Avoid the sun -- but not a biopsy
I'd always had a vague feeling that my mother needed to be aware of skin cancer. A redhead with creamy-white freckled skin, she was at higher risk than darker-skinned people. Years earlier, Southern California's beaches had represented pure heaven for her as a young woman who'd immigrated to Los Angeles -- a life far away from New York's gritty streets, cold winters and oppressive summers. Baby oil and the "healthy" glow of a tan were her standard summer fare.

Come 1997, when she mentioned to me that the doctor had found something called melanoma on her left arm, I reacted with some concern. She had gone to a doctor some six months earlier; that doctor had assured her, "It's nothing." No biopsy. Something we now suspect might have ultimately saved her life.

Mom lived believing doctors were all wise and could do no wrong. Six crucial months passed between this first "Don't worry about it" and a panicked, wide-area excision at UCLA. The doctor there couldn't say if he had "gotten it all" and scolded her for having waited so long. The damage was done.

And so we waited, anxious and uncomfortable, for two years. Then, during a trip to Las Vegas, Mom awoke with left arm and chest pain. At the hospital, the doctors did every check for a heart attack imaginable. They examined her up and down but somehow missed the egg-sized lump under her left arm -- at the lymph nodes. Diagnosis: No heart attack -- you're fine.

Back in Los Angeles, Mom's internist found the lump, brought her into surgery and removed 16 lymph nodes.

She did not realize it, but I knew this was the beginning of the end game -- her melanoma had spread to her lymph system and probably to the rest of her body.

Unlike other cancers, there are no effective treatments for melanoma. This disease has its own calculus, plan and schedule. Its own evil mind. As the year progressed, she felt worse, often responding to the question "What hurts?" with "Nothing, but I feel awful."

Fifteen miserable months later came the terminal diagnosis: cancer in her stomach, liver, brain and spinal cord -- the very same cancer, according to the pathologist, that had first showed itself five years earlier as a seemingly harmless spot.

The cancer had run its distance, done its intractable damage.

Our family was crushed by Mom's death -- all from a largely avoidable disease and some uncaring and inept physicians. Lessons: You'll hear it a thousand times -- stay out of the sun and wear sunscreen. Always go with your instinct and common sense. If something doesn't look or feel right, have your physician look at it now. If you don't like your physician, get another.

Don't wait. Mom waited; Mom died.

Papel grew up in Los Angeles and now lives in San Francisco. He works as a technical trainer for SAS Institute, a North Carolina software company.

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