Dancer Cancer, Part One

Hopping on 1 Foot

by Najia Marlyz
posted June 26, 2011

Maybe there was a life lesson in all of my dread in August of 2008; perhaps there were several — it remains to be seen. My “truly bad adventure” began on a scenic California beach, where I was walking along the water’s edge with my long-time friend and former dance student, Lillian Lehman. Lillian, whether she likes it or not, has become my role model in her retirement years. She had raised a large family of six children and accomplished many things in her own youth, but the part of Lillian that has grabbed and held my attention is the way in which she has re-created herself during her retirement years, becoming a fine arts sculptor. The woman has a gift, a talent that she is now exploring, and I have been inspired repeatedly by her ability to start life anew.

When I first met Lillian back in the ’60s, and in the ‘70s became her dance teacher, who could imagine that the tables would turn and she would teach me? Moreover, she would help save my life with her sage advice.

Now, Lillian lives within walking distance of the long sandy beach near Bodega Bay with its wind-blown dunes of fine white sand, and she can view the Pacific Ocean from the front window of her home.

I was delighted to go to visit my friend for a couple of days and enjoy the peace, quiet, and inspiration of the artistic environment she has created there. As we walked along the beach that foggy August morning in 2008, with the cold foamy waves washing in and out over our feet and ankles, I mentioned to Lillian that I had an annoying “dirty-looking spot” on my right foot. I told her my story about how I had spilled my coffee on the kitchen floor and while wiping up the mess I had made, I noticed a spot on my sandal, wiped it away, and then noticed a small splatter of it on the top of my right foot. I had tried to wipe it away, only to find that it did not wipe off. It looked like just another large freckle (about the size of a one-carat diamond, I gauged). I had been aware of a round brown spot minimally for a long time and was quite annoyed that now it looked more like a splatter and it made my foot look dirty when I wore my dance shoes in the studio.  It also was noticeable while I wore my sparkling ballroom shoes for cabaret dancing.

Lillian said, “I’d have that looked at if I were you; it could be something dangerous.”
“Really?” I asked, “It seems too small and flat to be anything important.”
“Well, I have had a little incident with skin cancer, and you should just make an appointment and get it out of your mind,” she said. “If it is anything, they can just remove easily it while it is small.” 

Previously and coincidentally, I had scheduled an appointment with my general practitioner within a few days for my blood pressure check; so while I was there, I showed my offending foot-splotch to him. I was almost embarrassed to take up his time with such a small mark and commented that I knew how vain I sounded, but I did not like the “dirt-mark” on top of my right foot.  “Oh, I am sure that is nothing,” he said. “It is really small, but there is a well-known dermatologist just down the street. You can have him look at it and then you can forget about it. I’ll give you a referral.”

So down the street I went.  The dermatologist looked at it and said, “Humm… I don’t like the looks of that; I am going to biopsy it.”  “When?” I asked. “Right now!” was his answer. Lightly, he rubbed it with some anesthetic and used a stainless-steel thing that looked like a little potato peeler, peeling a narrow swath of flesh off the top of my right foot.  Foolishly, I thought that that would be the end of my annoyance, but I noticed that a darker spot was still there, beneath the deep little shard of flesh he had removed.

Still, I was confident that there would be no further problem and that I was letting my vanity get the best of me. By wanting to look good, I had caused all my own discomfort, I reassured myself. He said I would have the biopsy report in a few days and to call my referral doctor to hear what the UC San Francisco laboratory report said.

In four weeks, I returned to my general practitioner to weigh-in and have my blood pressure checked again and my doctor, an optimistic minimalist, looked at my file and said, “I see there is a lab report here that says you have a little cancer there on your foot.” I couldn’t believe that my biopsy had turned out such a hideous diagnosis! The Big C? On the top of my foot? A dancer’s foot? It was too much for me to digest and I must have appeared not to care because, uncharacteristically, I was speechless. My world seemed to shift beneath me as I took his referral to a specialist in skin-cancer surgery in a neighboring city, and my doctor urged me to “take care of it right away.”

It seemed that my perspective on all things was changing rapidly! My thoughts drifted back to a late dance colleague named Sula whose studio was in Walnut Creek, CA. She had created the “Bellydancer of the Year Pageant”. I remembered that her dance teacher and mine, Bert Balladine, told me that she had checked into the Kaiser Permanete Hospital there to have a Melanoma cancer removed from her thigh, and while there, she had died of an organ failure. I had attended her funeral, wondering why such a seemingly small thing had become overpowering and snuffed out her life so early. I became extremely apprehensive about my own prospects for having a future but was fortunate enough to have a compassionate dancer in my clientèle, Khalilah, who volunteered to drive me to my first dreaded appointment with the Walnut Creek skin surgeon. 

I am most grateful that she did because she calmed me and, most probably, saved me from a terrible traffic accident because I was in no shape to drive myself anywhere. These generous moments of giving mean so much when one is frightened!

The doctor’s referral was to an expert surgeon in Walnut Creek who had a reputation for doing “Mose” surgery (microscopic layers of removal with a minimal amount of scaring, each layer removed is inspected on-site until a safe margin of depth is reached) on skin cancer patients. We sat in his waiting room with about ten other patients, most of them with cumbersome bandages on their ears or noses.

“Now for a little bad news,” he said when he first saw me, “You have the most dangerous type of skin cancer called ‘Melanoma’; so we have to get it off of there as soon as possible. It is not advisable to do the Mose surgery because that could allow cancer cells to escape into other parts of your body.  We are going to do a regular surgery here in my clinic next week.” I began to develop an unsettling sense of urgency, but even then, while wrapping myself in shaky denial, I thought, “At least it won’t be in the hospital where Sula died.”

My surgery was scheduled within the month to allow my biopsy wound time to finish healing. I received the information that the surgeon would not be closing the surgical wound for over a week while the flesh he removed was sent to the UC Laboratory in San Francisco for analysis to see if there were sufficient cancer-free margins to provide for safety. If not, he would have to cut more tissue away.

By the end of the week after my surgery, I went back to the surgeon for the wound closing procedure, feeling confident.  My surgeon explained that–though my wound was small (only about a centimeter)– because it was on my foot where much flexibility is demanded, (especially in dancing) he would have to do a skin graft, taking flesh from my upper thigh.  I was beginning to have visions of Dr. Suess’ “Cat in the Hat” in which the pink goo became spread all over everything.  It seemed to me that every move I made, this “little dirt splotch” problem kept growing larger as I attempted to get rid of it. Now I was going to have a four-inch square on my thigh to heal as well as having my foot in bandages.

Never have I felt such pain as when they stitched my foot closed, debriding the wound after only one week’s healing! That, alone, should have told me that altogether, things were not going to go well for me!

The assistant surgeon sewed up my thigh after removing about four square inches of skin for the graft and she sewed it over my foot wound. She bandaged it, gave me instructions for self-care, and sent me on my way with instructions not to get my surgery site wet. Have you ever tried to bathe without wetting one of your feet?

Of course, I did not have the antibiotic cream I was supposed to apply to my surgical wound nor did I have the pain reliever, so, even though it was raining, I had to stop by my busy, not-so-friendly Walmart pharmacy on the way home with one bare foot wrapped in bandages. The pharmacist advised me that he would have my prescription ready in about forty-five minutes to an hour, and since there was no place to sit down, I hobbled around the huge box store with its dirty floor, trying to feel brave but wishing for home and a warm bed–or at least a place to sit.

I thought, “Of all things that could happen to a dancer, this small spot of Melanoma on the top of my foot seems so bizarre; it is causing me so much pain!”

The surgeon told me that the doctor-lore about Melanoma is that we victims probably have developed the beginnings of it by overexposure to the sun in childhood, and he had asked me about exposing the top of my feet to the sun’s rays when I was a child.  Well, I could remember only a normal amount of exposure at first, but also I recalled that one of my family’s major weekend activities was sport-fishing on the rivers, lakes, and streams of California.  Oh, of course, my mom had always made sure that my skin was protected from sun-burn by clothing and tanning oil, but not much was known that time about sun-screening lotions, etc. Perhaps here was the problem then: I usually took off my shoes in the sand and walked on the ocean beaches and banks of the rivers and lakes barefoot. In the boats, I would usually take off my shoes and drag my feet in the water. Certainly, I could have had too many of the sun’s rays pelting my skin with regularity during my early years!

Additionally, I remembered how fun it used to be to go shopping for new shoes as a child. The newest sales gadget at that time was for the child to try on the new shoes and stick his/her feet into a freely accessible X-ray machine in the shoe department. I did that many times. Sometimes, I even jumped up on the machine just to look at the bones in my feet just for fun! My bones were so awesome-looking, and peeking through my skin seemed so harmless… but I noticed that a few years later, all those machines disappeared from the shoe stores. I wondered: had I given myself this melanoma by my childhood fun, looking at the bones in my feet? Or playing in the sand? Or propping my feet up on the bow of the boat as we trawled the river?

My surgery wound (that should have healed within a couple of weeks) began to become a dancer’s nightmare!

My skin graft slowly became discolored, then turned black.  It had become necrotic! 

The only shoe I could wear for many weeks were my soft kid-leather dance shoes from Capezio and Revolution Dance-wear. Still, in all my wildest dreams, I did not understand fully how close I had come to loosing my foot from infection until my general practitioner saw it and sent me packing to a near-by sports podiatrist. The sports podiatrist wanted to surgically debride the entire ugly wound once again and start over, and had I realized how much pain I was going to experience, and for how long, perhaps I would have let him. No, I thought that the whole hateful incident would soon be over —after all, I had been healthy and resilient all of my life! I decided I could “tough it out”.

After several months of caring for my foot, and struggling with throwing out nearly all the shoes I loved and buying shoes that were “more sensible”, I finally arrived at a point at which I considered myself cured in the Spring of 2009, but even my cure has proved imperfect.

I learned from the Internet that “Once you have Melanoma, you always have Melanoma”.  It is dangerous, and there is no cure.

Melanoma appears to go away when you cut it away, but it hides in your body and can slowly develop at another site.  A Melanoma victim has to have his/her entire body inspected for new occurrences and color changes elsewhere and everywhere, yearly. To my sorrow, I learned that I would never, for the rest of my life, be able to relax from the intense fear this irregular brown spot that I had mistaken for a large freckle and then a coffee splatter, had caused me.

A helpful “friend” mailed me a magazine article that stated near the end, without compassion, that most Melanoma patients were usually dead within seven years!

Nevertheless, I slowly began to re-direct my energy back into dancing. However, the months of pain and disuse of my feet had caused me to loose my keen sense of balance, and residual foot pain made my future in the world of dance seemed clouded. Still, I believed that I could resume my teaching, and I was certain that I could drop the extra weight that the months of inactivity had piled on my frame. I began to think that since I was vulnerable to this horror and had seemingly escaped, with both my feet relatively intact, that I could simply go on a diet, resume dance and my exercise regime, and I would be good to go in spite of the seven year prediction mentioned in the article I had received in the mail.  With my yearly skin checks, as well as attention to a reasonable life-style, I planned to keep my health under control, and my dance would keep me together, mentally and physically.

It has been two years now, since the rug was pulled from beneath my dancing feet. I still cannot wear beautiful shoes or dance as I once danced, but in spite of the next pieces of further bad news I received unexpectedly shortly after I began to teach dance again, I am still hopeful and dreaming of a time when I will be able perform in public once more.

My word of wisdom to you dancers concerning skin cancer is to keep yourselves (and your children especially) slathered in sunscreen lotion or stay out of the sun… maybe both, and wear a hat in the garden!

My brush with looming mortality has stirred up all kinds of questions for me about my plans for a lifelong career in dance:

1. When is enough enough?
2. How important is the show that “must go on”? …and important to whom exactly?
3. Can a dancer be satisfied with “not doing it all”?
4. Is there life after dance?

Next, please see Dancer Cancer Part Two: Who? Me? –-Coming soon!