The M Word

Skin Cancer Awareness

Oh my goodness, where has the month gone?  Nonetheless, as of today it is STILL May, and therefore still Skin Cancer Awareness month.  I have had the contents of this blog bouncing around my head for weeks and it is time too just type it out and post it!
Skin Cancer…  I had the privilege of giving a Lunch and Learn talk about this important topic at the beginning of the month.  Preparing for the talk required that I review all of the latest literature and reminded me that one of the most important aspects of teaching is that it gives the teacher a great opportunity to gain a greater depth of understanding.  I will post my whole power point presentation as soon as I figure out how to do it, but here are some of the key tidbits:

No surprise, exposure to UV (sun or tanning beds) is directly linked to your risk of getting skin cancer.  Basal Cell Carcinoma and Squamous Cell Carcinomas are the most common but thankfully grow relatively slowly and rarely spread or become lethal — unless you ignore them way beyond reason like the patient of mine who I talked about in my lecture and almost died from her squamous cell carcinoma that started on her neck and invaded her parotid gland and even her carotid artery!  Check out the images of basal cell lesions — they typically have a “pearly” border, sometimes a central ulcerated area and are usually a little pink.  Squamous cell lesions are usually scaly, often sort of scabby in appearance and can seem like a little non-healing bump or pimple.  You can’t actually tell WHAT kind of lesion something is without looking at it’s cell-types under a microscope and so you NEED to have suspicious lesions biopsied, or preferably just taken all of the way out/off.

Melanoma is far less common but scary because it can and does kill millions of people worldwide.  Melanoma killed my grandfather.  He had a lesion on his ear when he was in his 80’s that they cut out but did not pursue further because of his age.  Then, when he was 92, a 2 inch-sized metastatic tumor was found on his lung because he happened to get an x-ray.  Although the disease did eventually totally take over his body and killed him, he lived a miraculous two more years (his prognosis at the time was less than 6 weeks.)  I remember him telling me that he didn’t have time to die because he had so much work left to do!  At that time, they were experimenting with giving Stage IV melanoma patients a medicine called thalidomide that causes horrible birth defects.  It turns out that the medicine probably did nothing to help him fight the melanoma, but he LOVED that every month he had to sign a document promising that he was not having sex with any woman of child bearing age.  He was 95.
Surprise!  Melanoma can occur almost ANYWHERE in the body!  It is NOT directly correlated to sun exposure, BUT your risk of having melanoma is MUCH greater if you used tanning beds before the age of 30.  So, you need to watch out for strange dark lesions, not only on the exposed skin, but also in the butt crack, between the toes, even on the gums and in the eyes.  Check it out, even dogs get melanoma, sometimes on their gums! (See picture.)  

Here are the ABC’s of melanoma that you need to know and think about when you notice a funny lesion:

A – is it Asymmetric?
B – is the Border irregular?
C – is there more than one Color, or is the Color peculiar compared to other moles?
D – is the Diameter or greatest Dimension more than 1/4 of an inch (4 mm)?
E – is it Evolving or changing?

The bottom line for all of this though is that everyone should get regular annual skin checks every year with their primary care doctor or dermatologist.

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