Scott Webb (Host): There are different types of
skin cancer, and it's important for all of us to know the signs, symptoms, and
ways that we can prevent skin cancer. And I'm joined today by Laraine Kemery.
She's an Oncology Hematology Nurse Practitioner at the Genesis Cancer Care
Center.

 This is Sounds of Good Health with Genesis, brought to
you by Genesis Healthcare System. I'm Scott Webb. Laraine, it's so nice to have
you here today. We're going to talk about skin cancer and I know there's
different types and different things to be on the lookout for. So great to have
your expertise today. Just sort of a baseline question here, what are the
different types of skin cancer?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: Well,
I think to, you know, explain the different types of skin cancer; we first
should know, you know, what is skin cancer? It's when normal cells in the skin
change to abnormal cells and they grow out of control. And when those cells
grow out of control, they cause harm. So, we can group them into two types of
skin cancers.

We have nonmelanoma skin cancer, and then the melanoma. The
nonmelanoma skin cancers include basal cell carcinomas and squamous cells
carcinoma. They could be found anywhere on your body. But they're likely to be
found on your head, face, neck, back of the hands, arms and legs. Think of the
areas where the body is mostly exposed to the sun and, and then we have
melanoma, and that's the one a lot of people are scared about.

 It can also occur anywhere on the skin, but you also
need to think about the back. And then other, hard to see areas such as the
lining of your mouth, your nose, and even genitals. We know that melanomas can
run in families. So if you have a family history, please tell your family care
provider.

Host: Yeah, we, definitely, uh, cannot outrun
our family history and genetics. As you say, like some of these things we can
see and some of them we can't. So, what are the signs? When we look at
something and we go, well, you know, we ask somebody else, like, hey, take a
look at this. What does, does this look normal to you? You know, we often ask
family and friends and not the doctors. So what are the signs that we should be
on the lookout for?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: So the
basal cell and the squamous cell carcinomas, those are the non melanomas. They
look more like pink. They're red, maybe swollen or peeling. Some people think,
oh, it's an open sore, or I got cut. Sometimes they bleed. They're thick. Or it
can be crusty as well. But then the melanomas, they appear more brown, black,
or even look like a birthmark at times. So, there's many different features. We
just have to kind of be aware of what they are and be diligent about them.

Host: Yeah. And when we think about the
diligence if you will, when should someone speak with a doctor, whether that's
first their primary or a dermatologist, or, you know, we're going to get to
that in a minute here. But generally speaking, if something feels suspicious, a
mole, a spot, whatever it is, when is it time to see a doctor?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: I
think ABCs. That's what you want to tell people. ABCs, A for asymmetry, right?
Does one side look the same as another? So if you fold it in half like a taco,
does it lay evenly over itself? Or is it overlapped? Or B, border. Is it jagged
or uneven? Those are things we also need to worry about. And then obviously the
color for C, they brown black or mixed with red. Sometimes they're all mixed
together, something that just doesn't look uniform. The diameter for D it's
bigger than the eraser on a pencil end. Okay, that's concerning. The bigger
they get. And then evolution for E. You know, does the size, the color, or the
shape, does it change over time and is it changing quickly?

And I think that's what we need to know. If you have any
concern or you think any more birthmark looks abnormal, just show it to your
doctor and we can help you figure it out from there.

Host: there Yeah. And so when we think about,
you know, should we speak with our family doctor or primary care physician or
go right to a dermatologist to what's the, you know, is it just depend on how
suspicious we are of something? Or is there sort of an order in which we should
do things?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: Well,
both are great now. A family doctor and a dermatologist, you can both see them
and they're both appropriate for concerns. What I, worry about sometime is how
quick you can get in to see somebody. So, if you are established with a
dermatologist and you're able to get in quickly with them, then you can go
straight to that route.

 Family doctors, they can do smaller procedures and
biopsies in the office, but they may ultimately refer you on to a dermatologist
if further interventions are needed, but both are appropriate to see.

Host: Yeah, let's assume then, if somebody has
been diagnosed with one of the forms of skin cancer, especially melanoma, what
are the treatment options?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: So
first I, I would like to explain, you know what the patients need to expect? So
you'll likely undergo a full body exam, right? Skin exam when you go in to see
one of your providers. Then they'll biopsy the area. And a biopsy is a
procedure where the doctor or the nurse practitioner takes a small sample of
the abnormal area and then they look at it under a microscope.

And that's how they check to see if there are cancer cells
in there. And then the right kind of treatment depends on the type of skin
cancer and then how severe the disease is. For the non melanomas, there's many
options. They have creams, photodynamic therapy, surgery. But then for the
melanomas, that's where you get into maybe more aggressive surgeries,
immunotherapy, targeted cell therapy, radiation therapy, and chemotherapy.

So there are many options to treat all sorts and all
different types of cancer. So we're not limited anymore.

Host: Yeah, that's the great thing about
medicine and science and technology is, all of this is easier, right? Easier
for folks like yourself to, you know, to diagnose, to biopsy, to treat and so
on. Here's the million dollar question, and I think I know the answer to this,
but we talked earlier about how the sun is, you know, often not our friend when
it comes to these things. So how do we, can we, and how do we best prevent skin
cancer?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: So you
can prevent it right by protecting your skin from the sun's rays. The sun
exposure and the sunburns over time increase your risk for developing skin
cancer. So you want to stay out of the sun in the middle of the day, usually
from like 10 to four. That's when the sun is most intense. And if you're going
to be outside during those times, then wear sunscreen and reapply often,
especially if you're in the water or swimming and playing a sport maybe with
increased sweating, things like that.

Wear like a wide brimmed hat that can cover your ears, nose.
Long sleeved shirts and long pants are great options as well. And, most
importantly, which I can't stress enough, is avoiding tanning beds. That's
something that is pretty detrimental to our health over the years, so.

Host: Yeah, I, I, I find it surprising, you
know, cause when I was younger, like, uh, I'm in my fifties, but when I was in
my twenties, that was all the rage, you know? And I, I am often surprised at
how many tanning places are still in operation. How many people still do that
despite the advice and recommendations by experts like yourself? Like what is
it about the tanning beds that's so bad for us?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: It's
the UVA and UVB rays, right? It's the rays. It's directly onto the skin, so we
want to try to avoid that as possible. As much as possible.

Host: You're right. Yeah. It's bad enough, you
know, with the sun, way up in the sky and us being outside without protection
and sunscreen or whatever, but

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: Yep.

Host: It's literally touching your skin. I, I,
see why that might be bad. Well, this has been fun and educational today,
Laraine. Just want to give you a chance, final thoughts, takeaways. When we
think about skin cancer, signs, symptoms, prevention, treatment options,
whatever it might be, what are your final thoughts?

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: The
thing is, is if anything's changing, just talk to your provider, right? We're
there to help and, make you feel comfortable and get things going if need be,
but be able to talk to your provider.

Host: talk

Yeah, that's always the best advice is that when in doubt,
right, you're not, I'm not a doctor, I don't know. So if something looks weird
or feels weird, then you know, is suspicious. Speak with your doctor, see a
dermatologist, have things biopsied and so on. So Laraine, nice to meet you
today. Great speaking with you. much.

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: Yeah,
thank you so much.

Host: You stay well.

Laraine Kemery, MSN, APRN-CNP, RN, AOCNP: You
too.

Host: Thanks. And for more information, go to
genesishcs.org/services-search/cancer-care.

 And thanks for listening to Sounds of Good Health with
Genesis, brought to you by Genesis Healthcare System. If you found this podcast
to be helpful, please be sure to tell a friend and subscribe, rate and review
this podcast. And check out the entire podcast library for additional topics of
interest. I'm Scott Webb. Stay well.