Susan Tannura grew up soaking in the sun. She spent her summers working as a beach lifeguard, and recalls long days lying out in the sun.
"I was always the kind of person who had to have the best tan," she said. "You always look better with color."
Her quest for the constant tan continued into adulthood. A few years ago Tannura bought a convertible to get an extra dose of sun on her way to work. She loved spending all of her free time with her husband and two children at their backyard pool.
Then, in May 2007, at the age of 38, her dermatologist found multiple suspicious lesions on her face and referred her to Dr. Anthony Tufaro, a surgical oncologist and plastic surgeon at The Johns Hopkins Hospital in Baltimore.
CLICK HERE for behind the scenes videos, doctor profiles and patient updates.
It was Tufaro who biopsied the lesions and diagnosed her with basal cell carcinoma, which is not only the most common type of skin cancer, it is the most common form of cancer overall. Basal cell carcinoma grows slowly but can spread if ignored for several years. Left untreated, it can do a lot of local damage, penetrating below the skin into the bone or nerves.
Tufaro told Tannura that he needed to operate on her.
"It's five separate malignancies on your face, so left unchecked, these will grow and become problematic," Tufaro told her.
On the day of her surgery, Tannura worried what she would look like after the lesions were removed from her face. After the operation Tufaro admitted that initially, she might taken aback by the scars.
"Now she's got a bunch of scars and incisions, so no matter how good it looks to us, it's going to be devastating to her," Tufaro told ABC News.
As a reconstructive surgeon, Tufaro's goal is to not only remove the cancerous lesions, but also to make her scars barely noticeable.
"No matter how you try to masquerade these things, she has a lot of incisions," Tufaro said of Tannura's face. "I can place the scar in the right position so it will animate well, meaning it will go with a natural crease. A thin white scar that is flat will not attract attention, but if it's raised or depressed or doesn't animate properly, it will get your attention and you'll keep looking at it."
According to the American Academy of Dermatology, it is estimated that more than one million Americans develop skin cancer ever year. Tannura was diagnosed with basal cell carcinoma, but doctors warn that over-exposure to the sun can lead to other more dangerous forms of skin cancer, such as squamous cell carcinoma and malignant melanoma.
Squamous cell carcinoma, the second most common skin cancer, often appears as a bump or red, scaly patch on the face and can spread to other parts of the body. Squamous cell carcinoma is generally the result of sun exposure, but according to the American Academy of Dermatology it can sometimes occur as a result of chronic wounds or damage to the skin.
Malignant melanoma, the rarest but most dangerous type of skin cancer, accounts for the overwhelming majority of skin cancer deaths. Melanoma often begins in or near a mole and early detection is essential for removal in a curable stage.
According to the American Melanoma Foundation, one American dies from melanoma almost every hour. Sunscreen as well as limiting time spent in the sun can help prevent melanoma.