I am so doomed

As the sunshine gets hotter on the Mid North Coast of NSW, Australia, we get more and more paranoid about it. I got a first hand experience of this paranoia this Monday morning when I showed up at work with my forearms pink from getting mildly burned (gasp!) while walking this weekend. Getting burned is something I diligently try to avoid but hey, it happens. Expecting a lecture on sun safety and attempting to avoid one, I wore a high neck top but my bare arms still showed the tell-tale signs of my weekend indiscretions. The practice nurse took one look, threw her hands in the air, did the tsk tsk tsk, demonstrated the sun damage on her legs while hysterically enumerating my future ails. My raised eyebrow did nothing to quell the outpouring of the well-wishing criticism: “These young people think they are invincible… Skin cancer… How could you… A smart doctor…”

Eventually we switched to the topic of her weekend which was marked by a birthday celebration. The nurse proudly announced that she “ate too much and drank too much” and is feeling decidedly sick this morning. It took all my willpower NOT to point out that a weekend of junk food and alcohol probably carries a higher risk burden to your health than a weekend of walking out in nature, even if accompanied by mild sunburn.

This incident really drives home how we see melanoma. We zero in on one risk factor (“it’s the Sun, stupid!”) and ignore all others. However, we seem to be a lot better at understanding that for other cancers a variety of genetic and environmental influences is at play.

Somehow I don’t think I will ever see this conversation:

– I had a lovely dinner last night: a delicious lamb roast and a glass of red wine.
– Oh my god, you should not have done that. Don’t you know that alcohol gives you breast cancer?
– But I just had one glass with dinner.
– Yeah, but alcohol is a risk factor for developing breast cancer.
– But surely, a risk factor is not the same thing as the cause.
– It totally is. It pretty much means that if you have alcohol you are a reckless ignorant individual willingly putting yourself in harm’s way.
– But I am aware of the risks and benefits of red wine consumption and I am also an adult. I think I can estimate my own risk and make a rational decision.
– No you can’t. Let me show you post mastectomy images to horrify you even further. These women had been thoughtless like you, exposing themselves to alcohol when they were young. And that’s how they got cancer.
– But aren’t there other risk factors?
– Don’t be ridiculous.
– Do I even know you?
– …..

Pretty sure somebody will get punch out in this scenario. But somehow it’s ok for total strangers to share their unasked opinion when it comes to melanoma. If you want to replicate this experience I recommend that you paint yourself red and then go to work, go shopping, go to a café or see your family. And note every time you get told off for your recklessness and your upcoming demise.