I’ll admit that I’m a serial hobby quitter. You can ask my parents to see the home video of my one and only synchronized swimming performance (yep), or about the expensive tennis racket collecting dust in the garage, or even about the Fender Strat (long since bequeathed to my brother, who also has no clue how to play it) they gave me when I duped convinced them no, really, I was going to stick with guitar lessons. For about a year, I was a blogger. And then, in 2010, I quit that, too. But maybe if you’ve been around these parts of the Internet for a while, you might know me as Law School Wife.
Today I’m a happy wife of a law school graduate, and things are going pretty swimmingly if I do say so myself. But there’s another hobby long since quit that keeps on giving and I wish it wouldn’t. The spring and summer of my junior and senior years of high school, I tanned in a tanning bed. I might have even been a tanning bed addict, which is a real thing you guys. I know it’s stupid and vain, but I loved being tan. The bed took me to a whole new level of tan-ness in quick 20-minute doses- more than what I could achieve under the sun, and in my impressionable, not-fully-formed mind, that meant more hotness. Freshman year of college I found a couple more brain cells and never again set my size 9.5 foot in a tanning salon. But you know, you can’t drop your skin like a once (barely) loved tennis racket.
When I was 22, I suddenly had cystic acne, mostly on my face, sometimes on my back. It was embarrassing. Not quite pizza face embarrassing, but it was more than enough and could be physically painful. But, having been down Vanity Street before, I thought seeing a dermatologist for acne was vain—and 22-year-old me was above that. Eventually, though, having spent a ridiculous amount on ineffective drug store products, I decided I could reward myself for being a non-vain, very responsible 24-year-old woman by having my acne seen by a dermatologist only after having scheduled my first annual skin cancer check.
Funny aside: When I called to schedule a skin cancer check one day in early October, the receptionist told me “we don’t have a screening appointment available until January.” I said, “Ok…I’ll take it. I also want to see someone about my acne.” The receptionist then said, “How does next Tuesday sound?”
I’m not going to go into all of the scary details, but suffice it to say, had I listened to everyone (and there were a lot of people) who told me it was silly and paranoid and hypochondriac-ish of me to go in at my young age for a skin cancer screening, I could have full-blown skin cancer right now. What I really want you to know is that if you had asked me to show you my five most concerning moles, I would never, ever have thought to show you The One. It’s not enough to show your GP one or two moles you think are funny. It can’t be self-selected. You need an expert look over every last inch of you. Do yourself a favor—if you’ve never been, call up a dermatologist and schedule an annual skin cancer screening.
I’d apologize for being a little melodramatic, except that skin cancer is the most common cancer in the U.S., and melanoma is the #1 cancer in young adults 25-29. So think about it like this: that beats out cervical cancer, and you probably don’t make it a habit to miss your pap smears, do you? In my mind, an annual skin cancer check is just like a pap smear—it’s all about prevention. The chances are excellent that you are perfectly fine. But why not know for sure, or catch something before it’s something bad? Since my first skin cancer check, I’ve been religious about keeping my annual appointments, and have had to have several more biopsies. None have been as scary as The One, but all were atypical and I’m more than happy to have them (painlessly) sliced out before they have the chance to jeopardize my health. The good news—if you make that phone call—is the five-year survival rate for patients who catch and treat their melanoma early is almost 100 percent.
There are so many things most people don’t know about sunscreen—it is not proven to prevent skin cancer! for real–here’s a second source!—and skin cancer, and I only have the space to point you to a few good resources. Please take a few to check them out.
I hope my story stays one of prevention, and I hope you do yourself a favor.
Brittany is a former blogger and reformed tanning bed addict trying to decide when mid-twenties stop and late-twenties begin. She’s happily married to her high school sweetheart (and you can bet he’s had a skin cancer check) and is a new dog mom to a Sheltie—actually, her dog has a mole she thinks should be checked.
It’s also important to note that contrary to popular belief, melanoma does not only strike those who are former sun-worshipers. I have never used a tanning bed, never laid out in the sun to tan, and in my 28 years of summers, have never, ever, even just once, had a sunburn. And yet three years ago, I underwent surgery to remove melanoma on my foot.
EVERYONE, whether you have a history of tanning or not, should be seen by a dermatologist for checks, starting in your 20s. There is no excuse — to me, it’s as routine as seeing my dentist every 6 months and seeing my gynecologist every year.
Is that the kind of thing that should be covered by insurance? How do you talk to doctors about getting tests/exams that they aren’t already concerned about giving you?
I grew up without insurance and as a result I really don’t know how often you’re supposed to get preventative care of various kinds. To me, seeing the dentist ever is a new concept, and the insurance I have now said a pap smear every 3 years, not every year, is appropriate at my age. Nobody has ever suggested skin cancer screening for my age group. They bug me about chlamydia screenings specifically but I had to ask about a general STD panel.
A couple of years ago, I went to see a doctor about a freckle that seemed to be spilling out of its normal contour. He said it was probably nothing to worry about, wait and watch, and I’m not concerned anymore because it hasn’t changed since then. But during the course of the exam he said it’s very very unlikely for someone as young as me (then 19, now 22) to develop skin cancer. I get the impression my insurance, at least, is not that interested in screening lower risk populations, I hate over-the-phone bureaucracy, and I have no idea how much medical care costs out of pocket – besides which, this might not be the only screening I don’t know I should be getting. How can I deal with all that and feel confident that I’m getting the care I should be?
I’m glad you are reaching out and trying to tackle the mountain we all call “health insurance” which can be so intimidating some people never reach out. I’m sorry you’ve had such a tough go of getting routine screenings. Typically general dental insurance will cover 2 cleanings & a check up a year and medical insurance should cover an annual pap smear if your doctor says it is medically necessary (family history, past results, etc.) If health care reform isn’t replealed by the Supreme Court, next year your insurance must offer, at no cost to you, routine screenings that include well women visits (pap smears), STD screening, breastfeeding support and services, domestic violence screening and services and FDA approved birth control. As far as skin checks go, the general rule of thumb is to get checked out (by a dermatologist) every year, but if you have a few good check ups & low risk factors your doctor might tell you to only get checked out every few years- yay!
If you have an HMO insurance plan, you should call your general physician’s office and ask for a referral to a dermatologist. Be friendly but firm, tell them you have a mole or freckle that is bothering you and you want to have it checked out. If you have a PPO or EPO then you can contact any dermatologist in your network (you can find this online) and call and explain you are a new patient and you’d like to set up a full skin check up.
If you ever come across something your insurance won’t cover you can ask your doctor’s office for a price list. You can often speak with the finaicial person at the office to set up payment plans, cash payment discounts and even income based price reductions to make sure you can afford the care you need.
I hope this helps- I’d also recommend checking out the HHS (health and human services) website which contains a plethora of information for consumers.
Wow thank you for so much information! I’m a college student and my parents got some insurance right at the end of high school, so I have resources now but have to learn the new habits kinda on-my-own, plus I am less familiar with my own insurance than I could be because the campus health center is so much more convenient for physicals and day-to-day issues. I hear about so many tests and conditions and I’d like to believe a doctor would recommend it if it was a good idea, but I don’t want to slip through the cracks.
Just remember you are your only advocate and if something doesn’t feel right then speak up – and if your general practioner doesn’t seem responsive to your concerns and questions, remember you can ALWAYS change doctors until you find one you are comfortable with.
Everything Daisy suggested is spot on. While getting reimbursements back from insurance companies can be a nightmare, I’ve never had difficulties calling my insurance company directly and asking who I can/can’t see under my coverage. Call your insurance company and say you want to see a dermatologist for a skin check and they will tell you if you need a referral from your PCP or if you can just make an appointment, and how much your copay will be. If the doctor who said it was nothing to worry about wasn’t a dermatologist, I’d still recommend seeing one if your insurance company will cover it, which they should, although you may need to get a referral first. As the original poster mentioned, often times the moles/freckles we aren’t worried about are the ones the dermatologist will immediately spot as potentially problematic.
Regarding pap smears, that’s the new national standard — every 3 years for women in their 20s. A giant cohort study found that cervical cancer for younger women is very slow growing, and many abnormalities repair themselves while you are still in your 20s. There were a lot of false positives and repeat pap smears, so the number was increased from every other year to every 3 years after a normal pap smear, so you’re insurance is following national standards of care in that instance. You should still see your gynecologist yearly, though — they’ll still poke around to ensure everything looks/feels normal, even without a pap.
Hi K–I don’t know all of the ins and outs of insurance (that is an understatement!) so I can only speak to my own experience: with my PPO, I pay a regular copay of something like $40 for the visit and it does not require a referral (I think HMOs require referrals?). I have pretty bad insurance (no maternity, vision or dental, very high deductible), but a screen is covered as an office visit since it’s really not a special procedure–it’s just a highly skilled set of eyes examining every inch of you. My biopsies were about $180 each because I hadn’t met my deductible (which is a good thing, even though $180 isn’t exactly cheap). Unfortunately it might require a phone call to your insurance to see what is covered. Or you could try calling a derm to see what they say. The good news is that free skin cancer screenings are available across the country. I’d google to see what is available in your area.
If you have a spot you’re concerned about, I encourage you to pursue a dermatologist (or a free screening from someone specifically trained to identify skin cancers). My derm tells me that the story she hears most often when making a cancer diagnosis is “my regular doctor told me it was nothing.” I say this not to scare you about yours, but to say that GPs and family doctors might not detect a skin cancer early enough (even though they are great, necessary doctors) because it’s just not their specialty.
And while it is unlikely for a young woman to be diagnosed with skin cancer, it’s more common now than cervical cancer (pap smears have dramatically reduced the rates of cervical cancer) and much more common than breast cancer at such an early age, and everyone (doctors, insurance) supports regular screening for those.
One other thing I wanted to add: If you have a clear skin screen, your might tell you that you will not need one annually. In this case, you’ve established a baseline so you’ll be more aware if something is new or has changed, and can rest more easily that you have and/or will receive the care you need when you need it.
A good friend of mine just lost his brother to melanoma earlier this year. He was only in his 40′s. Very scary and very sad.
Remember your A, B, C’s:
A= Asymmetry – if you drew a line in the middle of your mole, both sides with be identical
B= Border – moles should have a clearly defined border
C=Color – moles should be uniform in color
D=Diameter – moles should be smaller than an eraser head
I’m a regular dermatologist goer because I have a terrible family history of skin cancer. Last month I had my first pre-cancerous spot removed and my derm is watching a few other places. I’m 26.
I went into more detail on my blog. Here’s the link if you’re interested: http://lifelovelibrarianship.com/2012/05/skin-cancer-scare/
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