Youth, Indian skin won’t protect you from melanoma

TAHLEQUAH, Okla. – Anyone can get skin cancer. Cierra Lynn Fields learned that at an early age.

When she was four, she was bitten by a tick behind her ear near a small birthmark. The bite irritated her so much that it bled when she scratched at it. The school nurse looked at the spot behind her ear and then called Cierra’s mother to advise that Cierra should be checked for skin cancer. It sounded crazy and impossible.

“You’re thinking, ‘Four-years-old,’ for Pete’s sake,” said Terri Fields, Cierra’s mom. “She’d been out in the sun, we had a swimming pool, but this was not what we expected.”

What everyone, including Cierra’s pediatrician, thought was a birthmark was inherited dysplastic nevus syndrome developing into melanoma – congenital melanoma. The tick bite had aggravated the skin and melanoma cells and made it more identifiable. Because of the bite and the actions of the school nurse, the family was able to address a condition that typically is discovered when the patient is a teenager.

Cancer-free for eight years, Cierra, now 13, religiously takes precautions to avoid sunburn, which can contribute to skin cancer. Because she has had it before, she is at high risk to develop it again. As a Little Miss Cherokee Ambassador, she has made skin cancer prevention among Indian people her platform.

“Cherokees, well, Native Americans in general, have the No. 1 highest death from skin cancer (among non-white people). And there’s a myth that, ‘We’re Cherokee, we can’t get skin cancer, we’re dark.’ It kind of doesn’t make any sense because, hello, you have skin. Of course you can get it,” Cierra said.

According to a study by the Center for Disease Control and Prevention, Native American and Alaska Native people and Hispanics had the second highest rate of getting melanoma, a form of skin cancer. White people had the highest incidence rate.

There is a common misunderstanding in the general population that people with dark skin are protected from skin cancer because of melanin, the pigment in the skin. The darker a person’s skin, the more melanin is present in it. Darker skin has more UV filtration capacity, but there is still a risk of damage.

Health professionals also fight attitudes in the battle against skin cancer, said Greg Bilby, public health educator and outreach coordinator for Cherokee Nation Comprehensive Health Cancer Control Program.

“A lot of people don’t realize the danger,” he said. “They think skin cancer is not that important, that breast, colon and lung cancer is more prevalent, but cancer is cancer. If you had cancer near a lymph node, it can spread throughout body” through the lymphatic system, which reaches all the extremities.

Cierra turned 5 when she was taken into surgery to remove the cancerous growth behind her ear and two lymph nodes nearby. She also took radiation pills and had frequent check-ups, but she did not require chemotherapy. She shares her experience with students and adults at presentations she makes all around the Cherokee Nation at schools and at area health care centers.

Focus in the CN Comprehensive Health Cancer Control Program is split into two directions: prevention of breast and cervical cancer and prevention of other forms of cancer, including colon, prostate and skin cancer.

In the last two months, Cierra, her mom and her grandmother, Leona Henderson, have driven from their Fort Gibson home to Jay, Tahlequah, Catoosa and other locations to add a push to CN’s campaign for skin cancer awareness and prevention.

“Slip, Slop, Slap and Wrap” translates to slip on a shirt, slop on sunscreen, slap on a hat and put on a pair of wraparound sunglasses.

Bilby said this message is important especially now as summer hits and the sun is in full force. Cierra’s presence bolstered his presentation to a key audience that can be difficult to reach.

Just before summer, “we always do a big push to encourage people to take care of their skin,” Bibly said. “Cierra was ideal (to help) because she’s so young, and that encourages, especially, young girls to take care of their skin.”

Reaching teenagers is significant to educating the population because that is usually the time when they begin tanning outdoors or on tanning beds to achieve a summer look.

At a recent talk, Bilby made his presentation. The kids, said Henderson, didn’t seem to pay much attention until Cierra stepped up. A few girls in her audience even said they planned to visit a doctor about their skin.

Cierra wanted all of the students to be aware of the damage caused by tanning under the sun as well as under a lamp. A tanning bed also emits UV rays. Tanning becomes popular as prom season draws near. Her own opinion of tanning bed use is not favorable, likening it to cooking bacon on a grill.

“That’s gross,” she said. “You look gross when you’re old, and you look leathery.”

Bilby said he notices the difference with youth, too.

“I can put up a Power Point (presentation) to show how dangerous tanning beds are to them, but when they see someone younger than them, it makes them really think about it,” he said.

Bilby became aware of Cierra and her work when he received an email about two months ago that she was collecting donations of coloring and activity books, crayons and other items for children undergoing treatment for cancer at the Children’s Hospital at St. Francis in Tulsa. Gifts of stickers, puzzles, DVDs and more in addition to the coloring books came in from CN employees, students attending Sequoyah High School and other places around Tahlequah.

When she delivered the donations to the hospital, she visited with children on IV fluids and undergoing intense chemotherapy treatment. The children were grateful for the gifts.

“It’s just touching to see how much a coloring book can make a child so happy,” Cierra said. “It makes me really glad that I didn’t have to spend any of that hospital time (for her own treatment). I could go still go outside and play.”

The children at the hospital could do nothing to prevent their cancer, but everyone, including Native Americans, can take precautions against skin cancer.

If you have a suspicious, nonsymmetrical mole that changes in color or shape, see a doctor.

Use a lot of sunscreen with at least a sun protection factor (SPF) of 15 all parts of the body exposed to the sun. Try to avoid prolonged periods of sun exposure between noon to 4 p.m., when the sun is brightest.

Use hats and try to stay in the shade.



Cierra Fields, 13, Little Miss Cherokee Ambassador, spreads the word about prevention of skin cancer. A former cancer patient herself, she shares her story and message with youth and adults in the Cherokee Nation.

KAREN SHADE | NATIVE AMERICAN TIMES PHOTO