ASL Information on Skin Cancer

Be Smart, Beat Skin Cancer

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Title Sequence

  1. I had some changes in my skin?
  2. What's the difference between skin cancer and other cancers?
  3. What happens when someone gets skin cancer?
  4. What causes skin cancer?
  5. Are there different types of skin cancer?
  6. What is Basal cell skin cancer?
  7. What does Basal cell skin cancer look like?
  8. How is Basal cell skin cancer different from the other types of skin cancers?
  9. Does skin cancer bleed or hurt?
  10. Which skin cancer is the most dangerous?
  11. What are genes?
  12. What does melanoma look like?
  13. How do we find melanoma before it spreads?
  14. Can I check my own skin without seeing a doctor?
  15. Is it really necessary to see the doctor every six months if I have been treated for skin cancer?
  16. How do I protect myself from skin cancer?
  17. Does the color of my skin make a difference with skin cancer?
  18. Is there a safe way to get a tan?
  19. If I have a family member with skin cancer am I at higher risk?
  20. Do you need to see a doctor if you have many moles?
  21. How can I avoid getting skin cancer?
  22. How much is too much sun?
  23. Will wearing a hat protect my skin?
  24. Do I need to wear sunscreen?
  25. What do the numbers mean on sunscreen?
  26. How often should I reapply sunscreen?
  27. What happens after I find a spot on my skin?
  28. Does a skin biopsy hurt?
  29. How is a skin biopsy performed?
  30. What happens if I have skin cancer?
  31. Are there different kinds of surgery for skin cancer?
  32. What is Mohs surgery?
  33. Can Mohs surgery be used on any part of the body?
  34. How long will it take for the surgery to heal?
  35. Can radiation treatments help?
  36. Is there a cure for skin cancer?
  37. What about treatments for Melanoma?
Credits

I. Introduction

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Transcript:

Welcome everyone. As you all know I’m Shari the vice president of our school’s Parent Teacher Association (PTA). I know you all read about the PTA’s parent education program about skin cancer. We tried to get interpreters for the presentation, but no one was available.  Then  I called the American Cancer Society.  You also see the organization just listed by it’s initials - the ACS.   I was pleasantly surprised to learn that one of the ACS’s  volunteer educators could do the presentation in ASL for us

I feel that it’s important to learn about skin cancer, and I thought it would be more fun to have you all come to my house.  The morning was so beautiful, I thought we should enjoy being outdoors. Of course, we’re going to stay under this tent, so we don’t get too much sun.  Before we start the program, let’s be sure we all know each other.  Marla, would you like to start by introducing yourself to everyone?

Now I am going to hand the program over to our guest speaker, Marla.  When we were emailing each other back and forth to arrange this program. Marla told me that, just like us, she realized that she needed more information about skin cancer.  So she looked on the Internet where she found the websites of the American Cancer Society and the National Cancer Institute’s Cancer Information Service.  Eventually she became quite well informed about cancer and wanted to share her knowledge with other members of the Deaf community.  So she started volunteering for the local office of the American Cancer Society.  Today, it’s my pleasure to introduce you to Marla.

Marla, maybe you could start your presentation by explaining what it means when someone has cancer?   Why is that so dangerous? Everyone I know is really scared of getting cancer. So am I!

Thanks for your kind introduction, Shari. That question is a great starting point. Cancer happens when one or more of your body’s good cells start to behave in a bad way. Normally, old cells are replaced by new cells in a very orderly manner. They make identical copies of themselves. 

However, sometimes cells start to make copies of themselves faster and in a very disorganized manner.  When that happens, they are called “pre-cancer” cells.  They are not cancer cells yet, but they are not normal, healthy cells either. 

Often, those cells will make new cells that are even more abnormal.  Eventually some of those cells could become cancer cells.  Because we don’t know for sure what will happen, it is generally best to remove pre-cancer cells so they have no chance of ever becoming cancer cells. 

However, sometimes the cells are not discovered in the pre-cancer stage.  Instead they are found when they have actually become cancer cells.  They have already become very dangerous and must be treated promptly because they will make more bad cells.  Sometimes these bad cells might spread to other parts of the body where they will cause more harm.

II.    I've had some changes in my skin...

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I had some changes in my skin, but my doctor told me not to worry about them.  They were just part of the aging process.

That’s very possible.  There are many changes in the skin as we get older.  You may notice that you have rough, scaly bumps on your skin, especially in areas that have been in the sun a lot throughout your life.  They can be red, brown, or the color of your skin.  You may feel like you want to pick them off because they are so rough and may itch or hurt.

These bumps are called actinic keratoses.  They are very common in skin that has spent a lot of time in the sun.  Babies never have them, but older people often have many.  You can think of them as “pre-cancers.”  They are not skin cancer, but sometimes, if they are not treated or removed, they can turn into a skin cancer over many years.  There are two things to remember about actinic keratosis.  The first is that only your doctor can tell you for sure if a change in your skin is a pre-cancer or cancer.  The second thing to remember is that because the body’s cells are constantly changing, you need to be constantly watching abnormal skin for further changes.  Because of this, doctors sometimes recommend treating them with a cold spray or a special cream.

III.    What's the difference between skin cancer and other cancers?

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So what’s the difference between skin cancer and other cancers?  Like breast cancer or prostate cancer, for example?

We generally name the cancer by where the first abnormal cells start.  So if they start in the breast tissue, we call them breast cancer.  If they start in the prostate gland, we call them prostate cancer.  In the case of today’s topic – skin cancer-  the cancer cells start in the layers of cells that make up the skin that covers our body, so we call them skin cancer.  So with “skin cancer,” the bad cells first start to grow in the skin.

IV.    What happens when someone gets skin cancer?

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So what actually happens when someone gets skin cancer?  Why is skin cancer so bad?

Skin cancer creates several problems.  First, it causes the skin to stop looking nicely.  When you have skin cancer, the cells are on the surface of your body.  Because they are not healthy cells, they can bleed or ooze and look like very ugly sores.  The second problem is that the skin provides a protective layer around your body.  It keeps bad germs out and it helps maintain the right balance of water inside our bodies.  So when skin cancer develops, it causes a break in the body’s defense system.

The third problem is really dangerous.  Sometimes the skin cancer cells move from your skin to other parts of your body. That can make you whole body very sick and it can kill you. When the bad cancer cells move from the skin into other areas of your body, it is called metastasis or metastatic cancer.

V.    What causes skin cancer?

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So what causes skin cancer to start behaving abnormally in the first place?

Skin cancer is usually caused by having your cells exposed to too much sun.  That’s why most skin cancers are on the parts of your body that get a lot of sun, like your nose, the tops of your ears and your arms.  However, we also know that getting one very bad blistering sunburn can also increase your risk of getting skin cancer.  So you often see skin cancer on the shoulders and back because we often get really badly sun burned there. 

A little later in this presentation, I will explain the many things that you can do to prevent skin cancer in your children and yourselves.

VI.    Are there different types of skin cancer?

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I wanted to learn as much from this program as possible, so I did a little reading about skin cancer at the library and on the Internet to get some basic information.  Could you clarify something for me, please?  It seems like there are different kinds of skin cancer.  Is that right?

Yes. That’s exactly right.  The specific names of the 3 different kinds of skin cancers are: Basal Cell skin cancer, Squamous cell skin cancer, and Melanoma. Sometime you’ll see the word carcinoma used, but that is just another word for cancer. All three kinds of skin cancer can be caused by too much sun.

VII.    What is Basal cell skin cancer?

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What is Basal cell skin cancer and what part of the body does it affect?

Basal cell skin cancer is the most common type of skin cancer.  It usually does not spread to other parts of the body (remember the word is metastasize), but can grow very big and cause big sores on your skin that do not heal.  It can happen on any part of the body, but is usually on the skin that spends the most time in the sun, such as the head, neck, arms, and legs

VIII.    What does Basal cell cancer look like?

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What does it look like?

Basal cell skin cancers usually look like red, round bumps or sores, but they can be pink or clear, too.  With some people, they may bleed, itch, or hurt.  But for other people, they don’t feel any different than regular skin.  Basal cell skin cancers can grow fast or slow, but they usually grow slowly in size.  They will not go away on their own.  If a doctor does not remove the basal cell skin cancer from your skin, it will continue to grow and look even worse.  People who don’t seek treatment can lose their eyes, nose, and ears as the skin cancer cells take the place of healthy, normal cells.  Therefore, if the skin cancer is allowed to continue growing, it will also be more difficult to treat.   Basal Cell Skin Cancer can even become metastatic if they are left untreated for a long time.  Remember “metastatic”?  That’s the term doctors used when the spreads to other parts of your body)

IX.    How is Basal cell cancer different from other skin cancers?

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So how is a Basal cell skin cancer different from the other two skin cancers?

Let’s talk about Squamous cell skin cancer next.  Squamous cell skin cancer is the 2nd most common type of skin cancer.  Just like Basal cell skin cancer, the Squamous cell skin cancer usually shows up on the areas of your skin that get a lot of sun.  Squamous cell skin cancer can look like many things, but it will often look like a scaly red bump or sore.  It usually grows faster than Basal cell skin cancer.

X.    Does skin cancer bleed or hurt?

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Does it bleed or hurt like Basal Cell skin cancer?

Just like Basal cell skin cancer, the Squamous cell skin cancer can bleed, itch, or hurt.  Or the skin can feel completely normal.  Squamous cell skin cancer can spread from your skin into your body and become a metastasis. This could make you very sick.  Since Squamous cell skin cancer can grow fast and spread within your body, it is very important that you see your doctor quickly if you think you have one.  If you don’t see your doctor and it continues to grow, then you might die.

XI.    Which skin cancer is the most dangerous?

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Even though screening tests can be uncomfortable, catching cancer before it spreads is vital. In Frank’s case, if he had the screening test 5 years earlier, the polyp might have been in the pre-cancer stage. Then only a small section of his colon would have been removed.

So if Frank had been tested earlier, he wouldn’t need a colostomy?

Probably not! That’s why I’m glad you all are here today. So you can learn what Frank didn’t know. And you can help us get this information to others.

What happens when the cancer has spread to other places in the body already?

If colorectal cancer has already spread to other parts of your body, surgery and chemotherapy are usually given only if they might make some of your symptoms better. This is because our treatments cannot cure colorectal cancer if it has already spread throughout the body. This is called metastatic cancer. So you can see how very important early detection is. The scientists have not been able to develop very good treatments for advanced cancer yet.

XII.    What are genes?

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Q: Genes? What are genes?  Can you explain that term, please?

A: Genes are like instructions in your cells.  When you are born, each cell has these coded instructions that make you who you are.  They determine what color hair and eyes you will have, how tall you will be, and whether or not your chances of getting a Melanoma are higher than other people’s chances.  You get your genes from your mom and dad.  Each parent gives you a set.  That’s why you look a little bit like each of your parents.  You have many of the same genes as your mom, dad, brothers and sisters.  Since you all have many of the same genes, if anyone in your family has Melanoma, then you might have a higher chance of getting it, too.  Genes are not the only reason why people get Melanomas.  It is usually a combination of genes and sun exposure, and perhaps other factors that we don’t even know about yet.

XIII.    What does Melanoma look like?

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What does a Melanoma look like?

That’s a good question.  A Melanoma looks very different from the other two kinds of skin cancer.  A Melanoma usually starts from a regular mole that is a normal part of your skin.  Moles are those little brown spots that most of us have on our bodies.  So having a mole is not the same thing as having a Melanoma type of skin cancer.  However, having a lot of moles does increase your risk if some of the moles are starting to become abnormal looking.           

Because most Melanomas start from a mole, they often look like a brown or red spot.  But a Melanoma can also be pink or tan colored, or it can be a combination of these colors at the same time.  Some melanomas show up in a place where there was no previous mole.  Melanoma is the most dangerous skin cancer of the three because all Melanomas will eventually spread to other parts of the body.  Even worse, there is not yet an (especially good method to treat this type of cancer after it has spread to other parts of the body.) 

XIV.    How do we find melanoma before it spreads?

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So I guess the clear question is how do we find a melanoma before it spreads?

Here’s where we have really good news.  It’s easy to see a Melanoma and there are very clear warning signs to tell you that a mole’s cells are changing.  So it’s pretty easy to do, if you know what to look for on your skin. 

So the first step is to find the moles all over your body.  Make a little drawing or a person and then mark on the drawing where each of your moles are located. 

Here’s the simple list of 6 things to consider when you look at each mole.  They’re called the A, B, C’s of finding a melanoma:

1 The A stands for “asymmetrical.”  The word “symmetrical” means that the two halves of something are the same.  So “asymmetrical” means “without symmetry” or without the two halves being the same.  That means that when you look at the two halves of a mole, one half is not the same as the other.  Moles or spots that are asymmetric should be an area of concern.

2. The B stands for “border” of the mole.  Normal moles have a smooth even border.  Melanomas have jagged or irregular borders. Some look like lace at the border.  A border that is changing from a smooth border to an irregular one should be a concern.

3. The C stands for “color change.”  Usually moles are only one color, so if you have a spot that has more than one color in it or is darker than your other moles, you should see a doctor. 

4. The D stands for “diameter.”  If a mole of any size starts to grow wider that should be examined by your doctor. Also if you have any mole that is larger than the size of a pencil eraser head or greater than 5mm, you should have your doctor look at it.  If your mole is bigger than this, and especially if it is growing, this is a reason to see your doctor immediately.

5. The E stands for “elevation change.”  The mole starts to grow above the normal skin around it.

6. The F stands for ”feeling change.”  The mole just starts to feel different.  It gets itchy, crusty, bleeds easily, or always looks injured.

Since a Melanoma skin cancer can happen in moles that you have had for a long time, it’s a good idea to describe all the moles on your body along with where each one is located on your body. Use your picture of the body outline to mark where each mole is located on your body and add a description of each mole.  Write down on your diagram the shape, border, color, size, elevation and feeling of each of your moles today.  Keep that drawing so you can make comparisons of your moles at future dates.  When you are doing this drawing, be sure to use a mirror so you can see all sides of your body.

Of course, if anything worries you on this first inspection, you should call your doctor right away and get a professional opinion because Melanoma can spread and kill you if it is not treated early enough.  Dermatologists are doctors who are specially trained to treat the skin, so they are the best people to tell you if you actually have abnormal cells that might be dangerous and should be evaluated further or removed entirely.  Even if you aren’t sure, but have a funny feeling about a spot on your skin, it is better to be safe and let a skin doctor check it for you.

XV.    Can I check my own skin without seeing a doctor?

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So, can I actually check my own skin to see if I have cancer without having to go see a doctor?

It is important for you to have your doctor check your skin, but you should also do a skin self-exam.  For those parts of your body that are difficult to see, you can use a mirror or have a loved one help you look for new red or brown bumps that don’t look normal.  You want to look for any patch of skin that is changing colors or changing spots on your body.  Don’t forget to check all your skin including your back, scalp, genital area, and your feet.  A skin check after a shower once a month will help you be aware of your skin.  The most important thing to remember is to call your doctor if you are worried about a spot.

XVI.    Is it really necessary to see the doctor every six months if I have been treated for skin cancer?

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I have a friend who’s already had skin cancer and goes to the dermatologist every 5 or 6 months.  Is that really necessary?

That’s about right.  Once you’ve had one skin cancer, you are at increased risk to develop others because other parts of your skin received the same amounts of sun damage.  The doctor will check your wound and also check for new cancers.  Also remember that we mentioned earlier, that if an immediate family member, such as your father or sister, has had Melanoma, you have a higher chance of getting melanoma too.  In those families, everyone should have a full skin check at least once a year to make sure there are no worrisome moles on anyone’s body.  Also people who have multiple risk factors for getting skin cancer should also be checked more often. 

XVII.    What are the "risk factors" for getting skin cancer?

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What are some of the risk factors of getting skin cancer?

Skin cancer risk factors are things that increase your chances of getting skin cancer. Some of the risk factors are things that you can do something about, while others are things that you are born with – in your genes – remember?  Your genes will influence if you are more likely to get skin cancer.  In both situation, there are things you can do to protect yourself.

Sun exposure is the most important risk factor for skin cancer.  The more sun exposure that you get throughout your life, the higher your chance of getting skin cancer.  A lot of our sun exposure happens when we are children playing and having fun in the sun without proper protection from the sun’s damaging rays. 

But even when you are an adult, sun damage continues to happen.  Sunburns, especially blistering ones, increase your risk of skin cancer and are a warning to you that your skin has gotten much too much sun exposure.  The good news about sun exposure is that there are many things you can do many things to limit the amount of sun exposure that you get throughout your life.  We will talk about some of these ideas later.  The bad news about your skin is that the damage you do every day is added to the skin damage you experienced earlier.  Your skin never forgets the past damage.  Even when your sunburn goes away, the cells have still received some degree of damage.  So there is much to be gained if you can greatly reduce future damage.

XVIII.   Does the color of my skin make a difference with skin cancer?

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Does the color of you skin play a role in how much at risk you are?

Yes, in a way it does. People who have blond or red hair, light skin, and blue or green eyes don’t have as much natural coloring in their skin.  That coloring can provide a little extra protection from the sun.  So very light skinned people are at higher risk for skin cancer than people who have more color in their skin.  People with red hair, very white skin and many freckles are especially sensitive to the bad effects of the sun.  However, even people with tan skin, dark hair, and dark eyes get skin cancer.  It is important to remember that even though people with light hair, skin, and eyes have a slightly higher risk of skin cancer compared to people with darker hair, skin, and eyes, everyone is at risk!

XIX.    Is there a safe way to get a tan?

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I know a lot of friends who go to a tanning salon instead of sitting out in the sun,. Is that a safer way to get tan without getting sun exposure?

Tanning salons are becoming very popular.  Many people are unaware that going to tanning salons also increases your risk of skin cancer.  Tanning salons use lights that are just like the sun.  This means that going to a tanning salon is just like sitting out in the sun without any protection and can cause you to get skin cancer. Since people usually do not put on any sunscreen when they go to tanning salons their skin does not have any protection.  This can lead to skin cancer.

XX.    If I have a family member with skin cancer am I at higher risk?

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If someone in my family has had skin cancer before, does that mean I have a higher chance of having it also?

You should always ask your family members if they have had skin cancer.  As we mentioned before there are some skin cancers that happen more often in families.  Melanoma is the best example of this.  A person whose mother, father, brothers or sisters has had melanoma has a higher chance of getting Melanoma, even if they do not spend too much time in the sun.  Therefore, it is very important to know if anyone in your family has ever had skin cancer so that you can tell your doctor.  As I mentioned earlier, if anyone in your family has had melanoma, you should have your skin examined by a doctor at least once a year.

XXI.    Do you need to see a doctor if you have many moles?

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My friend has many moles; do you think she should go to see a doctor?

Well that depends. Any moles that are changing should be seen by a doctor.  Remember the A, B, C’s of finding a Melanoma that we discussed earlier?   

XXII.    How can I avoid getting skin cancer?

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Wow it seems that for anyone, it is easy to get skin cancer. How can I avoid getting skin cancer?

There are numerous ways you can prevent yourself from getting skin cancer. The first way is to limit the time that you are in the sun.

XXIII.    How much is too much sun?

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So how much time is considered to be “safe” to be in the sun every day? 

Well, it isn’t realistic to never go in the sun, especially since we get sun exposure even when we are driving in our cars.  But it is important to be smart when you do go outside.  You should try to stay out of the sun from 10am to 2pm when the sun is the strongest.  So getting up early and playing outside or waiting until after 2pm is best.  You can go to indoor pools instead of outdoor swimming pools, or swim in the early morning or evening.

It is also important that babies younger than 6 months-old be kept out of the sun.  Their skin is very delicate and they can get sunburned more easily.  If you do have to bring babies outside then it is very important to wear protective clothing.

XXIV.    Will wearing a hat protect my skin?

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Will wearing a hat help protect my skin from cancer?

Of course! A hat is a very good way to help protect your face, ears, and neck.  The hats that are big and floppy and cover your neck and ears are best.  In addition to a hat, you should wear other kinds of protective clothing when you are in the sun.  Protective clothing such as hats, long sleeve shirts, and long pants give you the most protection from the sun.  Chose hats and clothing that have a tight weave to avoid letting the sun reach your skin.  There are companies that make sun protective clothing so that you can cover up your skin without being too hot or uncomfortable.  You should also remember to wear UV protective sunglasses when you are out in the sun or even driving around.  Just like your skin the sun can damage to your eyes too. 

XXV.    Do I need to wear sunscreen?

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My wife always makes me put on sunscreen every single day. Is that necessary?

Wearing sunscreen every day as part of your normal routine is the exact right thing to do. A sunscreen is a special cream that helps to block the sun from getting into your skin.  It is one of the best ways of protecting your skin from sun damage when you have to be out in the sun.  There are many different kinds of sunscreen that you will find at the store.  They are many varieties.  Some are water proof.  That means they will stay on while you are swimming or engaging in other water sports or work that requires you to use water.  Some sunscreens are just water resistant.  They are not as effective because they come off more easily when you are in the water.  Both of these sunscreens will come of on to your towel when you are drying off, so it is important to reapply them after swimming.   

XXVI.    What do the numbers mean on sunscreen?

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The sunscreens all have different numbers on them.  What do those numbers mean and which one should I buy?

The numbers tell you the sunscreen’s “sun protection factor.”  That’s called its SPF number.  So the higher the number, the longer you can stay in the sun without damaging your skin.  The higher number also means you will get more protection, even when you are in the sun for only a short period of time. You should choose a sunscreen that has an SPF  of at least 30, but in general, the higher the number the better. 

 When choosing a sunscreen there are other important things to consider besides the product’s sun protection factor and usefulness with water sports.  

A sunbeam is made up of several different rays.  Think of the different colors of the rainbow as a way of seeing how sunlight has different rays.  Two of these rays cause damage to your skin.  So you want to buy a sunscreen product that says it protects against both of these rays.  They are called ultraviolet A and ultraviolet B.  The container should say the sunscreen includes protection against UVA and UVB.  Those letters stand for the sun’s ultraviolet rays A and B. 

Finally, you want to buy a sunscreen that also includes a chemical that physically blocks the sun from the skin.  The best ones are called zinc oxide or titanium dioxide.  There are now many good facial moisturizers that include these chemicals. So it is reasonable to encourage people to use them as part of their daily grooming routine.

XXVII.    How often should I reapply sunscreen?

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How should one apply sunscreen and how often should they use it?

Good question!  Simply buying a sunscreen lotion with all the 4 components is only part of the protection; the other part is applying the lotion correctly. You should put your sunscreen on all areas of your skin that are exposed to the sun.  Do not forget your ears, the back of your neck, and the backs of your hands.  If you have a receding hairline, you will need to be especially careful to protect the top of your head.  If you’re applying sunscreen to a child, always be careful not to get sunscreen in the child’s eyes.

It’s also important to apply your sunscreen 30 minutes before going outside in the sun to allow time for the sunscreen to bond with your skin.  You should re-apply the sunscreen after you have been in the water and every 2 or 3 hours while you are in the sun. 

XXVIII.     What happens after I find a spot on my skin?

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Can you explain what happens after I tell the doctor that I am worried about a spot on my skin?  How do they make a diagnosis?

Although a dermatologist will usually know if something on your skin looks like a skin cancer or not, the only way to know for sure is with a skin biopsy.  To do a skin biopsy, the doctor will take a very small piece of your skin and look at it under the microscope to see if there are cancer cells.  There are doctors who just look at skin samples.  They are called pathologists.  That’s the person who will look at you small piece of skin to determine if the cells are normal, abnormal, or cancer cells.  If there are cancer cells in the piece of skin, the pathologist will be able to tell you and your doctor whether the cells are basal cells, squamous cells, melanoma or another kind of skin cancer.  The kind of cells will help the doctor to know what kinds of treatment will work best.

XXIX.    Does a skin biopsy hurt?

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Does a skin biopsy hurt? Is it major surgery?

The skin biopsy procedure is very simple and only takes a few minutes.  It’s done in the doctor’s office.  There’s just a little discomfort because the dermatologist will give you a little shot to numb your skin.   The shot is only slightly uncomfortable, just a small prick and you may feel a little burning for a second or two.  Then you might feel the doctor working, but you won’t feel any pain. 

XXX.    How is a skin biopsy performed?

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Can you explain how a skin biopsy is done?

There are a few ways doctors can take a sample of your skin.  They can do a punch biopsy, shave biopsy, or excisional biopsy.  Let me explain each one. A punch biopsy uses a tool that looks like a very small cookie cutter and quickly takes a small piece of skin.  Usually you will need one or two stitches. 

A shave or scoop biopsy is when they take a piece of your skin that is not as deep, so you won’t need stitches for it. Sometimes, your bump or mole may be bigger than the punch biopsy tool and so the doctor will cut out the spot and put in a few more stitches.  This is known as an excisional biopsy. 

You will always have little scar from these procedures, but usually they are small and worth it to know for sure that your skin is OK.  After a biopsy, you take care of the area like any other small skin sore.  Keep it dry and covered.  It is best to put an ointment like petroleum jelly or antibiotic ointment once a day and change your bandage once a day.  If you have stitches, don’t forget that you need to go to the doctor in one or two weeks to get the stitches removed.  Your doctor will tell you when to return to have your stitches removed.

XXXI.    What happens if I have skin cancer?

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What happens if I have skin cancer?  What are the treatment options?

There are a few ways to treat skin cancer.  The treatment selected will depend on what type of skin cancer you have and how much it has grown.  For fairly early Basal cell skin cancer, a cream called Aldara is sometimes given.  This cream works by stimulating your body to fight off the skin cancer by causing a localized inflammation.  Your skin will be red and inflamed while you are using the cream.  You use the cream for a few days a week over a course of a month or so depending on how your doctor wants to plan your treatment.

More often the doctor will remove basal and squamous cancer cells by scraping them away or burning them.  This has about a 90% cure rate.  However, sometimes a few cells are missed and will continue to grow.  Then the treatment must be repeated.

XXXII.    Are there different kinds of surgery for skin cancer?

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If the cancer is serious, will surgery be an option?

Surgical removal is still the most common treatment of skin cancers.  The surgeon will take a little extra skin from around the skin cancer to make sure all the cancer is out.  The pathologist will also look at the tissue and make sure there are no signs that any cancer cells are left in the body.  Therefore, your scar will usually be a little bigger than the skin cancer because you have to take some normal skin to make sure all of the cancer cells are removed.  This

When the skin cancer is on the face or ears, the surgeon’s goal is to end up with the smallest scar possible.  That’s where Mohs surgery is used.  Have any of you heard about Mohs surgery?

XXXIII.    What is Mohs surgery?

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I read about Mohs surgery on the Internet.  It seemed like that was a different kind of surgery, right?

That’s correct.  Mohs surgery is another procedure that is used to treat skin cancer. It is named after the man who first used this technique.  Mohs surgery takes as little normal skin as possible, so it produces the smallest possible scaring and the least change in the shape of the patient’s face.  As the doctor removes a very thin layer of skin, it is immediately studied under the microscope to see if there are any cancer cells visible.  This process is repeated until the doctor reaches the point where the removed skin shows no sign of skin cancer cells.  So this usually takes 2 or 3 attempts to be sure all the cancer cells have been removed.  Then, the surgeon repairs your skin to leave a small scar.  Because you know right away that all the cancer is gone, Mohs has a 98% cure rate.  It also leaves the most minimal scars. 

XXXIV.    Can Mohs surgery be used on any part of the body?

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Can this surgery be done anywhere on the body?

Actually, this technique is best used on the head and neck. But, importantly the doctor also wants to be absolutely sure that there are no cancer cells still left in the skin where they can continue to make new cells.  So Mohs surgery is the best choice.  When skin cancer occurs in other parts, the doctor can just remove a slightly larger ring of skin from around the cancer cells if the procedure needs to be done again to be sure all the cancer cells are gone.

XXXV.    How long will it take for the surgery to heal?

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How long will the surgery take to heal?

The skin will take 4-6 weeks to heal.  There will usually be a small circular scar left where the skin cancer was removed.

XXXVI.    Can radiation treatments help?

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I have read in the newspaper that radiation can be used to treat cancer? Is that true? Will it help?

Yes, radiation is sometimes used as a treatment or together with surgery.  The radiation kills any cancer cells that are left. Sometimes, radiation is used for patients who can’t have surgery because of other medical reasons.  Radiation is also used for very large skin cancers or if the cancer cells have invaded other structures like bone.  This usually requires multiple treatments, but is painless.

XXXVII.    Is there a cure for skin cancer?

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Is there a cure for skin cancer? Or will there be a cure soon?

While there is no cure for skin cancer, the treatments for Basal and Squamous cell skin cancers are quite likely to be successful.  Of course, the best thing is to prevent of skin cancer by reducing your time in the sun.  If you do get skin cancer, then the next most important thing is to find it early so it can be easily and effectively treated.

XXXVIII.    What about Melanoma?

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What about Melanoma?

Melanoma is different.  It must be surgically removed just as I described earlier.  The skin will be numbed and the doctor will use a knife to remove the Melanoma.  The doctor will remove a larger amount of skin for a Melanoma because this cancer is so dangerous.  If the cancer is found early, before it has spread to other parts of the body, the only thing required will be for the patient to see the doctor for regular skin exams every six months or so.  Your doctor may also want to check your lymph nodes.

If this Melanoma cancer has spread has spread, it is much harder to treat.  Medicine is sometimes given that will spread throughout the body with the hope of killing any Melanoma cancer cells that have spread to other parts of the body.  The medicine is called chemotherapy because it is a chemical that is used for the therapy.  However, the treatment options for Melanoma are not yet very effective. 

The good news is that a lot of research is being done to try to fine better treatments for metastatic Melanoma.  When doctors are testing new methods to treat cancer, this is called research or clinical trials.  Doctors will sometimes ask patients if they would like to join a clinical trial that is testing a promising new therapy.  This can help doctors learn more about skin cancer and how to prevent it or treat it.  Thousands of patients will be enrolled in these studies to determine if the new therapy is better than the therapy already available.  You can learn more about participating in research by talking with your doctor or contacting the National Cancer Institute’s Cancer Information Service or the American Cancer Society.  There are also good websites can help you find studies that are being done.

Well, I hope you learned a lot from this program.  Even more important, I hope you will take the steps I discussed for preventing skin cancer and finding it early.  This could save you life or the life of someone you love.  So please join me in helping to spread this information about skin cancer.  The Deaf community really needs to become well informed about this cancer.  It is both preventable and treatable if you have the right information!  Together, we can reduce the effects of cancer on the Deaf community.

It’s been really fun for me to have this opportunity to talk with you.  I know the folks at the American Cancer Society and the National Cancer Institute’s Cancer Information Service join me in thanking you for your interest in how to prevent and control cancer.  This is one of the cancers where we know what to do to prevent this cancer and find it early.  There are specific actions you can take, and recommend that others follow, that will make a huge difference in reducing unnecessary pain and suffering and premature death.  PLEASE, remember that you can contact both of those organizations if you have any questions about skin cancer or any other cancer.  I’ll give you the specific information you will need to contact these organizations.  So thanks again for inviting me to talk with you today!

Well I hope you found this information useful.  Even more important, I hope you will use the information I have given you today and share it with your loved ones.  It’s important that we get this information to other members of the Deaf community. (Looks to host and says (NAME)) Thank you for inviting me today.  Maybe we can get the folks who are here today interested enough that they will was to learn about skin cancer and then share that information with other members of the Deaf community.

Thanks for joining us today.  We’ll all be acting on the information you gave us today!

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