As told to Melba Newsome

SKIN CANCER

The freak-out: As luck would have it, the day after Suzanne Green, a 25-year-old fashion stylist, read an article on skin cancer, she found two new moles on her body. “I’m convinced that one or more of my moles has turned cancerous. It’s all I can think about,” says Green, who spent her teen years sunbathing on the beaches of her native California, slathered in baby oil. “I know I should really get them checked out, but I’m scared the dermatologist will flip out when she hears I haven’t been checked by a doctor in five years. “The advent of tanning beds in the 1980s spawned a generation of tanning addicts – the darker the better. As a result, many of those young women now fear they’ve done irreversible damage to their skin and are bracing themselves for the fallout. The reality check: The hard truth is, Green, like most women, has cause for concern. Melanoma, the most lethal form of skin cancer, is the most common type in women ages 25 to29. (Basal cell and squamous cell cancers, which are more common than melanoma, have considerably higher cure rates). And enemy number one is – you guessed it – the sun, which is responsible for 90 percent of skin cancer cases.

But don’t beat yourself up over baking in the rays as an adolescent. Instead, from now on, vow to seek shade during the sun’s most intense hours – 10a.m. to 2 p.m. – and wear sunscreen with at least an SPF of 15 all year-round. Alan Kling, a New York City dermatologist, also recommends doing a thorough head-to-toe self-exam regularly. As you can check out each mole, beware of warning signs by following the rules of A, B, C and D: Asymmetry; irregular borders; changes in color, and changes in diameter. Other telltale signs include spots that continually itch, hurt or bleed. Super-safety measure: have a spot check examination by a dermatologist once a year.

from Cosmopolitan June 2000

1) Now you are going to read a true story “I Got Breast Cancer at Twenty”. Explain the underlined vocabulary in English.

After Sarah Aschenbach had

a mastectomy, insensitive boyfriends

and body-image problems

threatened her happiness – until she

realized she was lucky to be alive.

When I was 20, my life seemed perfect. I was a college junior majoring in business at Washington and Lee University in Virginia and was looking forward to making good money at a major accounting firm after graduation. I wasn’t in a relationship, but I had a large group of friends and an active social life. I was also a starting player on the varsity lacrosse team. Then, totally out of the blue, I was diagnosed with breast cancer. I knew the disease could afflict women as young 30, but who’s ever heard of breast cancer striking someone who hasn’t even reached the legal drinking age? At first I was in complete shock. Later, I became freaked out by how the surgery I had to have physically changed my body. But the one thing I never expected was the psychological toll it would take on me. It turned that my emotional recovery would be the biggest hurdle of all.

Disturbing Discovery

One morning as I was getting up for class, I suddenly noticed a golf ball-size lump in the side of my left breast. It wasn’t painful, but it was tender to the touch. I had never noticed it before, so I figured that I had just pulled a muscle while playing lacrosse and it would go away in a few days. When I went home to Maryland for Christmas break a month later, it was still there. But I wasn’t worried – I never even considered that it might be breast cancer.

A few days before I was supposed to return to school, I told my mom about the lump, and her attitude was not nearly as dismissive as mine. Her family had no history of breast cancer, but my father’s did. At the time, his mother was a long-term breast cancer survivor and his 52-year-old sister, my Aunt Joy, was in remission after having a lumpectomy and chemotherapy several years earlier.

Mom immediately made an appointment for me at the George Washington University Breast care Center in Washington, D.C. I agreed to go to appease her, but secretly I thought she was making a big deal out of nothing. When we got there, the doctor took great pains to tell me that the chances of a 20-year-old having breast cancer were very slim – women in their 20s account for only 0.3 percent of all cases. He said that the lump could by a cyst caused by too much caffeine, but because of its large size, he insisted that I have a biopsy, which was scheduled for three weeks later.

Back at school, I kept my friends and roommates totally in the dark about everything that was going on. When they asked me why I was going home again so soon after Christmas break, I lied and told them I needed a minor operation to remove some scar tissue. I felt embarrassed about the whole thing, and it seemed stupid to get everyone alarmed fro no reason.

Putting Life on Hold

The biopsy took place early in the morning. I woke up in recovery several hours after the surgery feeling angry, cranky, and desperate to get out. Simply being in a hospital had forced me to consider that maybe something was wrong after all. But I would have to wait two days for the lab results to come back to find out for sure. When I returned home from an errand on Monday afternoon, my mother’s face said it all: I had cancer. Suddenly, instead of parties, classes, and lacrosse games, my life would be consumed by doctors, hospitals, surgeries, and treatments. And what if none of it worked? My friends would finish college and move on with their lives and leave me behind. What had I done to deserve this? Supposedly, if you exercised, ate right, and took good care of yourself, this wasn’t supposed to happen. I did all of those things and still got cancer. It seemed so unfair.

But I didn’t really have much time to feel sorry for myself. The surgery was scheduled for Saturday morning, just five days after I heard the bad news. I had two options: have my breast removed and if the cancer had not spread everything would be over or have the lump removed, undergo chemotherapy, and hope for the best. My Aunt Joy had gone through chemo, and having watched her suffer with bouts of nausea and hair loss, I was convinced not to go that route. I chose to have my left breast removed – a drastic option that also seemed like the best chance for a quick recovery, which is what I wanted more than anything.

My doctor suggested that I have my breast reconstructed at the same time as the mastectomy – it would mean one less operation and I wouldn’t have to see myself with only one breast, which might be traumatic. When I met with the plastic surgeon, I refused to agree to the reconstruction unless he promised I could return to lacrosse right away. “You’re dealing with a life-threatening illness and your biggest concern is playing lacrosse?” he asked impatiently. True, I loved the sport, but also I loved what it represented – being normal and healthy.

The next step was deciding what kind of reconstruction to have. The doctor could not use fatty tissue from my backside because I was too thin, and all the news reports about the dangers of silicone implants frightened me, so I chose a saline implant. The doctor explained that most of the operation would take place immediately after the surgery, but the nipple would have to be reconstructed several months later after the swelling had gone down.

The five days between the diagnosis and the surgery dragged o n. My friends and family tried to keep me busy and I put up a brave front, but I was terrified. I’d never even thought about getting old, and now I was confronting the fact that I could die. I cried myself to sleep every night.

Not quite Whole

Saturday afternoon, I awoke from the four-hour surgery to find my breast gone and a new one in its place. Four days later, we found out from the lab report that the cancer hadn’t spread, so I wouldn’t need any further treatment. My mom wanted to open a bottle of champagne, but I was too nauseous and I didn’t really feel like celebrating. I was ready to put the whole incident behind me. Little did I know, I was only beginning the healing process.

My parents urged me to get counseling. I agreed even though talking about my cancer each week did not seem like a good way to move on. I tried several different counselors but couldn’t relate to any of them – the women were much older and the men seemed like they couldn’t understand. Each time I walked out midway through the session, feeling worse than I had before I went in. Soon I stopped going altogether. In retrospect, I realize that I was angry I had to deal with this at my age, and no counselor could have reached me.

When I returned to school two weeks after the operation, I was greeted by a group of incredibly supportive friends. I was a little weak from surgery, so people would offer to do my grocery shopping or laundry, but I’d usually turn them down. I wanted to prove that I could manage on my own. I also grew tired of people asking “How are you?” I always said that I was fine and changed the subject. But I was not fine.

My reconstructed breast was uncomfortable and felt very different from the other one. I hated looking at myself nude and dressed for lacrosse practice at home to avoid changing in front of my teammates. I had always been insecure about my body, forever wanting to be thinner or fitter. Having the mastectomy multiplied those insecurities tenfold. I overcompensated for losing my breast with compulsive exercise, spending a lot of my free time in the gym after lacrosse season ended. At least the rest of me will be perfect, I reasoned. I also stopped going out socially and completely lost interest in guys. How could I be with anyone when looking at my own body caused me so much pain?

After a second surgery in June to reconstruct my nipple using skin from my bikini line, I spent the rest of the summer working for the LPGA (golf) tournament. I loved being outside and meeting professional golfers, so when they asked me to stay through the fall semester, I jumped at the chance to take a breather from college. During the previous semester, I came to realize that I no longer wanted to be an accountant. After facing death, I could not imagine spending my days locked in a cubicle crunching numbers.

Making My Way back

I needed time to figure out what I really wanted to do with my life. Then something happened that would start to change my negative feelings about myself. One night I went to a friend’s Christmas party and met this great guy named jay. “We clicked instantly and dated for about two months before things got physical. Though I dreaded it, I knew that if we were going to sleep together I would have to mention the mastectomy. After days of agonizing, I finally told him one night while we were at my house watching television. “About a year ago, I was sick,” I said, as tears rolled down my face. “I had breast cancer and had to have my left breast removed and reconstructed.” His response was perfect. “This only makes me think more of you,” he said. “Now I really see what a strong person you are.” Jay’s sensitivity was a tremendous boost to my self-confidence. Throughout our eight-month relationship, Jay never gave me indication that the mastectomy mattered in the least. At first I felt uncomfortable when he touched my left breast, but he acted as if there was no difference between the two. A year and a half after my surgery, I finally began to feel more comfortable with my body.

Unfortunately, not every guy was as mature as Jay. After we broke up, I encountered more than a few jerks. “I don’t know what to say to that,” one guy said after I told him about my ordeal. There was no “I’m sorry” or “How are you doing now?” - Nothing. He wouldn’t even talk about it! When he stopped calling shortly afterward, I was crushed. This never would have happened if I were whole, I told myself. For a long time, I believed I should accept that kind of treatment and be grateful to whoever wanted me.

Then something horrible happened that really changed my perspective. Three years after my operation, my Aunt Joy died. She had been a very caring person – she really understood what I had gone through- and I loved her deeply. When I was diagnosed, she spent a lot of time talking to me and telling me that I’d be fine. Suddenly, with her gone, all of my fears about dying came rushing back. But my mother and doctor reassured me that my aunt and I had two entirely different kinds of breast cancer. That was when I recognized how lucky I was to have survived.

That acknowledgment helped me to accept myself – scars and all. It also helped me change my attitude about relationships. Telling guys about my medical history is still hard, but it’s become a kind of litmus testto weed out the jerks. If a guy freaks out or stops calling, good riddance. I know there are other great guys out there who can make me feel pretty, confident, and sexy.

Getting breast cancer has changed my whole perspective. I’m less concerned with what others think of me, and making a lot of money is way down on my list of priorities. Life’s far too short to delay happiness for a job that isn’t personally rewarding. After I finished college, I coached high school lacrosse. Eventually I went to work as a real estate broker, which allows me to set my own schedule and spend a lot of time outside, which is something I insist on being able to do. I also go to local high schools to speak about my experience. I’m still obsessive about my body, but now I’m also more appreciative of it. When I was diagnosed with breast cancer, I really thought my life was over. Now I’m reminded that it’s only just begun.

From Cosmopolitan June 2000

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