority of saturated fat comes from animals and animal by-products, cutting out meat is an easy way to decrease your saturated fat intake.
2. Curb the risk of cancer
“Processed meats such as lunch meats and bacon have been connected to an increased risk of some cancers,” says Langer. In 2015, The International Agency for Research on Cancer classified processed meat as carcinogen, and red meat as a probable carcinogen. To reduce your risk, limit your intake of both.
3. Improve heart health
Meat alternatives provide nutrients such as iron, zinc, magnesium, B vitamins, and protein. “While nuts and seeds are meat alternatives that can be high in calories, they contain monounsaturated fat and polyunsaturated fats, which are beneficial for cardiovascular health,” says Briand.
The best part about Meatless Mondays is that it’s so simple! Here are five veggie-friendly recipes to get you started.
By now, we’re quite well-versed in the area of healthy eating. We know what foods are good for us, and we know why it's important to have a diet that’s rich in superfoods. What we could use help with is the how. How do we ensure we reach for nutrient-dense foods over less healthy options? How do we shop for superfoods on a budget? How do we avoid a #SadDeskLunch that makes us brave the iciest winds to replace said depressing lunch with a more enticing meal option from the greasy take-out joint across the street? To help us put our want for a healthier diet into action, we’re seeking expert advice from Registered Dietitian Julie Bednarski.
CL: How can we ensure we eat well?
JB: I always recommend keeping items in your kitchen that are high in fibre, protein and contain good fats. Healthy eating can be easy and cheap if you have the right ingredients on hand. Grains, including quinoa, brown rice, millet, oats and brown rice pasta, can be used to create many different types of meals from breakfast to dinner. These are high in fibre, contain protein and will keep your blood sugar levels stable throughout the day. Canned beans, dried lentils, canned salmon, eggs, nuts/seeds and nut butters contain protein and healthy fats that will keep your body strong and brain healthy. Fruits and vegetables are essential for maintaining health and should be the star of every meal. Eating an array of colourful fruits or vegetables is important to ensure you are getting lots of different vitamins and minerals. My top fruits and vegetables to have in my kitchen are kale, blueberries, sweet potato, avocado, squash, beets, spinach, strawberries, kiwi, apples and arugula. Many of these are superfoods that are nutrient-rich and especially beneficial for health and well-being.
CL: How do we eat well on a budget? What are the top fruits and vegetables that should always be on our shopping lists?
JB: Kale, sweet potatoes, apples, canned tomatoes, broccoli, frozen berries and carrots. All of these foods are superfoods that contain an array of vitamins, minerals and antioxidants. Incorporating these foods into each meal ensures that you’re getting the best value and nutrients for your body. Many of these foods are low in price and store well in your fridge or freezer.
CL: How can we guiltlessly eat packaged foods?
JB: Reading food labels is the easiest way to know what you can eat guilt-free. If you don’t know what an ingredient is or you can’t pronounce it, don’t buy it. Look for products that have real ingredients—they can often be found in the organic section. Which leads me to my next point, look for organic or non-GMO food products as these items will have cleaner ingredients and less additives and preservatives.
CL: How can we prep food to help us eat healthier during the week?
JB: Eating healthy is all about planning ahead. Do all of your food shopping on the weekend so you aren’t rushed and make time to prep your ingredients in advance. My top tips for prepping on the weekend are:
1. Wash and chop all your vegetables, then place them into containers so that you have vegetables ready for salads and stir-fry dishes.
2. Make a large pot of quinoa or brown rice on the weekend to add to salads, soups, veggie bowls or to use as a side dish.
3. Roast a whole chicken or bake fish on the weekend to add protein to your meals throughout the week.
4. Make salad dressings in advance and store them in mason jars in the fridge, where they can last for over a week.
CL: How can we snack in a healthy way?
JB: Snacks that are high in fibre and protein and low in sugar are best. Finding ways to incorporate fruits and vegetables into your snacks ensures you’re eating a variety of vitamins and minerals throughout the day. My favourite go-to snacks are my very own Healthy Crunch kale chips, homemade trail mix with various nuts, seeds, dried chickpeas, apple with pumpkinseed butter and veggies with hummus.
CL: How can we organize our kitchens to help us make healthier choices?
JB: When hunger strikes, you’re more likely to reach for easy junk food instead of superfoods, especially if your kitchen is not properly organized. The first step is to avoid storing junk food in your cupboards or fridge. This will keep it out of sight and out of mind. Instead fill your cupboard with canned beans, grains (including quinoa and brown rice), nuts and seeds, and frozen vegetables. When you stock up, be careful not to overload your cupboard! It will make it difficult to see what ingredients you have and easy to fall off track. If you keep a moderate amount of these foods in your home you’ll find that they are easy to cook with, which will help you avoid the temptation to order-in.
For your fridge, store like-foods in the same place so you always know where to find them. Nutrient-packed greens should be together, proteins should be together and you should also have an area where you keep cut-up vegetables and fruit. When at the grocery store, avoid purchasing excessive amounts of food that will go bad if you do not eat them. Overstocking your fridge can be overwhelming, so it’s important to plan your meals in advance and only buy those ingredients.
CL: How can we avoid #SadDeskLunch?
JB: Prepping ingredients earlier in the week makes it easier to make a meal on the fly. I always recommend making mason jar salads that are jammed-packed with fibre and protein. These salads are quick and easy to make if you have ingredients all ready to go. In a mason jar, layer quinoa, chickpeas, spinach, cherry tomatoes, carrots, avocado, pumpkin seeds, sunflower seeds and dried cranberries. For your dressing, try mixing apple cider vinegar, flax seed oil, maple syrup, dill, mint, parsley and Himalayan pink salt—trust me, you’ll go from #SadDeskLunch to #FabDeskLunch!