Living With Skin Cancer: Part Two – Embracing a Mindset of Self-Care

By Holli Kenley

In Part One: Living With Skin Cancer: Embracing a Mindset of Self-Compassion, we explored three healing properties:

Knowing and Honoring Your Truth
Releasing Your Past
Infusing Yourself With Gratitude

I think that most of us who face ongoing health issues want to be brave and hold up a good front. I believe that most days we do a decent job of maintaining a positive attitude. I also know that as time goes by, we get discouraged and depressed. This is understandable. However, we don’t want to stay there too long. And, we don’t have to. We can choose to treat ourselves gently and tenderly. We can comfort ourselves by Embracing a Mindset of Self-Compassion. If you have not already done so, I encourage you to return to Part One and then join us here. Although I am incorporating my journey in living with skin cancer into the messages I am sharing with you, I believe these concepts of shared suffering and healing are applicable to individuals who are dealing with other kinds of cancers, chronic illnesses, or serious conditions.

Let’s explore these five areas:

Listen and Learn
Live Differently and Intentionally
Lean Into Your Source
Lead With Integrity
Love Yourself Along the Way

Listen And Learn

Over thirty years ago, I began seeing a dermatologist on a regular basis. I asked a lot of questions regarding my skin cancer, especially after seeing patients in the waiting room who were dealing with horrific skin damage and disfigurement. I listened to my doctor. I read the pamphlets she gave me and asked more questions. When the skin cancer first surfaced on my scalp about twelve years ago, I was confused. I had stayed out of the sun and covered my head. Why was this happening? I continued to ask questions, not just of my doctor at that time but of the other doctors I have seen since.

Over the years, I’ve learned the following:

Most sun damage to the skin is done during childhood through young adulthood. However, damage to the skin will worsen if exposure to the sun continues.
90% of basal cell carcinomas appear on the face and head, from the sides of the mouth on up.
Genetics are a factor. If a relative has skin cancer or other types of cancer, this places someone more at risk.
The standard care for treatment of basal cell carcinoma consists of a biopsy by shaving or scraping off the discolored area of the skin. If the biopsy is positive, typically Mohs surgery is performed, a technique designed specifically for its removal. Many times this can be performed in an office setting with a physician who is trained in the procedure. If the Mohs surgery is extensive, plastic or reconstructive surgery is often necessary in order to deal with disfigurement. This is performed within a hospital setting.
Mohs surgery eradicates the basal cell carcinoma where it has originated. Mohs surgery does not prevent a further occurrence.
Without Mohs surgery, the cancer most likely will spread into the bone and lymph nodes. Therefore, it must be removed in a timely manner.
According to my current dermatologist, there are no other medical options for treatment. Radiation is rarely used and only on very specific populations such as albinos or in elderly patients who may not be able to undergo surgery. Further research is ongoing and needed.
Skin cancer affects all people. It is a myth that only folks with fair complexions, with blonde hair and blue eyes are susceptible to skin cancer. In addition, because an individual may “tan” well and have olive or dark skin, this is not protection against skin cancer. Any type of over-exposure to the sun along with sunburns to the skin place individuals at risk.

With the Internet, there is a plethora of information. Several of my physicians have strongly recommended NOT searching for information online. Their reasoning? There is too much misinformation being disseminated.

Because my previous Mohs and reconstructive surgery experience in 2016 was so traumatizing, and because my past Mohs surgeries on my scalp have been quite extensive and extremely painful, I was incredibly anxious about facing another Mohs surgery. After meeting with my dermatologist and disclosing my anxieties, I asked Dr. M what other options I had.

Dr. M responded empathically. “Holli, given your history I think the best plan of treatment would be for you to have the Mohs surgery and the reconstructive surgery at the same time under general anesthesia. That way, if the wound is large and requires reconstruction, it can all be done during one surgery.”

I listened intently. Dr. M. continued. “I am not able to do the plastic surgery. However, I work closely with an extremely talented general/plastic surgeon who is able to do both. Dr. T is right across the hall. We’ll set up an appointment for you. How does that sound?”

I smiled nervously. “Well, I’m a little disappointed. Is Dr. T as nice as you?”

Dr. M laughed softly. “He just might be nicer.”

Whatever you are dealing with, ask lots of questions. If you don’t get the information you are looking for, seek out other sources. Listen to the experts. Learn about your condition and your options. While some information can be very discouraging and disappointing, knowing what you are dealing with is far better than fearing the unknown.

Live Differently And Intentionally

When we receive a serious diagnosis, many times our options for treatment are limited or there are factors surrounding our prospects for recovery which are out of our control. However, one of the most important aspects of Self-Care after Listening and Learning about our condition, is to Live Differently and Intentionally. We can control how we want to treat our bodies and our minds. We can decide what healthy practices we will embrace so that we nourish all aspects of our being. And, it feels empowering to do so.

After seeing a dermatologist in my early thirties, I learned that the main cause of my skin cancer was the sun damage done to my skin throughout the first twenty to thirty years of my life. However, I wanted to take whatever preventative measure I could to reduce further damage even though I knew reoccurrence was a strong probability. Immediately, I started making life-style changes. As I have gleaned more information over the years, I’ve continued to add to them.

Some of the changes include the following:

I ceased sun bathing. Since then, I no longer lay out in the sun. If I am outside, I use sun screen.
I was a runner and then later a power-walker. I always wear a hat. In my younger years, I wore shorts and a tank top. I know now I should have covered up better. Even when in the swimming pool, I wear a hat, shading my head and face.
I’ve always worn face make-up, selecting one with a high SPF.
Taking good care of myself has been a priority all my young adult and adult life, psychologically and physically. After my first skin cancer diagnosis, I became much more mindful about healthy eating, exercising, and taking care of my skin, especially my face. Thus, I’ve made it a priority in my budget to spend money on quality skin care products, not just for my face but also for my hair.
This is important. I thought hats and regular clothing protected my skin. They do to some degree. We know now that they are not nearly as protective as UV hats and clothing, which I have incorporated into my wardrobe.
As I continue to practice Self-Care, I remain open to options which will enhance the wellness of my body and my mind. It is important for me to be intentional about every decision I make regarding their care.

For example, after my first Mohs surgery, I was left with a very large circular burn scar on the top back of my scalp. Hair would not grow on it and I had a difficult time covering it up. It was an ugly brownish bald spot. I did not feel good about my appearance. After the scar tissue solidified and with my dermatologist’s permission, I sought out a plastic surgeon to see if the burn scar could be removed and the scalp pulled together. Although insurance would not cover the surgery, I moved ahead with it. For me, it was an issue of Self-Care and of tending to my psychological wellbeing.

Several years later, another basal cell carcinoma surfaced on my scalp. After its removal, I was left with a large rectangle-shaped wound surrounding my temple near the hairline. Two days following the Mohs surgery, I endured a traumatizing invasive reparative surgery within an doctor’s office setting. Three areas of healthy scalp were removed, rotated, and stapled to cover the Mohs wound. Where the incisions were made on the three areas of healthy scalp, they were also stapled in order to close them. Three weeks later, after the removal of over two dozen staples, my scalp and hairline were greatly scarred and barren. I felt very self-conscious about my looks because there was no hair to cover the disfigurement of my scalp. I found it difficult to look at myself in the mirror. However, I thought about my options. Although I began styling my hair differently, there wasn’t enough hair left to work with. For over a year, I wore cute cloth wide headbands and a variety of loose soft hats. I also purchased a small hairpiece which didn’t work well and easily blew off in the wind!

Thus, a few months ago when I knew I was having another Mohs and plastic surgery, I wanted to try something new. I went online and searched under cancer scarves. To my surprise, there were hundreds, in all different colors, textures, shapes, and styles. I purchased a couple before my surgery. They were so soft and comfortable. After my surgery, I purchased several more and have been wearing them every day. To my surprise, folks have complimented me on them. More importantly, I feel good about taking charge and finding a comfortable yet fashionable solution for me.

When you Live Differently and Intentionally, you no longer are held hostage to your conditions or remain victim of your circumstances. You choose to view your disease or disorder as an opportunity for growth and change. And, you intentionally act upon your new understanding, living differently than before while advancing your physical and psychological wellbeing. As you create, prioritize, and implement your Self-Care, you continue to take back your power, making choices which will benefit your body and your mind.

Lean Into Your Source

While it is critical to take care of your body and your mind, I believe it is as important if not more important to tend to your spirit.

Why? This is important:

No matter how much love, comfort, or quality care you have in support of your condition, you live it alone.
Read again, slowly.
No matter how much love, comfort, or quality care you have in support of your condition, you live it alone.
Becoming aware of this “aloneness” is something that most individuals experience, especially if they are going through ongoing health issues or experiencing life-threatening conditions. In addition, there are countless individuals who do not have anyone to support or care for them. They are living with their suffering and experiencing it, alone. This can be terribly isolating and frightening.

Although I have embraced a spiritual path for most of my young adult and adult life, it has changed and matured, as have I. What has remained constant is that when I face challenges of any kind, I always Lean Into My Source, beliefs which tether me to a Higher Power of hope and healing. Just as I have been implementing during my latest round with skin cancer, I follow a planned and purposeful approach.

Pre-Care

Whether I’m getting ready for a biopsy, a doctor’s appointment, in-office procedure, surgery, or other aspects related to my treatment of skin cancer, I spend several days ahead of time by tending to my spirit Leaning Into My Source. I make sure I am walking in Nature, an extremely important staple of comfort. As I am walking, I stop along the designated paths, taking time to sit by the man-made waterfalls where I pray or meditate. For me, I know I need quiet. Therefore, I cut down on ALL the noise in my life, real and cyber. I monitor very carefully the degree of energy I am expending, especially if it involves any degree of negativity. I end my day in quiet prayer time or mediation. I ask for the things I need: strength, courage, calm, and trust. I release the things I cannot control, turning them over to my Higher Power.

Aloneness Care

During the surgery to remove the skin cancer in my most recent occurrence, there was extensive tissue which required removal. Therefore, a skin graft was needed. In addition, an extender was implanted under my scalp. When the skin graft healed, the extender was filled several times in order stretch the skin on my scalp which had hair. My most recent surgery involved removing the extender and replacing the skin graft with no hair with the stretched skin with hair. Although I was hoping not to have two surgeries this time around, Dr. T and I discussed this possibility before my first surgery. Having two major surgeries so closely together, the feeling of aloneness is still with me.

Being vulnerable is never easy. Laying on a gurney, stark naked under a flimsy hospital gown, magnifies the emotional exposure. Two weeks ago, as the surgical team moved into full preparation mode and my husband kissed me goodbye, I embraced the aloneness. I closed my eyes and Leaned Into My Source. The comfort my spirit sought was there. The peace was there. I was ready. I did not feel alone.

After-Care

When I return home from any kind of treatment, I also take care of my spirit. If there has been a significant procedure or operation, I make certain I have planned for this during the Pre-Care phase. Once again, because I know how important quiet, still, alone time is for me, I take care of obligations ahead of time and clear my calendar for as many days as needed. As I do during Pre-Care, I Lean Into My Source by spending time in prayer or meditation. However, during the After-Care, I focus on being grateful. I am mindful of all the blessings in my life and I nourish my spirit with positive healing thoughts and energies. Many times, I work quietly in my office, writing. It is a healing tool and it soothes my spirit.

As you face your challenges, in health or any areas of life, embrace the love, comfort, and quality care which are available to you. And as you prepare for your moments of “aloneness,” Lean Into Your Source, allowing your spirit to rest in the arms of an eternal companion.

Lead With Integrity

Integrity has several definitions. However, the one explanation which resonates for me as I continue my journey with skin cancer is the following:

Integrity is a state of being whole.
This is important. Read slowly, aloud.
Integrity is a state of being whole.

When I think about a state of being whole, I think about the connotations of “wholeness.” I think most of us tend to think that wholeness is perfection. For me, it is not. Wholeness is a desired state. Wholeness requires an ongoing process of working through loss, regret, disappointment, and many other emotions which accompany chronic or episodic health issues. However, it is our choice if and when we move toward wholeness. I have found that I can Lead With Integrity, in a state of being whole, only if I have addressed the brokenness which is weighing me down.

For example, over the past dozen years in which I have navigated the more serious nature of skin cancer on my scalp, there have been times where I felt angry and sad. I was angry over the fact that for over thirty years I have taken really good care of my skin. I have stayed out of the sun. I’ve done what I was told to do. And, the skin cancer resurfaces. I have been sad over the loss of my hair and disappointed in my appearance. Often times, I have felt as though my body was betraying me.Therefore, throughout the various treatments, I have taken time to grieve the losses and release the resentments. I let them go. I did not stay there. I moved out of a mindset of brokenness.

At this stage and age in my life, I want to spend as little time as possible in a state of despair. It is not helpful. It is not healing. It is not how I want to live my life or how I would want it to end. For me, when facing chronic health issues or other challenges, it is absolutely forgivable to slide into those periods of sadness, loss, and self-sorrow. It is unforgivable to stay there.

If you are finding yourself in a mindset of despair, know that it is understandable and expected. Take time to grieve your losses. Take care of any regrets or resentments. As you clear out the broken pieces, feel peace and acceptance take hold. Lead With Integrity. Let it be your legacy.

Love Yourself Along the Way

As we bring Embracing a Mindset of Self-Care to a close, it is important to note that by implementing each of the previous four areas: Listen and Learn; Life Differently and Intentionally; Lean Into Your Source, and Lead With Integrity, we are Loving Ourselves Along The Way. At the same time, because each individual is so unique with various accompanying health challenges and complexities, it is critical to incorporate practices into our lives or engage into activities which tend to our needs in very personal and meaningful ways. With so many aspects of our lives out of our control, we can have a say in how we enrich, nurture, and pamper our beings.

In between my two last surgeries, I had a three month break. My husband and I were able to do some traveling. However, the time I most enjoyed was spending time with my daughter, her husband, and her two adorable pups. My daughter and I took long walks with the dogs and enjoyed lengthy conversations. We swam in the pool (covered with UV hats) and made delicious dinners together. After discussing our outfits and dressing up, we enjoyed a few dinners out. One day, she and I pampered ourselves with a spa splurge. Mostly, I cherished each and every moment with her. Being able to spend time with my daughter is a way of loving myself.

Whatever is on your bucket-list or where ever you want to go, no matter how big or how small, if it is within your means do it. I have found that when it is not within my means, there are plenty of simple yet soulful substitutes.

You are not being selfish by embracing a mindset of self-care.
As you love yourself along the way, you will have more of you for you.
As you love yourself along the way, you set a living example for others to do the same.
As I live with skin cancer, I will continue to embrace practices which augment my healing. I hope my messages of self-compassion and self- care will enhance your journey and encourage you to do the same.

Publisher’s Note: Holli Kenley is an American Licensed Marriage and Family Therapist and the author of “ Daughters Betrayed By Their Mothers: Moving from Brokenness to Wholeness” and “Power Down & Parent Up!: Cyber Bullying, Screen Dependence & Raising Tech-Healthy Children