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Wednesday, July 26, 2017

DENNIS PATRICIK: SUMMER, SUNSHINE AND—SKIN CANCER

JIM’S TRUCKS

 

 

Cancer. This is a powerful word. The very mention of cancer raises concern and alarm. The emotional power of this single word conjures thoughts of deadly malignancies, interminable suffering and death.

Knowledge, too, is powerful. Knowing something about the type of cancer helps us deal with it rationally. This is particularly true of skin cancer. Unlike internal cancers, skin cancer can be touched and seen and, in doing so, the mystery of the unknown diminishes.

I speak from experience. My first bout with skin cancer culminated with surgery in 1977. I wish I knew then what I know now. I wish my physicians knew then what they know now.

Summer days in the sun march on. As words of encouragement now is a good time to recount my own experiences with skin cancer.

As a young adult I first noticed a red spot on my left temple but promptly ignored it. In about a year’s time the spot changed in texture and appearance becoming scaly and somewhat larger.

In the months that followed the spot grew scalier and began to “weep.” It never healed completely, a telltale sign that should have alerted me. In retrospect, I was witnessing the slow transformation of sun-damaged skin (actinic keratosis) into what became basal cell carcinoma. Various keratoses are pre-cancerous but, if allowed to continue untreated, the keratoses may become cancerous. My case was a textbook example.

During a routine exam I discussed the spot with my physician. He referred me to a dermatologist and a week later I was in surgery. The surgeon excised the rather large basal cell and then repaired the wound using a skin graft with skin taken from the area of my collar bone. That was my first, but by no means my last, encounter with skin cancer.

Three types of skin cancer may result from exposure to the sun’s ultraviolet rays. Basal cell carcinoma is the most common skin cancer. Prompt removal of a basal cell in its early stage is key to minimizing damage and scarring. Removal may include excision, as in my case, with the resulting scar. Alternative procedures may involve electrodessication, micrographic surgery or laser surgery.

Squamous cell carcinoma is the second most common skin cancer. In addition to sun damage, squamous cells can also result from burns, scars, X-rays or chemicals. Treatment is essentially the same as for basal cells. Squamous cells rarely spread to vital organs, but if they do, the results can be serious.

Melanoma, the least common skin cancer, is also the most serious and can be deadly. Initially, melanoma may resemble a mole but differs in that it may be asymmetrical, have an irregular border, have non-uniform colors and may increase rapidly in diameter. As with any suspicious skin blemish, a dermatologist should be consulted immediately. If allowed to progress, colonies of melanoma cells may spread to internal organs. Typically, melanoma is removed surgically.

In my most recent case, state-of-the-art Mohs procedure was performed to remove a very early stage melanoma. Developed by Dr. Frederic Mohs, this procedure was refined over the past seventy years. As the most exact and precise method of tumor removal it minimizes the chance of cancer recurrence while reducing potential scarring. It relies on microscopic identification and removal of cancerous growth layer by layer while leaving healthy tissue untouched.

Given my skin cancer history, regular dermatology visits are a must. Treatment focuses on identifying and eliminating the damaged skin cells before they become cancerous. Freezing the evident keratoses with liquid nitrogen is routine. A series of prescribed treatments using topical ointment containing fluorouracil may follow. The active ingredient isolates and kills the less obvious damaged skin cells before developing into visible keratoses.

People with fair skin, blue or green eyes and red or blond hair run the highest risk of sun damage. Dark skinned, non-Hispanic people are not exempt from skin damage. A serious sunburn incurred by a young person may manifest itself as damaged skin years later.

Preventing sun-damaged skin is a year-round task. The Skin Cancer Foundation and the American Cancer Society recommend the following sun safety tips:

            * Limit sunbathing.

            * Avoid unnecessary sun exposure between 10:00 AM and 3:00 PM.

            * Use sunscreens rated with a sun protection factor (SPF) of 30 or higher that protects from both UVA and UVB radiation. I use sunscreen with an SPF 45.

            * Wear protective clothing, especially a broad-brimmed hat.

            * Examine skin regularly for changes in blemishes.

            Experience is a great teacher and understanding skin cancer makes prevention a whole lot easier.

 

Dennis M. Patrick can be contacted at P. O. Box 337, Stanley, ND 58784 or (JavaScript must be enabled to view this email address).

 

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