Brown skin too: get tested
Tereska James has a message for people of colour: put on the sunblock, slip on a hat, seek out the shade — it's a myth that being brown will protect you from skin cancer. Her family found out the hard way in September 2015, after doctors discovered her sister, Tanya Haman, had stage four melanoma. Within two months, she was dead, aged 44.
“It had already metastasised to her brain. She went through chemotherapy and radiation, but the cancer was so aggressive and the tumours were very aggressive and the treatment did not ward off the path it was on,” said Ms James, who started the Brown Skin Too Foundation in response. She will share her story tomorrow at a talk organised by the Bermuda Cancer and Health Centre.
According to the cancer charity, Bermuda has a higher incidence of melanoma than elsewhere. And because people of colour are more likely to find out they have the disease in its later stages, they have a lower survival rate.
“I remember growing up I was told I didn't need SPF or sun cream because of the melanin in my skin,” said Ms James, who lives in Delaware. “I have a lot of friends who are part of the diaspora, family in all parts of the world, and that's the message we all grew up with. You think you're immune but, while somewhat a preventive measure, it doesn't fully prevent you from getting skin cancer.
“Almost four years [since starting Brown Skin Too], I still come across people who are shocked that people of colour can get skin cancer.
“That's most shocking when you think about the amount of information that's out there.
“I think a lot of that comes from if you're not seeing someone who looks like you who has been impacted by this disease, then the message misses you.”
Ms Haman fell ill over Labour Day weekend. Doctors told her that the headaches and vomiting were likely caused by a virus and that she needed rest and fluids. The day after the holiday she got into her car to go to work — and couldn't start it.
“She called my mom, who got in the car and started it perfectly fine,” Ms James said.
As it turned out, her sister had lost all feeling in her right side.
An emergency room scan identified cancer. A week later it was diagnosed as melanoma stage four. “The shock, of course, was that it was at that advanced stage,” Ms James said. “When we heard melanoma, we took pause: skin cancer?
“Black people don't get skin cancer. When she initially lost feeling, we thought she had a stroke.
“Never in a million years would we have thought skin cancer.”
That her sister “was religious about using sunscreen on her son and herself” only added to the family's confusion.
They learnt that sun exposure is responsible for about 90 per cent of skin cancers, but not all.
“Other factors could be involved, such as genetics, if there is a history of skin cancer in the family, which we actually didn't have,” Ms James said. “That's the mystery of the disease.
“We know using a tanning bed is bad, laying out in sun and getting sunburned is bad.
“But for black people, when skin cancer is diagnosed, a lot of times it's not where you would think to look for it.
“It's usually in places not exposed to sun — in the middle of toes, fingerbeds, even genitalia.”
The more she read, the more she understood just how “dire” the situation was.
“I realised, wow, there is nothing that we can do to change the course of her outcome,” said Ms James, a marketing executive who put her 20 years of experience to work for Brown Skin Too. “After she passed away, a few weeks later, I told my mom we have to do something to let people know of this disease and how it can impact people of colour.
“I did not want another mother, daughter, son, family member or friend to go through what we went through for a disease that [has a survival rate of] 100 per cent when caught early enough.
“Recent studies show the incidence of skin cancer has increased — part of that is because people are becoming more aware; more people are going to get checked.
“With people of colour, typically [their GP] would not recommend a skin check unless it was something obvious.
“Skin cancer is not very high on the priority list especially when you're talking about the prevalence of big cancers that are more prevalent in our community.”
Brown Skin Too holds an annual workshop for children aimed at making sun protection a habit even when parents don't teach its importance.
“If you live in an area where you're exposed to sun on a daily basis, if you've grown up in that environment and not been impacted [you might say], ‘I've got this far and I'm OK why is this message important to me?' But if you believe in global warming, the UVA and UVB rays are getting stronger.
“Going forward, the ozone layer is depleting and how those rays impacted in the past is becoming even stronger.
“It calls for even more protection. If you're not taking care of your skin then at some point your skin, is going to start showing you the effects of you not taking care of it. Do it, if only just for vanity's sake.”
• Hear dermatologist Deborah Daly and Tereska James, founder of the Brown Skin Too Foundation, speak at the Bermuda Underwater Exploration Institute tomorrow at 5.30pm. Admission is free. For more information: www.brownskintoofoundation.org; www.cancer.bm