Being diagnosed with skin cancer can leave you feeling devastated, terrified, and isolated. This is especially true for the many black patients who struggle to overcome challenges such as delayed diagnosis, difficulty in finding medical providers of color, racial bias by physicians, and dermatologists who are not trained to recognize and treat skin cancer on black skin. These obstacles, along with exposure to racial prejudice in everyday life, make it especially difficult for black people with skin cancer to feel empowered to stand up for themselves.
Such was the case for Tracy Johnston, a 38-year-old black woman from Los Angeles. Johnston developed a small spot on the bottom of her foot, which she dismissed as a mole. But over time, the mark turned from brown to black and began to widen.
“I showed it to my mother, and her reaction almost scared me,” says Johnston. “I knew immediately something was off and begged me to see a doctor.”
After a biopsy of the lesion, Johnston learned that what she thought was a harmless mole was stage 1 melanoma, a rare form that makes up only 5 percent of skin cancer cases but has a lower survival rate than other types.
“I felt lost. Everything I knew was real turned upside down, and I was waiting for the biggest emotional roller coaster of my life,” says Johnston.
Facial challenges after diagnosis
Immediately after her diagnosis, Johnston felt so emotionally crippled that she put off seeing her doctor again for about two months.
“I just got married and finished graduate school. I was due to start a new job a week after I was diagnosed with skin cancer. But I shut down. I quit my job. I quit life. I felt helpless and hopeless,” says Johnston.
Johnston’s response is not uncommon, says Leisha Edwards, coordinator of cancer support groups at Core Church in Los Angeles, and she’s seen similar reactions from other cancer patients. There is often discussion about the physical toll that cancer and cancer treatments can take on the body, but the mental and emotional toll is often overlooked, says Edwards.
Johnston eventually decided to see her doctor for a follow-up appointment, and her doctor referred her to a dermatologist who specializes in treating skin cancer, particularly melanoma.
“I was very depressed and frustrated. But after meeting with the dermatologist, I suddenly felt better. I was relieved that we had a plan, and she was very positive about the prognosis,” says Johnston.
Johnston’s dermatologist explained that she felt confident her melanoma treatment would be successful by removing the remaining lesion and a portion of the surrounding healthy tissue. Johnston was still scared and weary, and although she was beginning to feel somewhat more optimistic about the future, she continued to struggle with feelings of isolation.