19 August 2007

factoid of the week: skin cancer

as i believe i mentioned in an earlier post, i've been making an effort to pay attention to material i come across during my studies that piques my curiosity or interest. i'm calling these little nuggets "factoids," for lack of a better term.

this week's factoid proved more difficult to study than i'd anticipated. it all began while i was studying the dreaded brachial plexus in lab on wednesday. our group went to look at this meshwork of nerves in one of the cadavers. it was the first time we'd seen one of the cadavers face up this year. for whatever reason, it's more difficult to see the ventral side of these bodies than the dorsal side. our group took it in stride, though, and began to make sense of the mass of nerves in the cadaver.

it's hard to tell what's what in a cadaver. the preservation process they undergo leaves the tissues looking rather like thanksgiving turkey meat--for the most part, all the tissues are the same color, and they're dehydrated, so they're not always in the same position as one would expect them to be. it takes quite a while to learn how to appreciate the difference between an artery and a nerve, as you can imagine--both look like beige string.

as we were reviewing the nerves and arteries in the brachial plexus, though, we noticed a large, brownish-red mass on one of the nerves. 'strange.' i thought. 'that shouldn't be there.' then as we were digging around in the cervical area, we found more of these masses. as we went through our studies, i wandered around to view the rest of the body, and then it hit me: this was the cadaver that had died of cancer. skin cancer, to be precise. the masses we saw were metastases. and they were spread *everywhere.*

friday, as i was sitting through yet another exceptionally droll administrative lecture, i went to a blog i'd heard mentioned on dr_couz's blog (gotta love the blog chain effect!) written by a woman with melanoma. in it, sarah, a woman who was born the same year i was, describes her battle with cancer. her blog is stunning. i highly recommend you read it, from beginning to end. now.

sarah's blog sent me to another, living with melanoma. between the two, i gained a whole new perspective on what it must be like to be a cancer patient, particularly a young one. some of what they experienced overlaps with my experience, and likely the experiences of anyone who has faced a chronic disorder that requires careful and consistent management; but their experiences run deeper than i could've ever imagined. i never really thought about what it must be like to live with a disease that you can literally watch eating you alive. i also had no idea it could spread so fast....

and that's what brings me to post about what i've seen and read: it's clear to me now that the signs of disease can be extremely subtle and that we need, more than ever, to pay attention to our bodies. i don't mean to suggest that we all become hypochondriacs--that would be counterproductive. but rather that we take time to really look at our bodies, to check in with them, to observe change over time, etc.

i read a post back in july by kevin_m.d. that, well, frankly pissed me off. it basically suggested that breast self-examination is a worthless tool for the detection of cancer. the post and linked article angered me not because i doubt the stated statistics, but rather because it implies that women should ignore their breasts. the trouble with this is that society tells us--particularly those of us who are women (and i say this not to be sexist, but i noticed that nobody's done a study on the efficacy of testicular self-exam in men*)--that we're not supposed to be in touch with our bodies.

doing breast self exams may or may not allow women to detect possible malignancies earlier than they would be detected by other screening measures. but they do give women permission to pay attention to their breasts. (you'd be surprised at how many people are afraid to look at their bodies--this concept of it being okay to look at oneself wasn't fixed with hand mirror parties in the late 60s, believe me.) and one bright physician, dr. christiane northrup, extends the concept further. in her book, women's bodies, women's wisdom, she recommends what she calls a "monthly self-care ritual." the concept is that a woman take time, once per month, to examine her whole body. the idea is not to look for tumors or cancer--the concept is to appreciate one's body and learn how it feels when it's well. When we're informed about our bodies--their anatomy, physiology, and their innate unique personal quirks--we're more in tune with them, and we're more likely to notice changes, good or bad!

i assert, as well, that such a monthly screening ritual is not just for women. men would benefit from doing this, too. again, not to seek out disease--but to know wellness.

my factoid for the week was melanoma. my message(s) for the week? wear sunscreen. learn from the experiences of others. get to know your body. touch yourself! i promise you won't be sorry.

as one of my professors said this week: the lecture is over. now go learn something! :-)

* yes, i did look it up on PubMed, in case you're wondering.

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a little disclaimer...

i'm a medical student. just a student. so please, don't take anything i say too seriously. remember that i was an english literature major as an undergrad, so there is much fiction to be found in these pages. do you think i'm telling a story about you or your illness? more likely, you're tapping into my sense of "everyman"--that is, your story resonates with what i write here because it's not so uncommon after all. need help? please, please go see your physician. <--i'm not her. yet. ;-)