Tuesday, June 23, 2009

Beyond Surviving

“Human beings are designed to survive.” That is what I learned in a recent seminar that I participated in. The message was basically that our instincts would guide us in fight or flight or other responses needed to survive whatever situation we find ourselves in. On one side of the coin, this is a comforting thought—survival is the norm, and we will take action instinctively when our safety and well-being is threatened. It is nice to know we don’t have to stop and think in the face of danger, but just trust our automatic reactions. But in another sense, “surviving” is kind of a mediocre standard to set for our lives.

After my last column on survivorship, I was talking to some other cancer survivor friends who question the widespread use of the term as somewhat limiting. Hmmmm. I had never thought of it that way. While survivorship can be empowering as I hypothesized in May, it can also be limiting. When you are fighting for your life, surviving is certainly optimal, but once the immediate danger has passed, don’t we all yearn for something more?

I love the Sugarland song titled just that—“Something More.” The lyrics go: “There’s gotta be something more, gotta be more than this. I need a little less hard time, I need a little more bliss. I’m gonna take my chances, taking a chance I might find what I’m looking for. There’s gotta be something more. I could work my life away, but why? I got things I wanna do before I die.” Listen to the song here.

It is so easy to become complacent in life, accepting the challenges as they come, and “surviving” on a day-to-day basis. It reminds me of the first line from the book Good to Great by Jim Collins, “Good is the enemy of great.” So many of us settle for good, when our lives could be great, even extraordinary! Why? Because we are designed to survive. Taking the chance, as the lyrics mention, entails risk, and that could threaten our survival. At the very least, it feels dangerous to step outside the comfortable box we have created for ourselves.

My previous column on Security dealt with this theme. My cancer diagnosis freed me in so many ways from needing the stability and security I had previously pursued. Once you face your own mortality, and recognize that there is really no such thing as security in life, you realize that taking the risk to do something new can be the most rewarding part of your brief existence. This is true even if you fail miserably. After all, you will survive.

I am drawing on the wisdom of many others in this installment, but why would I try to say it better than George Bernard Shaw did: “This is the true joy in life … being used for a purpose recognized by yourself as a mighty one … being a force of Nature instead of a feverish selfish little clod of ailments and grievances complaining that the world will not devote itself to making you happy … I am of the opinion that my life belongs to the whole community and as long as I live it is my privilege to do for it whatever I can. I want to be thoroughly used up when I die. For the harder I work the more I live. I rejoice in life for its own sake. Life is no brief candle to me. It’s a sort of splendid torch which I’ve got to hold up for the moment, and I want to make it burn as brightly as possible before handing it on to future generations.”

Most of us are so afraid to live this way. In fact, we are afraid of everything: snakes, lightning, rapists, terrorists, tornadoes, embarrassment, failure, success, vulnerability. I’m not suggesting that these things aren’t scary; only that they will be there whether we spend time being afraid of them or not. A Course in Miracles teaches us that we can live in fear or we can live in love. Which do you think is more fulfilling?

I used to spend a lot of time worrying about what other people would think of me if I did such and such—wore a certain outfit, said something stupid, behaved in a certain way. I feared judgment for the fact that I was still single, that I didn’t fit society’s ideal body size, that I don’t make a lot of money. Then I realized that what other people think of me is none of my business, and that it was silly to worry about that anyway. When it no longer mattered to me what others thought, I could feel free to share myself more openly through writing this column, having genuine and meaningful conversations with others about what really matters, and putting my feelings out there even if they weren’t reciprocated.

Living this way entails taking risks, but it offers tremendous rewards in return. Surviving is certainly better than the alternative, but what about something more? If you knew you couldn’t fail, what would you do? Can you believe that anything is possible?

Wednesday, May 27, 2009

Survivorship

Survivorship is a relatively new term in our collective vocabulary. It represents both a positive direction in medical advancements, and at the same time, a host of new long-term impacts from traditional cancer treatments as people are living longer with the disease. My friend Matt just published a great article about this on the Huffington Post.

Many people are confused about what to call themselves or others when they are diagnosed with cancer. If you just found out yesterday that you have the disease, are you a survivor today? I say absolutely YES, and many others agree with me. Surviving the diagnosis is nothing to sneeze at, and those initial days can truly be the most difficult part – emotionally, if not physically. Wrapping your head around the idea that your life is now changed forever is no small task. Staring your mortality in the face is scary.

Being a survivor and living strong are empowering. Wouldn’t you rather be called a survivor than a cancer patient or worse, victim? We can borrow some wisdom from other areas like sexual assault or other forms of abuse. Being a survivor rather than a victim is always preferable. The minute you receive the diagnosis, you are surviving cancer, and every day you keep on breathing after that, you will be a survivor. June 7 is National Cancer Survivors Day, and believe it or not, this day has been observed for 22 years now. I hadn’t heard of it until last week, which was, incidentally, my 3rd Cancerversary (May 23).

My friend Ethan Zohn was recently diagnosed with a rare form of Hodgkin's. You may recognize his name as the winner of Survivor Africa. His new status gives a whole new meaning to his moniker as a "survivor." I was always proud of Ethan for the way he played and won Survivor, and for what he did with the prize money - invested it in a non-profit he founded called Grassroots Soccer which utilizes soccer players to do AIDS/HIV education in Africa. I'm sure cancer hit Ethan especially hard since his father died of the disease when Ethan was only 14-years-old. As he has overcome other challenges in his life, I know he will do so with this one as well. Watch him talking about cancer on CBS's Early Show here.

National Cancer Survivor’s Day is an annual, worldwide Celebration of Life that is held in hundreds of communities throughout the United States, Canada, and other participating countries. Participants unite in a symbolic event to show the world that life after a cancer diagnosis can be a reality, according to the website.

I met a pediatric neurological oncologist at a 4th of July party days before I was scheduled to begin chemo in 2006. In addition to pumping him for information about my chemo drugs and what kind of side effects I could expect, I shared my awe that he could do his job day in and day out. “Working with kids who have brain cancer must be so hard,” I mused. “Actually,” he said, “it’s way better now than 20 years ago when I started – many of the kids actually live now.”

Wow! Medicine really has come a long way. Many of those kids are experiencing side effects later in life from the toxic chemicals used to treat their illness, but at least they are alive. Survivorship brings up a whole host of new issues for us to focus on, such as fertility issues for young adults, long-term side effects of treatment, emotional issues and financial ones too (all these new medical advancements cost ALOT of money). These are good problems to have because they mean that the “patient” is still alive to have them, but they need to be addressed nonetheless.

I am proud to be a survivor, and whatever issues I have to deal with pale when measured against more time with my family and friends, important work to do, writing something that might help someone else going through a challenge, and great adventures and travel to experience – the joys, and sorrows too, of life. And I can’t say enough about the wonderful people that I have met along the way on this cancer journey. It’s a club that no one wants to join, but an amazing community once you are part of it. Here’s to the survivors!

Wednesday, April 1, 2009

Thirtysomething With Cancer

Remember the 90s television show Thirtysomething? If you do, you likely are thirtysomething yourself. It was a great show about a group of baby boomers who had lived through the counterculture 60s, and were trying to reconcile that past with their present as responsible adults and parents. I was in high school when it aired, and remember watching and thinking how old thirty seemed. Now, as I approach 40, my perspective has changed a bit.

I heard recently that most Millenials think that the term “grown-up” now applies to 30 and above. To them, it is not just high school and college that are reserved for being young and wild and making mistakes, but their early twenties as well. Adulthood keeps getting pushed further and further into the future by each succeeding generation. We are lucky to have the luxury to postpone adulthood according to our timeline. We haven’t had a great depression, world war or other calamity to force maturity upon us. That may be changing.

There is a challenge facing young adults today, though it isn’t visible and doesn’t get a lot of press. It is cancer. It is the leading cause of death among 15-39 year-olds, excluding homicide, suicide and non-intentional injury. Particularly women in this age group, have a higher likelihood to develop cancer as incidence rates for women are higher starting at age 20, and for those 35-39, cancer incidence among females is more than 80 percent higher than among males. Additionally, those 25-34 face an increased incidence rate of invasive cancer. (Albritton, Caliguiri & Anderson, 2006)

While five-year survival rates have improved significantly for both pediatric and geriatric cancer patients over the past 30 years, they have not for those in the AYA group (Adolescents and Young Adults). There are many factors that impact this, including: lack of regular health screenings and the highest uninsured rate of any age group, as well as delayed diagnosis because younger people feel invulnerable and ignore symptoms, and the fact that cancer is often not suspected for younger individuals by medical professionals.

Luckily, people are starting to pay attention. There are numerous groups now advocating for the AYA community (list at the end of this article), and even a National Young Adult Cancer Awareness Week (in it’s seventh year), April 5-11, 2009. “Consider Cancer” is this year’s call to action for Vital Options International and all the advocacy organization members of the LIVESTRONG™ Young Adult Alliance with an emphasis on encouraging young adults to talk to their doctors, know the warning signs of cancer, understand what types of cancer they may be at risk for, and learn about cancer screening and healthy life style choices.

I never thought it would happen to me, and while I thought I was young to be getting cancer at 36, I now know many, many others who were diagnosed at a much younger age, including one friend who had a complete hysterectomy for ovarian cancer at age 27.

Here are just a few things I recommend to insure a healthier future:

  • Don’t forego health insurance. That time between when you are no longer eligible for insurance under your parents (usually 23) and you finally begin to feel somewhat successful in your career can be a struggle financially. On their own for the first time, most young adults are busy navigating retirement contributions, leases, utilities, and new furniture. Health insurance can seem like a logical expense to cut out when you’re young and healthy. It’s not.
  • Listen to your body. That strange ache or swelling or weird dry patch of skin could be telling you something significant. Don’t ignore it! The longer you wait to get something checked out, the more likely it is to grow and spread if it does end up being cancer. Being in a new town without a regular doctor, lack of insurance and other “excuses” can prevent you from getting help right when you may need it most.
  • Consider disability insurance. If you can’t afford health insurance, disability insurance definitely seems like a needless extravagance, but you are far more likely to become permanently disabled than you are to die from an accident or chronic illness, and if you are insured before any of these problems pop up, then you can’t be denied later, and your rates are also likely to be much cheaper.
  • Eat Right. There is more an more evidence that chemicals in processed foods and pesticides can lead to health problems of all kinds. Fast food is so cheap and convenient that it is difficult to forego, especially in this economy, but the cost of eating it could be your health. Michael Pollan says in his book, In Defense of Food, that in the past sixty years, Americans have spent the same portion of their income on two line items – food and healthcare – but the amounts have flip-flopped. As processed food has become cheaper and cheaper, healthcare costs have skyrocketed. Better to spend money on high quality, healthy food than doctors and drugs.
  • Don’t Smoke or if you already do, quit. Most of the risk factors for cancer can be controlled by our lifestyles. Exercise, eating right, getting enough sleep and controlling stress are all key, but the best thing you can do to reduce your cancer risk is not to smoke or spend time around people who do.
  • Get Screened. There are age appropriate screenings that you need to pay attention to such as colonoscopy, mammogram, pap smears and prostrate exams, and others that are dependent upon risk factors. Be aware of recommendations and get screened. You can also do self-checks at home for potential skin cancers and breast abnormalities.
Some organizations advocating for and providing services to young adults with cancer:

I’m Too Young for This
Empowering young adults affected by cancer through a weekly online radio show called Stupid Cancer, a great website full of resources, and a network of social groups across the country.

Cancer Care
Professional counseling, facilitated peer support groups, creative workshops and financial assistance for young adults with cancer.

Cancer Climber
Offering experiential and motivational adventures and excursions such as extreme mountain climbing and summit tours.

First Descents
An innovative camp experience for young adults with cancer offering kayaking, extreme sports and professional athletics.

Fertile Hope
Provides reproductive health information, support and hope to cancer patients whose medical treatments present the risk of infertility.

Planet Cancer
Award-winning young adult-focused community offering survivor retreat programs, social networking, and online forums with real world advice and inspiring stories.

Rise Above It
Provides grants and scholarships to young adult survivors and care providers who face financial, emotional and spiritual challenges.

Young Survivor Coalition
An international network of breast cancer survivors and supporters dedicated to the concerns and issues that are unique to young women and breast cancer.

Works Cited

Albritton, Karen, M.D., Caligiuri, Michael, M.D., Anderson, Barry, M.D., Ph.D., Nichols, Cherie, M.B.A., Ulman, Doug; Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults with Cancer Report of the Adolescent and Young Adult Oncology Progress Review Group; August 2006; downloaded from http://www.livestrong.org/site/c.khLXK1PxHmF/b.2662637/k.DE41/AYAOPRG.htm

Wednesday, February 4, 2009

World Cancer Day

Cancer is the leading cause of death around the world. Up to 84 million people will die of it between 2005 and 2015 without intervention, according to the World Health Organization, sponsors of World Cancer Day on February 4th. Their website states that more than 70% of the 7.6 million cancer deaths in 2005 occurred in low and middle income countries.

Reading these statistics once again made me feel grateful for the standard of care I received during my own cancer experience. I have often reflected on how fortunate I am not just to live in one of the wealthiest countries in the world, but in the city that the most people say they want to live according to a recent poll, and one that has top-notch medical treatment facilities. Even people who live in rural areas of this country have a more difficult time obtaining cutting-edge treatment.

As Americans, most of us rarely stop to reflect on just how good we have it. We don’t have to worry on a daily basis about clean water, a comfortable and spacious place to live, access to food, energy and health-care. I had the luxury during my cancer treatment, of access to reiki, retreats and programs targeted to cancer survivors, and, more recently, services for people in my specific age group. Many people in developing countries might be lucky to receive a diagnosis in time to do something about it.

Some incidents in the past few weeks have given me cause to ponder the many modern conveniences we take for granted in this country. They both make our lives easier, and also make us reliant upon them. The electricity in my condo went out for 45 minutes one night last week, and I realized how little of what I normally do was possible or convenient without it. I had just arrived home from a trip and was anxious to do laundry, make something to eat and watch a little television. Couldn’t do any of those things without electricity. It was nice to be forced to sit with a flashlight and a magazine and relax for a little while.

My experience, by any standard, was a very minor inconvenience. Just a few days later, my family experienced a much larger inconvenience, but one that even they describe as “having many silver linings,” even as they are still in the midst of it. The two-inches of ice that blanketed Kentucky and the surrounding region recently was lauded as the storm of the decade for that area the day before it hit, but I’m not sure anyone imagined just how bad it would get. Weighted down by ice, trees and power lines snapped under the pressure, and everything from roads to cell phone towers were coated with the cold, slippery substance.

Electricity was interrupted almost immediately, and for many, their main source of home heat as well. Over the ensuring days, phone service – including cell phones – would be impacted as well, and finally, even water pressure couldn’t be maintained without the electric pumps used to get the water out of the tanks and into the pipes. Even though one large tree is leaning against both of their homes, and part of one tree came through my parents’ bedroom ceiling one night as they were sleeping five feet away, my parents and sister’s family count themselves lucky. They huddled together around the fireplace at my parents’ house, and were able to cook meals on the gas stove. They had plenty of batteries to power radios and flashlights, and a neighbor who still had cell service so they could let everyone know they were doing ok. As my other sister and I kept each other up-to-date on the latest news, we marveled at how quickly the myriad communication methods we all rely upon daily can be cut off. It seems unthinkable in this day and age that we couldn’t communicate when normally there are so many ways for us to keep in touch.

Estimates are that it could take as much as a month to restore power to many, and trees still block the road-ways a week later in much of the area. My mom commented that far from being bored, it was taking most of their time just to survive. Cooking meals, chopping wood, boiling water – all tasks that might have been common in this country 50-100 years ago, depending upon where you live, or in many third-world countries even now. When I remarked to my sister that many people in the world live like this everyday, she replied, “At least they are used to it.”

Good point – and brings us back full-circle to the fact that we are both fortunate to have so many modern conveniences, and also completely reliant upon them. It is only when we find ourselves without them that we are able to fully appreciate how much modern technology brings to our lives, and how much it increases our life expectancy. Today, on World Cancer Day, I will be thinking about those who are not fortunate enough to have the standard of care that we take for granted. But in harmony with the mantra, “think globally, act locally,” I will be supporting organizations in my community that are doing their part to make the lives of cancer survivors easier. I hope you will too.

Saturday, January 10, 2009

Happily Ever After

When we were young, the stories read to us, or the Disney movies we watched in excited anticipation, almost always ended with the phrase, “and they lived happily ever after,” usually after the girl married the handsome prince and they rode off into the sunset. No wonder our expectations for love and life are so high! Happily ever after is a high standard - no fights, bounced checks, dented cars, screaming children or skinned knees - just sunshine and bliss and happiness forever and ever.

I have always felt that our entertainment was warping our view of reality. On TV and in the movies, everyone is beautiful and whatever problems they are having are wrapped up neatly in an hour (minus 15 minutes for commercials of course), their dialogue is full of the kinds of things you wish you could think of on the spot during your fight with your boyfriend, and they look better cleaning their house than I did at my high school prom.

There are studies that say people who watch a lot of TV tend to have a misplaced view of reality – feeling that the world is a more dangerous place than it is because of the violence and crime they see on the tube. For me, it has always been the opposite. I see happy people with great lives, love and talent, when I watch, and I wish my life were like theirs.

It’s easy to forget the wardrobe and makeup team and time it took to make Jennifer Aniston look effortlessly beautiful, and we rarely see the mundane parts of anyone’s life on television. No taking out the garbage, or scrubbing the kitchen floor or dealing with the clogged toilet. Their lives seem exciting and fulfilled, they rarely fight with their friends, and if they do, it’s always quickly and easily resolved.

The problem arises when we compare ourselves to the characters on television, in books or movies without the reality check of their personal trainers and chefs to help them keep in shape and eat right, and the overall fantasy of the silver screen. The truth is that behind the scenes even the beautiful people have problems and feel insecure.

We all want “happily ever after,” but there’s no such thing. Life is a journey filled with ups and downs, joys and sorrows, triumphs and disappointments. And what a boring life happily ever after would be anyway. What would life be without the occasional pain that teaches us our most important lessons? We have to be careful not to bring a happily ever after attitude to our own life events too. Weddings can be wonderful, but marriage will certainly be bumpy at best.

In cancer treatment, it’s easy to believe that life AFTER will be joyous again too. When you are doubled over throwing up or staring at your eyebrow-less face or bald head in the mirror, even normal life can seem like a fairytale. However, it takes a while to bounce back, though others in your life might not quite get that. Hair doesn’t grow back in a day, and neither does the idea that you are invincible. That might not ever return. A new perspective is born; and thank goodness for that. It can mean a new appreciation for the good things in your life, and a recognition that the challenges we feel are so insurmountable in daily life, are really not that bad after all.

Life is beautiful – and ugly, and desperate, and hard, and unfair, and peaceful, and loving, and joyous. And even if we don’t always have control of what happens to us, we always have control about how we respond. I have found that many of my biggest problems are of my own creation – they’re all in my head - and only I am capable of getting them out. Margaret Bonnano said, “It is only possible to live happily ever after on a day to day basis.” It might even be an hour-by-hour basis or a minute-by-minute basis, and when we find ourselves slipping into despair or life hands us a new challenge, we have the power to overcome it, and to find ourselves a stronger person on the other side.

Sunday, November 9, 2008

Angels Among Us

Two things prompted me to think of angels today. The first one is related to cancer, and the second one isn’t.

Imerman Angels is a non-profit that pairs cancer survivors with cancer fighters – those in the middle of their treatment or the beginning of their diagnosis. While Lance Armstrong defines a survivor as anyone who is diagnosed with cancer, from the day they are diagnosed, Jonny Imerman has to have a way to distinguish the two groups.

Diagnosed with cancer at age 26, Imerman had great support from family and friends, but never met anyone his age who was a cancer survivor while he was fighting his own battle. His own experience was the inspiration for his organization now helping so many others, and his goal is to make sure everyone diagnosed with cancer can talk immediately with someone else who is similar to them in age, gender and cancer type. These “angels” are walking, talking, living proof to inspire the newly-diagnosed that they too can beat the disease.

Jonny is the most enthusiastic, kind-hearted and loving soul you could ever hope to meet. He does his work with tremendous passion, and brings hope to so many. In that way, he is like the other angels I was reminded of today.

Matthew Shepard died on October 12, 1998, ironically, just one day after National Coming Out Day, and – unbelievably – ten years ago. At his funeral, Fred Phelps and other anti-gay members of his Westboro Baptist Church in Topeka, Kansas, picketed displaying signs reading: “God Hates Fags,” and “Matt in Hell.”

As a counter-protest, a group of supporters led by Matt’s close friend, Romaine Patterson, dressed in white robes with huge wings, and stood silently with their backs to Phelps’ crowd, making a human barrier between the two groups. This You Tube video depicts the story with great music, but many misspellings in the text.

This week as we have so much to celebrate in this country’s election of its first African-American President, we are also reminded that there are still great divisions among us. I don’t usually get political in this column, but it’s hard to ignore the divisive rhetoric whipped up by a long campaign season, and the outcome of three anti-gay ballot initiatives across the country.

Proposition 8 in California passed by half a million votes, removing the right of gay people in that state to marry. I have personally, never understood how consecrating a loving relationship between two individuals of the same sex in any way threatens the institution of marriage, and I am deeply disturbed that we spend so much time and energy on a topic that should be a non-issue - especially when there are so many important and true problems to worry about.

The labels we all wear don’t begin to describe us as individuals: Christian, gay, Muslim, Black, Republican, liberal, cancer-survivor, disabled, Latino, leader, friend, husband. Even “angel” isn’t the complete story, but a picture of a moment in time when we are at our best. I hope in time the labels won’t be necessary, and we can recognize the commonalities rather than the differences when we look someone in the eye.

I voted for Barack Obama in part because I felt he could bring us together as a country. I was convinced by his 2004 DNC speech that he would try when he said, “We are not a nation of blue states and of red states. We are the United States of America.” It is time for us all to find some common ground rather than continuing to hurl insults from the wings. I created a blog called Meet in the Middle in hopes of starting a dialogue on the issues. Join me in the middle, won’t you?

Saturday, October 11, 2008

Your Cancer Risk: How Much Do You Want to Know?

Sometimes medical advancements can give us more information than we want to know. With the discovery of the BRCA 1 and 2 genes, mutations of which are responsible for breast and ovarian cancer, women can now find out their risk of developing these two cancers. That is both good and bad news. There are many factors to consider before being tested. Is there a history of either disease in your family? Do you belong to one of the ethnic groups at a higher risk?

The test is expensive, and may or may not be covered by insurance, and there is still a chance of discrimination if you find out you do carry the gene mutation, though Congress did pass an anti-discrimination law this year to protect against this problem. Perhaps most difficult, though, are the decisions you will face if you find that you are positive. Would you have prophylactic surgeries, removal of your ovaries and breasts, to reduce or eliminate your chances of getting cancer? Many women have.

What if you are single? Want to have kids? How do those factors weigh into a decision that may save your life? It’s really an unfair position to be put into, and at the same time, gives us a new power to preserve life that wasn’t available before. One young woman, Joanna Rudnick, currently in her early thirties, documented her experience of carrying the burden of knowing, as well as that of others in her film In the Family.

The film is currently being screened at events around the country and on PBS during October for Breast Cancer Awareness Month. You can also watch it online here through the end of the month. In the film, Rudnick struggles with her own desire to have children, juxtaposed against the chance that she could die if she waits too long to take preventative measures. In her thirties and single, she hears the ticking of a potential time bomb in addition to the proverbial biological clock.

I recognized, as someone also stated in the documentary, that women and men who test positive for this gene mutation feel the same as those of us who are cancer survivors. Many of the same emotional and psychological issues apply. You are forced to acknowledge your mortality, and to make medical decisions that will “mutilate” your body, but could save your life. It is an impossible position, really.

I can understand Joanna’s need to do so much research and talk to other women faced with the same decision. Her search allows us to go along for the ride, and will help many women who are also struggling with finding their own path. At one point in the film, Joanna’s boyfriend wonders, “Does she only like me because she wants my babies, and she wants them quick?” All single woman of a certain age have probably dealt with this stereotype at some point, and those with a cancer history or probability likely feel it more acutely. As if finding the right person weren’t already difficult enough, the added pressure of a deadline is just so unfair!

I recently received my second cancer diagnosis. As always, the wait for test results can be the worst part. I knew when they asked me to call them for my biopsy results that it was “bad” news. If it had been all clear they would have just said so on the voicemail. Then when I told the receptionist my name, there was a long hold. I figured they were getting the doctor to deliver the verdict. Turns out it was a nurse.

Luckily this one was much less serious than my first. A small basal cell carcinoma (skin cancer) on my shoulder/back was dealt with in a minor office procedure at my dermatologist’s. Five stitches later, I will have a small scar, but we got all the margins, so it’s all gone this time. I have had two other scary-looking moles removed, but both biopsies were negative. This one was a tiny, innocuous-looking pink bump that I noticed back in the spring and was just too busy to worry about until fall. Meeting a melanoma survivor in July at the LIVESTRONG Summit in Ohio lit a fire under me to find a dermatologist when she told me her diagnosis began with a small pink bump on her shoulder in her early twenties.

My chances of getting more of these is higher now, so I will have to be even more vigilant about watching for changes in my skin and using sunscreen. I always figured skin cancer was in my future. I’m fair-skinned, and I life guarded for eight years starting at sixteen. I grew up on a lake, guide whitewater canoe trips, and I live in Colorado, where the elevation puts us closer to the sun’s rays and we get more than 300 days of sunshine a year.

Whether getting a genetic test or taking part in recommended screenings, there are many things you can do to reduce your risk of getting cancer. Go here to read more about them.

Find out more about genetic testing here.

Even if you missed the television event on September 5th, it’s not too late to Stand Up to Cancer. Find out how.

Watch a three-minute preview of In The Family here.