Like countless other sun worshippers who flock to the beaches for their vacations, New Jersey native Jennie Caprio always spent summers at the shore working on her tan. But what Caprio and others perceived as a healthy glow turned out to be just the opposite. In 1973 a dermatologist diagnosed a freckle that had appeared on the side of her nose as basal cell carcinoma, the most common form of skin cancer. Some 500,000 Americans are treated for basal cell annually, as President Reagan was in 1985 and 1986, and Mrs. Reagan in 1982. Ninety-five percent of those cases are caused by chronic overexposure to the sun—whether on the part of beachgoers or people with outdoor occupations, such as construction workers or farmers.
Though the disease is preventable (from infancy, sunblocks and protective clothing are recommended) and easily treated in its early stages, Caprio, 47, suffered dearly. Over a 12-year period, during which she was treated by four different doctors, her cancer recurred twice, eventually requiring the removal of the lower part of her nose, which was later restored through reconstructive surgery.
A divorced mother of two sons, Caprio is vice-president of her family’s textile firm in Paterson, N.J. She spoke with Assistant Editor Bonnie Johnson about her experience.
My skin cancer first appeared 14 years ago at the end of the summer. I noticed a tiny freckle on the left side of my nose that hadn’t been there before. It was completely flat, and after a while it turned from light brown to black. So I called a dermatologist, someone I found in the Yellow Pages. He looked at the spot and said, “I think it’s skin cancer. You should have it removed.” Before I could get to a plastic surgeon, the spot began to bleed.
I was terrified, but the surgeon didn’t explain anything to me. He strapped me onto a table, gave me shots in my nose of a local anesthetic and started cutting out the spot. I think he cauterized it, too, because I was feeling little electric shocks. When he was finished he bandaged my nose, which was throbbing. I went back a week later to have the bandage removed, and for the first time I saw I had a pea-size indentation. The doctor told me he thought he had removed the cancerous skin. When I asked him about going in the sun, he said, “Don’t get paranoid, just put some lotion on.”
Since no one said the sun was responsible for my cancer, I continued sunning myself. I suspected it might have been the cause because of an article I had read, but I guess I didn’t want to admit it. I was far more concerned about the dent in my nose. Even before the operation I was never satisfied with the way I looked. That’s probably why I spent so much time trying to get a tan. As teenagers, my girlfriends and I would go to the shore, slather ourselves with iodine and baby oil and just bake. Everyone did it. If you weren’t tan, you were out of it.
In 1978 the cancer recurred. The skin on my nose started to get dark again, and then it began to bleed. I was frantic. I wasn’t fearful for my life, only that I would be disfigured. This time I went to a specialist in Manhattan who had been recommended by a doctor friend of mine. He said he could get rid of the cancer through radiation. I went for 10-minute treatments for seven days. It was like getting an X ray, but my nose began to look as if it had a burn on it. It blistered and oozed, but it had to be exposed to the air to heal, so I couldn’t cover it. Finally a scab formed and when that fell off, a white scar remained. The doctor told me to cover up in the sun, which I did.
My husband, Nick, and I got divorced in 1981. It was a very hard time, so I took my children to visit relatives in Arizona. I would sit under an umbrella with my hat on and zinc oxide all over me. One day I looked in the mirror and saw that the tip of my nose was livid. I became very anxious, but I stayed there several more days. As distressed as I was, I didn’t see a doctor. I guess I didn’t want to know the truth. It wasn’t until at least two months after I got home that I went back to the specialist. He said, “It’s cancer again,” and took a chunk of my nose for a biopsy.
In the week that it took for the results to come back, I found another doctor, Perry Robins, who was more sympathetic. Dr. Robins is president of the Skin Cancer Foundation, the only national organization concerned solely with this problem. He explained that I had basal cell carcinoma, which had been caused by years of exposure to the sun. He said he would remove the cancer using the Mohs technique. That’s a procedure in which they take a thin slice of tissue and send it to a lab where it is checked for cancer. If there are any cancer cells present, they take another slice of tissue. They repeat this until no cancer cells show up.
The surgery was done on Dec. 1, 1981. I’ll never forget that date. I arrived at the doctor’s office at 8 a.m. They gave me shots in my nose to deaden the pain and then took the first slice from the tip. An hour later they gave me more shots and took more skin. That happened three more times. The bandages were getting bigger, and the pain was getting worse. I didn’t look at myself, but under the bandage I could feel that my nose was getting flatter.
I cried all the way home and all that night. I couldn’t believe this was happening. As the anesthetic wore off, the pain became excruciating. I kept asking myself, “Why all this pain, what did I do?” I’m Catholic, and I felt that God must be punishing me for having been so vain. Even though we were divorced, Nick came home to take care of me. Dr. Robins taught him how to clean the wound and change the bandages. When Nick first saw my nose he didn’t flinch. He said, “Oh, that’s not bad.” I hadn’t looked at it yet, but I knew he was lying to be nice.
Two days after the surgery, I went back to work. At first nobody would make eye contact. Finally I said to the man who runs our shipping department, “Buddy, you can look at me. I’m the same person.” Sometimes strangers would come up to me and say something stupid like “What happened, were you in an accident?” But everyone else just accepted it.
It wasn’t until two months after the surgery that I looked at my nose for the first time. My first reaction was, “Oh, my God!” Then I decided not to let it get me down. We had begun using skin-toned bandages and, by that time, were applying them cleverly enough so that they weren’t that noticeable. I always made sure the rest of me looked perfect. I spent a lot of money on clothes and put a lot of time into my hair and makeup.
I had always planned to have reconstructive surgery, and 10 months later Dr. Robins said I was ready. I went to Dr. Daniel Baker, a Manhattan plastic surgeon, who at first was reluctant to do it. He explained that they usually take skin from the forehead to graft onto the nose, but that because my forehead was small, it presented a problem. I was heartbroken. I explained to him that I didn’t expect to wind up looking like a beauty queen, that I wasn’t expecting miracles. Despite the problems my case presented, he agreed to do the surgery.
The reconstruction was done in two steps. The first operation was called a scalp flap. They made an incision from behind my right ear to the top of my head, bringing the front of my scalp forward and attaching a patch of skin from the side of my forehead to my nose. It had to stay like that for about two weeks in order to allow the blood vessels to start regenerating. Two and a half weeks later, I had the second operation. This time they replaced the skin that had been taken from my forehead in the first procedure with a skin graft from behind my ear. Then they sewed my scalp back in place. Despite the pain, I recovered quickly and 10 days later went home from the hospital. My nose was swollen, but it was okay. It was a nose.
In the past five years I’ve had several more operations, mostly to reduce the visible scars. I’m still very self-conscious about them. I’ve been dating a man now for a couple of years. We met at a party, and then he called to ask me out. On our first date I was frantic about the way I looked. I knew he had already seen me, but I was convinced that he hadn’t really seen my nose. I wanted to explain to him about the scars, but he said, “I think you’re beautiful—I hadn’t really noticed them.”
I never sit in the sun anymore. If I have to go out, I always wear sunblock, a hat and long sleeves. I also go back to Dr. Robins once a year for a total body check of my moles, birthmarks and the like. I lecture everyone—my family, even strangers—about the sun’s dangers. But it’s hard to get the message across. People don’t believe it can happen to them. They often say what I said when I first learned I had it: “Skin cancer? What the hell is that?”