Even black and brown people can be at risk

It is May, and Melanoma and Skin Cancer Awareness month.  There is a common misconception, that non-white individuals may not be at risk of skin cancer, like their white counterparts.  This assumption is not only wrong, but also dangerous.

This post will focus on what everyone needs to know about melanoma and skin cancer.  I am very excited to present this Q&A with my Dermatology colleague, Dr. Julia Tzu.  Dr. Tzu has a very unique and impressive set of skills including Dermatology (skin diseases), Mohs surgery (specialized form of skin cancer surgery), and Dermatopathology (skin diseases at the cellular and molecular level).  She runs a very successful Dermatology practice in Manhattan and is a Clinical Assistant Professor at NYU School of Medicine.  She also has a practice website with incredibly useful information that you may access at www.wallstreetdermatology.com


Can you tell us how often you encounter cancers of the skin in your practice?

Because I specialize in skin cancer treatment, I see and treat skin cancers routinely in my practice.  Sometimes, patients come in with an already biopsy-proven skin cancer for which they specifically seek surgical consultation.  Sometimes, people come in for an “ugly mole” that is eventually diagnosed as skin cancer.  Sometimes, patients come in simply for a full body skin cancer screening with no concerns, but are eventually found to have skin cancer.
What are the main risk factors?  
First of all, skin cancer can be found in people of all ages, races, and genders. However, certain risk factors increase the chance that one may develop skin cancer.  Common risk factors include having fair/light skin, a history of bad sunburns, numerous moles, a family history of skin cancer (genetics), a personal history of skin cancer, advanced age, a depressed immune system, indoor tanning, and significant sun exposure.
What are the main types of skin cancer? 
There are many different types of skin cancers. However, the most common skin cancers include:
Basal cell carcinomas: Basal cell carcinoma is the most common skin cancer (and cancer in general) in the world. They usually exhibit localized growth and prognosis with treatment is excellent.
Squamous cell carcinomas: Squamous cell carcinoma is the second most common skin cancer.  Squamous cell carcinomas have a higher capability to travel to distant sites of the body compared to basal cell carcinomas.  Prognosis with treatment is excellent if caught early (before spread to distant sites).
Melanoma: Probably the most famous of skin cancers, because the media has done an excellent job raising public awareness that this is serious type of skin cancer that can have rapidly fatal outcomes. Treatment for melanoma can be excellent if caught at a very early stage. Unfortunately, the diagnosis of melanoma has been on the rise in recent decades.
Some non-whites do not realize they too can be at risk.  Do you have any comments about this? 
I have diagnosed and treated skin cancer in people of all skin colors and ethnicities. While it is true that more skin cancers are found in caucasians, people of all skin colors need to be cognizant of changes in any mole/spot/growth anywhere on their skin (not just sun exposed areas) and see their dermatologist for routine annual skin cancer screenings.
What skin cancer treatments do you provide as a Dermatologist?
I’m a skin cancer surgeon, so most of the treatments I provide are surgical in nature (there are other nonsurgical options in some circumstances as well).  The main types of surgeries include:
-Mohs surgery: a highly specialized form of skin cancer surgery for treatment of skin cancers on cosmetically and functionally sensitive sites such as the face, neck, scalp, hands/feet, shins, and genitals; or for highly aggressive or large skin cancers anywhere on the body. It has the highest cure rate compared to other forms of skin cancer treatments.
-standard surgical excision: this is the basic form of skin cancer surgery for smaller and less aggressive skin cancers in general.
-electrodessication and curretage:  usually reserved for superficial basal and squamous cell carcinoma in situ on the trunk and extremities.
The decision to choose Mohs surgery vs standard surgical excision vs electrodessication and curretage is made during a surgical consultation, and is dependent on many factors, which can include the type, size, location of the skin cancer, and age/health status of the patient.
Thank you very much, Dr. Tzu!
Thank you for bringing awareness to skin cancer, Dr. Njiaju.


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Author of "Self navigate for health" available as eBook on Amazon and paperback on Lulu. Hematology-oncology physician writing about medical self-advocacy or "self-navigation", cancer, blood disorders, and books

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