After reaching the highest ranks of the U.S. Army, retired Maj. Gen. Vincent Boles suddenly found himself facing an enemy he didn’t know: skin cancer.
It started last October with what looked like a pimple on his scalp a few inches above his left eyebrow. Boles would routinely get dry, scaly patches and acne on his head so he didn’t think much of it.
But the spot, which started out a reddish color, began to turn dark brown and grow very quickly. It was bumpy and had an irregular shape.
Boles, who regularly appears on TV news shows as a military expert, noticed the makeup staff had to use increasing amounts of cosmetics to cover “this thing.”
“That’s when I began saying something is not right here. It’s not getting any better. It’s not responding to any kind of an anti-acne treatment,” Boles, 67, who lives in Madison, Alabama, told TODAY.
“It kept growing and I couldn’t mask it anymore.”
It was impossible to get an appointment with a dermatologist last fall, so Boles went to his primary care physician for help. A sample taken from the spot in December and sent to a lab for analysis confirmed it was melanoma, the deadliest form of skin cancer. Frighteningly, it began growing again immediately after the biopsy, Boles recalled.
Up to 25% of melanomas are found in the head and neck region, according to the National Library of Medicine.
Studies have found scalp melanomas are more aggressive, can more easily spread to the brain and have mortality rates more than twice that of melanoma located elsewhere on the body.
There are more blood vessels and many lymph nodes in the head and neck, which may make it easier for melanoma to spread if it begins in this region, the American Academy of Dermatology noted.
A spot on the scalp is often hidden by hair, which can lead to a late diagnosis when the disease has already spread. Hairdressers are often the first to point out a suspicious mole on the scalp — a place where many people simply don’t look when they check their skin. It took one woman’s tall husband to discover her scalp melanoma.
Boles doesn’t have hair on his scalp, so he noticed the suspicious mole fairly quickly. It took two surgeries in January to remove as much of the cancer as possible. When doctors checked the lymph nodes in his neck, only one of them contained a microscopic piece of the cancer, he said.
A skin graft from Boles’ thigh was used to cover the missing flesh on his scalp and he’s learned how to use makeup to conceal the scar, “but it does look like a divot has been taken out of my head,” he noted.
Because the margins were not clear even after two surgeries, Boles had to undergo follow-up radiation therapy and will receive immunotherapy treatments until the spring of 2023. He’ll also undergo regular PET scans to monitor for any cancer.
While Boles is optimistic about his prognosis and grateful for his “phenomenal” medical team and health insurance, he was caught off guard by the psychological impact of being diagnosed with skin cancer.
“I’m a military guy by nature — when a threat comes up, we just respond and deal with it. (But) I wasn’t ready for the emotional aspect of this,” he said.
“I found that was a really a challenge that I had to work through. Reaching out to friends, finding friends who were willing to talk me through it and talk about it… you can feel very alone if you let yourself.”
He got through the difficult time with support from his family and “a great deal of exercise.”
Melanoma is an enemy, so if you are worried about a suspicious spot, the the sooner you get it checked, the sooner you can act on it and defeat it, Boles urged others in military terms. The longer you put it off, the less flexibility and fewer options you have, he added.
And don’t forget to protect your scalp from the sun. Many people just don’t consider it, dermatologists worry. Always wear a hat or apply sunscreen — the spray-on kind may be less messy for the scalp. Seek shade and avoid the sun during the midday when its rays are the strongest.
A. Pawlowski is a TODAY senior contributing editor focusing on health news and features. Previously, she was a writer, producer and editor at CNN.
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