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Are You At Risk For Skin Cancer?
Dr. Jami Miller, the Director of the Dermatology Residency Program and Phototherapy talks with Teera Wilkins about skin cancer and it’s risk factors.
Teera Wilkins: Welcome to this edition of the Vanderbilt University Health and Wellness Wellcast. I am Teera Wilkins with Occupational Health Clinic. I have Dr. Jami Miller the Director of the Dermatology Residency Program and the Director of Phototherapy at Vanderbilt here to talk about skin cancer. Dr. Miller, studies have shown that skin cancer is the most common form of cancer in the United States. Can you please just start by telling what is skin cancer?
Dr. Jami Miller: So Yes. Skin cancer is the most common form of cancer in the United States. Skin cancer is like any other cancer and that it is an abnormal growth of the cells and in this case the cells of the skin. We think of it in two main types. There is the kind called melanoma which most people have heard of and is the worse type of skin cancer and then there is the non-melanoma skin cancer, some of which are not too much of a problem and some of which also you know can be every bit as dangerous as melanoma is. We do know that in most people skin cancer is caused by sun exposure, and the very least sun exposure plays a very significant part in the development of skin cancer. So, the people who tend to be most likely to get it are people who have had a lot of sun and who have very light skin, so, light skin, especially light eyes, those are the people that have a higher risk of getting skin cancers. Also, if you had more than five blistering sun burns in your lifetime, and I am not talking about just a little sun burn, I am talking about the big blisters that many of us know about that does increase your risk of skin cancer as well. It is the most common cancer in the United States. Over one million Americans will be diagnosed with the kind called a basal cell carcinoma this year. Luckily, the basal cell carcinoma does not pose quite a danger to people’s health as the other types of skin cancer because that kind just grows right where it starts. It can be destructive to the cells around it, but in general, you remove it and it is gone. Whereas the melanoma what we think of is the most dangerous type of skin cancer. There are a couple of others that are a little worse, but those are extremely rare. Melanomas also can come up in sun exposure again, and again, the people who tend to get them are those who are lightly skinned, who have a lot of moles, and about one in three melanomas comes up in a pre-existing pigmented site, so a dark place that can be something as benign as a freckle that can turn into melanoma or a regular mole, but again that is only one out of three, so that does leave two out of three melanomas that come up in skin that has not had any dark places on it at all. People who need to worry a little bit more about all skin cancers are those again who had a lot of sun, again who are lightly complected, but also people who have a family history of skin cancer. Again melanoma, if you have several people in your family who have had melanomas, then you are at a much higher risk than anyone who has not had a family history of melanoma.
Teera Wilkins: How often or who should be screened for skin cancer?
Dr. Jami Miller: Well a dermatologist would probably argue that everybody should be screened for a skin cancer, but in general, you can start with your primary care doctor. If you have never had a skin problem, and especially if you are kind of olive complected or more darkly complected, you are significantly at lower risk of getting skin cancer. So, it is probably good just when you see your primary care physician every now and then ask them to look you over. If you have any places that you are worried about or that your primary care physician is worried about, then they will ask you to see a dermatologist. It is never a bad idea to have at least one checked that should allover by a dermatologist and then you and your doctor can decide how often you need to come back. If you are somebody who has got… your skin has no evidence of sun damage, you do not have very many moles, then you may need to come back maybe every few years whereas if you are a person who has already had some skin cancers, you know you have got badly damaged skin, and you know everybody in your families had trouble, then some people even have to come in every couple of months to have looked in and to have even their precancers taken care of.
Teera Wilkins: Can smoking have an effect on the skin?
Dr. Jami Miller: That is a great question. It is under some debate. There is no question that smoking affects the skin and smoking definitely causes wrinkles. Next to the sun, smoking is the next most common thing to give you severe wrinkles, and I think we have all seen the patient with what we call smoker’s skin. It is very very leathery and what the smoking does is it decreases the oxygen to your skin and it actually generates free radicals within the skin that makes that happen. It has never been a 100% proved that people who smoke have more skin cancers than people who do not smoke, but there is no question that people who smoke when they get a skin cancer they tend to be a bit more aggressive. When you have them removed, they do not heal as well and take a lot longer to heal than someone who does not smoke. In fact, your surgeon who removes the skin cancer may ask you to stop smoking for 8 weeks beforehand because even 8 weeks helps the skin to repair itself better. So, it is always best not to smoke anyway, but it definitely does affect the skin.
Teera Wilkins: Thank you for taking time and actually you have just given us a better clear understanding of skin cancer and the different effects of it has on us. Thank you.
Dr. Jami Miller: Thank you.
Teera Wilkins: Thank you for listening. Please feel free to leave us any comments on this Wellcast on the form at the bottom of this page. If you have any story or suggestions, please email us at healthwellness.vanderbilt.edu or you can use the “Contact Us” page on our website at healthandwellness.vanderbilt.edu.
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