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RadioMD Presents: HER Radio | Original Air Date: May 14, 2015
Host: Michelle King Robson & Pam Peeke, MD

It's all about her. Her body. Her mind. Her wellness. Her sex. Her relationships. Her aging. Her beauty. It's HerRadio. Starring acclaimed entrepreneur and woman's advocate, Michelle King Robson, and leading women's health expert, the doc who walks the talk, Dr. Pam Peeke.

PAM: Hi, I'm Dr. Pam Peeke. Michelle is off today. Alright. It's time for fun in the sun. And that means it's time to protect yourself from skin cancer. We have Dr. Hooman Khorasani with us who is Chief of the Division of Reconstructive and Cosmetic Surgery and Assistant Professor of Dermatology at the Icon School of Medicine at Mt. Sinai.

Dr. Khorasani, welcome to HerRadio.

We are really listening up now because we are getting out that SPF once again and trying to make sure we can cut through all the confusion about how to be able to protect our skin the best. Especially, not just when we're sitting on a beach, but for crying out loud, when we just go outside during the day. When we have to walk to our car, when we have to be driving in our car and commuting. So, the first thing we want to do is welcome you to HerRadio, Dr. Khorasani.

HOOMAN: Thank you.

PAM: And now, tell us a little about skin cancer why are we really talking about this now, especially melanoma?

HOOMAN: Thank you so very much for inviting me. So, skin cancer, first, non-melanoma skin cancer occurs in about one in five Americans. At some point in your lifetime, you're going to have a skin cancer. It is very common. Most non-melanoma skin cancers are very highly curable. So, the reason we like to talk about melanoma so much is just because although it is not the most common, it is definitely the deadliest of all skin cancers. So, a way to think about it is that usually about every hour one American is dying from a melanoma. About ten thousand deaths are anticipated this year.

About 1 in 50 Americans are diagnosed with melanoma each year. In fact, 1 in 27 with non-invasive melanoma, which is called a "melanoma in situ". It is very common and there is some misconception about melanoma. People think that it is an old person's disease, which is not true. In fact the number one most common cancer in the ages of 21-25 is melanoma.

PAM: Wow.

HOOMAN: It is really an incidence that has been going up which is really concerning to all of us. In 1930's the incidence was about 1 in 1500 in the New York area. Now, the last year, as I mentioned, it is closer to 1 in 50.

PAM: Why? Why has that happened?

HOOMAN: That is a good question. There are certain geographic migrations and certainly travel is one of the main reasons that we talk about. In the 1930s, it was really rare that you could go to Florida or Miami Beach or the Caribbean.

So, travel pattern is a very important issue. People can afford to travel for spring break and go to places for vacation. In New York particularly, we have a large population who actually live in Florida during the winter and in the spring they come back to New York. So, travel patterns, I think, is very important. Number two issue would be something to talk about is tanning beds. We did not have tanning beds in the 1930s. That is like one of the huge public health issues that to us physicians, it is unbelievable that they are still not banned.

PAM: I am absolutely appalled every time I see one of those in some strip mall. And, of course, they have the sexy bodies and all of the enticing triggers and cues to young people who feel that having that having that extra-tanned body is really going to take them to Nirvana. I find it horrific. I have no idea why this is still going on now. It just makes me crazy. The other thing, too, I'm thinking about? Maybe I'm just crazy, but I am a triathlete and I think that a lot more people, maybe, who knows, are doing a lot more outdoor sports than they've ever done before.

HOOMAN: Exactly

PAM: I'm just saying. Maybe there are just not as good about covering themselves up with SPF and I think that sometimes they sweat it off. Here's another thing, I don't think they realize how many times you have to reapply it. You don't just sort of put it on at nine in the morning and assume that you are good to go until 5 p.m. Does that make sense?

HOOMAN: Absolutely. It does. And we are more active but these are just a few aspects. There are other issues such as the ozone layer. That is not a big problem in the U.S., but we know in Australia where there is thinning of the ozone layer is occurring, that is more of a problem there. And, stress. I think it's really important to mention stress because if you have more stress in society going on or, as we stress the adrenal gland produces the corticosteroid hormones which are suppressive to our immune system.

PAM: Right.

HOOMAN: We see this, especially, we have so much skin cancer that are immunotransplant patients.

PAM: Exactly.

HOOMAN: They have to be on high doses of steroids and other immunosupressants. We see much more skin cancer in that population.

PAM: Can I just ask you a quick question, then? I know that everyone out there is saying, "Oh, my gosh." So, what are some of the real coaching tips to help prevent skin cancer? Let's kind of run through some of the practical issues that people can really do. Everything from just checking in with your dermatologist, which I definitely do as an outdoor athlete. I make sure that she is taking pictures of me. She knows exactly if there is some strange thing that poked up on me. I just run to her. But, let's run down that list.

HOOMAN: Great. Number one, there are certain diagnostic issues that we can discuss and then, there is some prevention. In terms of picking up on a melanoma earlier and it is important to know that about 50% of melanomas are actually picked up by a patient themselves or a patient's spouse.

So, being able to know what to look for is really important. We always talk about A-B-C-D-Es of melanoma. "A" stands for asymmetry. If you have a mole, mark it with a circle and make sure that one side of the circle matches the other.

So, look for asymmetry. "B" stands for border. Make sure the border is not irregular. "C" stands for color. Make sure it is a uniform color and one part is not blue or red and the other part is different shades of gray.

So, color is important. Diameter, we usually worry about anything that is over six millimeters in diameter. That's the size of a pencil eraser. Probably the most important is "E"—evolving. Anything that is changing, bleeding, itching, something that is growing suddenly and it was flat before and suddenly it starts changing.

PAM: Okay. So, Dr. Khorasani, if I can just say, what you've just told me, is that it is very important if you have any questions whatsoever, get to your physician. More importantly, really make sure that you check in with a dermatologist, who is an expert who can really help you understand whether or not you do have an issue or not. Slap on that SPF all day long, everyone out there.

We have been talking to Dr. Hooman Khorasani who is a dermatologist at Mt. Sinai who has been helping us understand what skin cancer is, A to Z.

I am Dr. Pam Peeke with Michelle King Robson.

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