My sister Jill lived in Shropshire, England and me in Ottawa, Canada. Despite the distance, we travelled together to various countries over many years. During our lives, we were exposed to a great deal of sun: Jill by lying in it and me from playing tennis nearly every day for 50 or more years as well as kayaking and high-altitude skiing. My sun-damaged skin developed basal cell cancers – relatively harmless. Jill’s damage led to a spreading melanoma.
For many years, she had had a brown patch on her right cheek just below the eye. It was treated numerous times over several years with liquid nitrogen. Repeatedly, I asked her to send me a biopsy report – with no response. It was some years before I realized a biopsy was never performed on her, nor had Jill ever plucked up the courage to ask for one. This procedure is routine here in Ottawa for a persistent brown spot.
In November 2005, she developed a lump in the parotid gland in her neck. This was excised in February 2006 at the Selly Oak Hospital in Birmingham, England. The lump was diagnosed as malignant melanoma. A biopsy from her cheek taken during the same surgery also showed positive for melanoma, indicating it was the primary cancer. Total body and brain scans showed several questionable but poorly defined lumps and bumps in the brain and abdomen.
In September 2011, Jill lost any understanding of numbers and, although she could see her keyboard, she could make no sense of it. A brain scan showed an identifiable lump near the surface of her brain. In November of that year, a surgeon removed a portion of her skull and the tumour was removed. This was followed by intensive radiation therapy during which her head was held tightly in place by a hard plastic cap. Afterwards, her ability to understand numbers and her keyboard returned.
Two years later, Jill had surgery to remove a large growth in her abdomen and the length of intestine to which it was attached. Suffice to say, over the next few years we became good friends with her surgeon and oncologist. They did their best to help Jill stay alive with her customary vivacity and energy. Several growths were removed from her brain; her surgeon joked that he would open the trap door in her skull each year to clean out her brain—which he did three times—and, on each occasion, remove the most recent growth.
And on the whole, she was well enough that in May 2013, she and I travelled to Turkey on an archeological expedition. In August of that year, she had even completed a difficult level of sudoku. Her life wasn’t without incident though: every few months, she would fall down, be helped up only find that she had no speech – a bit like epilepsy without the tremors or twitching. Then, after a nap, she would be ready to go again.
By March 2014, her body and behaviour began to change. She began to laugh erratically at everything, regardless of the topic, and complained that her legs felt heavy. Later in March, she needed to be lifted in and out of bed and had to be admitted into a care home. In April, she became confused at times, but still recognized her friends and family. Her legs became useless as the tumours advanced. Jill’s last few months were spent under heavy sedation but in the wonderful care of the MacMillan Nurses. She died in October 2014.
I still feel I should have been more insistent that the patch on her cheek be biopsied and tested, which would have led straight away to its removal. I like to think that situation would not happen in Ottawa and Canada. The warning I want to convey with this story is not to dally in the direct sun, but to protect yourself with sunscreen and clothing.