The Trumpet Medical Advisor
|To contact me, please click on my email address in blue, at the right, for any health or health related problems or questions that you have. You will get a personal and confidential response from me.||
Patricia Naeder, RN, BS.
May, 2010 Edition
UPDATE ON SKIN CANCER
The warm weather is here and it might be a good time to think about protecting your skin. Most people underestimate the cumulative effects of the sun’s radiation on the skin.
Sun exposure ,from when you were a teen, through your 20s, 30s, and beyond, is cumulative, and one day you may get one sunburn too many, or get a cold or virus, and that is enough to trigger the battered skin cells to finally mutate into rapidly proliferating skin cancer. The goal is to lower the odds of this happening.
MOST SKIN CANCERS ARE BENIGN:
1- Moles: They can be brown or dark pigmented growths. They are benign.
2- Seborrheic Keratoses: Can be tan, brown, or black raised spots with waxy texture or rough surface.
3- Hemangioma: A group of blood vessels, often called strawberry spots. Can disappear spontaneously, or have the blood flow disrupted for a cure.
4- Port wine stains or Flame nevus: Flat blood vessels under the skin that show through. Present at birth, they may disappear spontaneously. If not they can be treated with laser or sclerosing injections for cosmetic effect.
5- Fatty lipomas: Soft growths of fat cells. They can be easily removed in Doctor’s office.
6- Warts: Rough surface lesions caused by a virus. Easily treated.
Skin Cancer is the most common form of all cancers. Cancer cells are cells that do not want to stop multiplying. Benign cancer usually cannot grow into other tissues. Metastatic cancer can metastasize and invade adjacent structures, and organs. It is always best to treat these early in Stage 1.
THERE ARE 4 BASIC GROUPS OF SKIN CANCER
1- Basal Cell: They are usually are benign.
2- SquamousCell: They are usually benign but can be metastatic.
These are less common than basal cells. People rarely die of these cancers.
Actinic Keratosis is a lesion that is considered pre-cancerous. It is said to be caused by too much sun radiation exposure.
These are slow growing, small rough spots that can be pink or flesh colored. Usually seen on the face, ears, back of hands, and arms of middle aged or older people, usually with fair skin.
These lesions can go away on their own or can turn into cancer, but not often. They need monitoring for changes. You and your Doctor may opt to remove them with one of the modalities listed below.
a. Squamous cell carcinoma In Situ means that the lesion seems to be staying in place and not metastasizing. This is also referred to as Bowens Disease. This can be considered the earliest form of squamous cell skin cancer. These can be scaly reddish patches that may be crusted.
b. Bowens Disease in the anal and genital area is often linked to the virus that causes genital warts, HPV. That is Human Papilloma Virus. These warts are also known as condylomata accuminata. These can be treated with pedophylin creams. This virus now has a vaccine for prevention.
3- Melanoma develops in the skin layer that produces melanocytes. The cells that produce the skin’s brown pigment. Melanomas can be benign but can be aggressively malignant. They can run in families.
4- Rare skin cancers: These are unusual lesions that can be difficult to identify. Your Doctor will make the diagnosis. Usually a Dermatologist sees skin cancer patients.
WHAT TO LOOK FOR RE. SKIN CANCER
1- Look for anything on your skin that is new or different.
2- Do not ignore any growth that does not go away, or that bleeds over and over, or is scaly and feels like sandpaper.
3- Trust your instincts and insist on an immediate appointment with your doctor.
4- They should be caught early to prevent invasion of surrounding tissue, and for easy treatment and/or removal. There will be a greater success rate, and less scarring.
5- Basal cell: Can be flat, firm, pale, small raised pink or red. Can be translucent, shiny, waxy, and may bleed easily. Can have abnormal blood vessels, a depressed area in center or blue, brown, or black areas. Large ones may ooze or crust over. Most often found in areas exposed to sunlight like the head, and neck, but can be anywhere.
6- Squamous cell: Can be a flat, pink, or reddish, rough scaly, sandpaper like patch that grows slowly. It can be a growing lump. Usually it appears on face, ear, neck, lip, back of hands. Less often in genital area. Can develop in the area of scars, or where there are skin ulcers.
Appearance may be only a slight change from normal skin.
RISK FACTORS FOR SKIN CANCER
1- Sunlight Radiation: Damages the genes in your skin cells causing mutations just waiting for your immune system to drop so they can multiply as skin cancer.
2- Geography: The risk in Arizona, for instance, is twice that of Minnesota. Warmer climates such as shore resorts have a higher risk.
3- Fair Skin: freckled people are at extra high risk because of the low melanin level. Melanin protects the skin from the ultra violet radiation damage. The repetition of sun burn eventually causes skin cancer.
4- Men: Are at 2 times the risk for skin cancer, and 3 times the risk for Squamous skin cancer, which can turn malignant. This is thought to be because of sports such as golf, surfing, and tennis.
5- Chemicals: Arsenic increases skin cancer risk. Arsenic is found in some well- water, and in some imported products. Also found in pesticides, and industrial tar, coal, paraffin, and some types of oil.
6- Radiation Therapy: People who have had radiation treatments are at increased risk of skin cancer in the area treated.
7- A history of skin cancer increases recurrence rate.
8- Psoriasis Treatment: Treatment with traditional cream therapy, and the UV light therapy (PUVA) can increase the incidence of skin cancer.
9- Weakened Immune System: Those whose lifestyle includes high stress, daily alcohol use, smoking, low vegetable, high fat, high sugar diet, and taking no fish oil, coq10 or multivitamin daily, are battering their immune system and are at higher risk.
10- Those taking immunosuppressive therapy for organ transplants are at higher risk because the therapy lowers their immune function.
11- Human Papilloma Virus (genital warts) in genital area can increase the risk of skin cancer.
12- Genetics: Scientists find that those with pre-disposed genes are more likely to respond to intense sunburns and the high ultra violet radiation of the sun, with the rapid proliferation of cancer cells.
PREVENTION OF SKIN CANCER
1- Limit Sun Radiation time. Use a strong sun block when playing golf, surfing, tennis, walking, and especially in a pool or the ocean. Avoid sun 10AM to 4PM. Wear a baseball hat or visor.
2- Keep your body temperature as cool as possible in summer. Drink iced drinks. Apply water to your body.
3- Keep your Immune System strong. That means:
a. Keep stress down.
b. Eat triple vegetables, and fresh fruit, especially red grapes.
c. Eat a low fat, low sugar diet with fish.
d. Eat yogurt with acidophylis to keep your gastro-intestinal tract in balance.
e. Avoid high fructose corn syrup which is in soda and juices. Read the labels.
f. Get extra sleep. Take naps. Build in breaks during the day.
g. Take a multivitamin, omega 3 fish oil, and Coq10 supplement daily.
h. Drink tea.
i. No smoking.
j. Low alcohol intake.
k. Try to just live in the present. Not the past, or worry about the future.
4- Avoid getting “colds” if possible.
5- Practice meticulous dental hygiene. Many problems are caused by food left between the teeth after eating. This draws the bacteria, and even virus in. They will eat away at your gums and teeth, causing infection. Brush teeth at least 2 times a day. Rinse with hydrogen peroxide and mouth wash, especially before bedtime every night.
WHAT TO DO IF YOU ARE DIAGNOSED WITH A SKIN CANCER
1- Ask your doctor what she or he thinks it is? They will use a magnifying glass or a scanner to examine the skin layers.
2- If they suggest a biopsy. Ask which type? Shaving? Or incisional, where they remove part of the growth, or punch biopsy, or excisional, where they remove the entire lesion. Some of these procedures will leave a scar. Ask about these before proceeding.
3- If your lymph node is swollen. Ask if they’re going to do a biopsy on that too. They may do a fine needle aspiration, which leaves no scar. If the lymph node is too large or too firm they may want to remove it. This may leave a small scar.
4- The doctor will measure the lesion, take a photo, biopsy it, and send the tissue to the pathologist.
5- There are four stages for cancers. I, II, III, IV. One being the best. Depending on the containment or spread of the lesion. When your pathology comes back ask about which stage you are.
6- Now you can discuss the options for therapy.
1- Depending on the type of skin lesion your physician has some choices of treatment. Surgical excision. Basal and Squamous are often cured with excision alone. You will have a scar.
2- Some skin cancers may require follow up radiation or even chemo if there is spread.
3- Curettage and electrodessication scrapes out the lesion, followed by electric needle to destroy any remaining cancer cells. This leaves a scar.
4- Mohs surgical treatment. Removes cancer layer by layer and does biopsy until all margins are cancer free.
5- Cryosurery is liquid Nitrogen which freezes and kills the cancer cells. The area will blister and crust. It takes 1 to 2 months to heal. Leaves a scar; perhaps a white spot.
6- Photodynamic Therapy: A drug is given which sensitizes the cancer cells. A light source is applied which activates the drug which kills the cells. You need to avoid sunlight for a while afterwards.
7- Topical creams are becoming more popular. There will be red tender skin for 3 weeks. It is uncomfortable.
8- Immune Response Modifiers: Some medication can boost the Immune system response by stimulating it to respond.
9- In the same way, Interferon can be injected but may not work as well as other treatment modalities.
10- Laser surgery is being used for squamous cells that haven’t spread, and for some basal cell cancers. It uses a beam of light to kill the cancer cells.
11- Radiation: This uses high energy X-ray beans to target tumors.
12- Chemotherapy. Attacks rapidly proliferating cancer cells. Can be used with radiation.
13- There has been some use of Curaderm cream. It is conservative in that there is no surgery. It seeks out the cancer cells and spares the normal cells.
New Research is being done now for treating advanced squamous cell cancers.
Cells from these cancers have too much of a particular protein on their surfaces, which may help them grow, and multiply and do damage. Drugs that target this protein to block it are:
1- Erbiturx (cetuximab).
2- Iressa (gefitinib).
Another protein that helps cancer cells grow is targeted by:
3- Sprycel (dasatinib).
I will keep you updated on these new therapies. The American Academy of Dermatology Sponsors free cancer screenings around the country every year. Check your local newspaper to take advantage of this service.
1- American Cancer Society 800-227-2345.
2- American Academy Dermatology (www.aad.org) 888-462-3376.
3- National Cancer Institute (www.cancer.gov) 800-422-6237.
4- Skin Cancer Foundation (www.skincancer.org) 800-753-6490.
Natural Strategies for Cancer Patients by Russell L. Blaylock, M.D.
|This column is for informational purposes only, and represents the opinion, and reporting of the author only. Any discussions with the Author should be presented to your own personal Physician for his/her Professional opinion. It is not meant to substitute for seeing one's own Medical Doctor, Psychiatrist, or Psychologist for Professional care.|