News from The Farber Center for Radiation Oncology

The Farber Center Monthly Newsletter

Greetings!

Welcome to our monthly newsletter. We will be featuring a patient story each month as well as cancer facts and newsworthy events.

PATIENT STORY OF THE MONTH

About a year and a half ago, I was diagnosed with a basil cell carcinoma on my lower left jaw. Although I have had pretty good results in the past with Carac cream in defeating cancerous and pre-cancerous cells, this one seemed resistant to it.

The dermatologist that I went to informed me that we probably had no alternative than to remove the lesion surgically, and referred me to a Mohs surgeon (a special surgeon for removing skin cancers). When I saw how large of an area was going to be affected and how large of a scar it was going to leave on my face, my heart sank. But they said that there was no other alternative at this point. However, before deciding to go through with the surgery, I decided to get a second opinion. The second dermatologist agreed that surgery was most likely going to be needed and referred me to yet another surgeon that he thought was one of the best. But this surgeon understood and sympathized with my reluctance to have the surgery and have such a large scar, and he had knowledge of another alternative. He then through the second dermatologist, referred me to Dr. Len Farber at the Farber Center.

In my first appointment with Dr. Farber, I was impressed with the caring attitude of Dr. Farber and of his entire staff, which helped to set me at ease. But I was most happy to hear him tell me that by treating the skin cancer with radiation rather than surgery, I not only could be cancer free...I could do so without having the unsightly scar. I remember Dr. Farber telling me that "When this is over, your skin will be as smooth as a baby's bottom".

I underwent eight sessions of radiation over a period of four weeks. The procedure is basically pain free, other then an eventual slight burning sensation, not much worse than a sunburn. There was a few weeks of having a scab as it healed. But after a few weeks from the initial treatment, I was able to see smooth, clear skin, free of scars, and free of cancer.

I am so happy that I sought out other options! It's disappointing that dermatologists appear to not have much knowledge of this option, leaving many patients to think that surgery is the only avenue of hope. Would I do it again? Certainly, without hesitation! Especially knowing that the rate of recurrence is just about as low as that of surgery. It's been over a year since my treatment. The cancer has not returned and the area on my face is indeed "smooth as a baby's bottom".

Scotch Wilks

EVENT DETAILS:

OUR NEXT OHE CLASS for TFC patients only:

TUESDAY

July 10th and TUESDAY July 17th

Please RSVP to Vivian

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QUOTE OF THE MONTH

"A successful man is one who makes more money than his wife can spend. A successful woman is one who can find such a man."

Lana Turner

True or False?

Skin cancer is the most common form of cancer in the United States.

TRUE. More than 3.5 million skin cancers in over two million people are diagnosed annually.

Each year there are more new cases of skin cancer than the combined incidence of cancers of the breast, prostate, lung and colon.

Basal cell carcinoma (BCC) is the most common form of skin cancer; an estimated 2.8 million are diagnosed annually in the US.8 BCCs are rarely fatal, but can be highly disfiguring if allowed to grow

Squamous cell carcinoma (SCC) is the second most common form of skin cancer. An estimated 700,000 cases are diagnosed each year in the US, resulting in approximately 2,500 deaths

Melanoma is the most common form of cancer for young adults 25-29 years old and the second most common form of cancer for young people 15-29 years old.

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NEWSWORTHY:

The Farber Center forms a Non-Profit to help with Cancer Care

With half of all new cancer cases appearing in the over-70s, the mortality rates among this group are failing to match the improvements seen in younger patients, this is directly due to support issues during treatment. It is vital that steps are taken to ensure that the right people get the right treatment at the correct level of intensity, together with the practical support to enable them to take up and complete the treatment. Often times there is no support after treatment.

What we would like the foundation to do is provide local support services for cancer patients during and after treatment. Support will be transportation, language assistance, financial support and education workshops. This support will empower cancer patients to participate fully in their cancer treatment ensuring better outcomes. We will keep you posted on our progress.

FROM THE EXPERT: Focus on skin cancer

We often think of caring for our skin as summer approaches. Truth is, we should care for and protect our skin all year round as skin cancer is the most common form of cancer in the United States but, also, the most preventable.

Genetic predisposition such as fair hair, light eyes or family history of skin cancer and environmental factors like blistering sunburns in childhood, X-ray exposure and scarred areas come into play in regard to skin cancer risks.

There are three forms of skin cancer:

1. Basal Cell Carcinoma

2. Squamous Cell Carcinoma

3. Melanoma.

Basal Cell and Squamous Cell Carcinoma are the most common forms. They arise within the top layer of the skin usually on the face, ears, bald scalp and neck. Basal Cell Carcinoma frequently appears as a pearly bump or new skin growth that bleeds and doesn't heal well. Squamous Cell Carcinoma often looks like a rough, scaly area or an ulcerated bump that bleeds. Melanoma is the most serious and deadly form of skin cancer and often presents as a dark irregular spot. Common areas for melanoma to develop are the upper back, torso, lower legs, head and neck but can occur anywhere on the body. It may suddenly appear out of nowhere but can also develop from or near an existing mole. Moles that are new, rapidly growing, itch, bleed, change surface characteristics like color or shape are often the warning signs and warrant prompt attention. Early detection and treatment are essential since the cancer can spread to lymph nodes and internal organs.

There are precautions we can take to protect our skin health no matter what the time of year. First, eat healthy foods. Fresh fruits and vegetables provide the essentials so your skin can have all the important vitamins and minerals it needs. Keep hydrated, exercise and rest so that your skin's natural defenses are at their peak performance. Next, use a broad spectrum sunblock of SPF 30 or higher. There are 2 different kinds of UV rays: UVA which penetrate deep into the skin to cause wrinkling and sun spots and UVB, the primary cause of sunburn. That's why you want to look for a "broad spectrum" sunblock that will filter both types. Some effective key ingredients to look for are: Avobenzone, Ecamsule (Mexoryl SX), Titanium Dioxide, or Zinc Oxide. Apply evenly on all exposed areas of the body 15 minutes before heading out into the sun so your skin will absorb the block and work more effectively.

You want to avoid burning, so do all the things you've heard for years: wear and reapply a water resistant sunblock, wear sunglasses, avoid exposure during peak hours 10-4, wear a hat and protective clothing and don't forget to use an SPF lip balm. Sun damage is cumulative. It's never too late to start protecting your skin.

We hear the letters SPF all the time but the meaning often confuses consumers. SPF refers to Sun Protection Factor and refers to how much protection a block gives to filter out the UVB rays (the ones that are more likely to cause the "surface burn"). The average fair person will burn in 10 minutes at noon wearing no sunblock. If they wear a sunblock with an SPF 5, this means that the block will allow them to stay out 5 times longer and they would burn after 50 minutes (5 multiplied by 10 minutes).

It is recommended that a minimum of SPF 30 be used at all times. With this protection it would take 5 hours to get the same amount of burn/damage you'd get if you went unprotected. Nonetheless, be sure to reapply every 2 hours since most tested blocks start to break down and lose effectiveness after this amount of time. Sunblock has a shelf life, check the expiration date.

A self-exam of your skin can't replace an annual visit to your dermatologist, but it can help you notice the above early signs of skin cancer or abnormalities like moles that may be changing. If you see any signs of change bring it to the attention of your dermatologist immediately. Otherwise, it is recommended to see your dermatologist yearly or twice yearly if you have had a prior skin cancer. Remember, as common as skin cancer is, its most easily treated when detected early and treated promptly.

Michael Eidelman MD

Medical Director of Chelsea Skin and Laser

Assistant Clinical Professor of Medicine, Albert Einstein College of Medicine

Assistant Clinical Professor of Medicine, Mount Sinai School of Medicine