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Posts Tagged ‘squamous cell carcinoma los angeles’

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So the compliments keep coming…

Thursday, March 23rd, 2017

I keep getting told that “you look good ” “you changed your hair”. No, but thank you! My brows are lifted! I must’ve really needed that laser eye lift!

It was a pleasant surprise to get an update on my review paper of metastatic squamous cell carcinoma which was published 7 years ago. It has been cited by 135 other articles! Ask me how we can prevent this situation. It is not common but unfortunately, there are at least a few people with it every year. It’s very rare that women get them, but last year I did see the second woman of my career that had a SCC spread to her lymph nodes. The first patient I had met was mismanaged by a medical group in town and had her tumor treated numerous times without cure. She couldn’t talk or swallow by the time she met me. It was too late. The second lady had let the tumor grow too long and just had some bad luck.

Typically, the average SCC that spreads to the lymph nodes in my practice is an older white male who has had previous treatment of the lesion with radiation or liquid nitrogen. Size of the tumor, aggressive pathology, a delay of treatment and location on the upper half of the head or back of the hand are higher risk factors in my experience, and is backed up by research.

There are ways of avoiding this situation! Mainly, wear a hat and a zinc oxide-based sunblock such as Verdure. Get frequent exams and examine your own skin by looking and feeling. Talk to me about options for treating precancers that we can’t even see or may be too numerous to treat. And most of all, don’t delay seeking help.

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Sorry for the absence!

Monday, November 3rd, 2014

Sorry for not posting a blog for months. It started with my girls’ bday party planning, and somewhere it morphed into the elementary school search.

A lot of you have been asking when Verdure sunscreen will be available again. We are really sure it will be March/April 2015. Thanks for your patience.

I hope you will enjoy getting to know my new assistants Rosa and Tracy. Once again, I have made the USC and UCLA crowds happy.

Mistakenly, I was omitted by Pasadena Magazine as a Top Doctor in Dermatology this year when the issue was published. Their editors were notified of this error. Once again, you will see my name in Los Angeles magazine as a SuperDoctor this January. Thanks again to my colleagues who have bestowed Dr. Bennett and me with this honor.

A friendly reminder that I will be out of the office as usual Thanksgiving week and between Xmas and New Years. Cosmetic treatments and appointments are very popular around this time of year so plan accordingly. The Mohs surgery schedule is also filling up, so if you decide to postpone your surgery until after the holidays (not recommended for SCC or melanoma), please make careful note of the exact location of your biopsy site and take multiple pictures with your cell phone or ask your referring dermatologist to take a picture and consider a diagram.

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Spot your own skin cancer

Thursday, October 31st, 2013

As I was reviewing my collection of research articles, I came across an abstract that was presented by some colleagues. They found that most skin cancers they operated on in their practice were discovered by the patient themselves! Get to know what your skin looks like so you can find the subtle changes. Besides the obvious, check your feet, your privates (epidemic of genital warts among my young patients), and go get your eyes and retinas examined by an ophthalmologist if you have had a lot of sun exposure or have a lot of moles. Let a friend or loved one check your back, or if you don’t have anyone, let me do it! It is always best for the dermatologist to do an annual total body skin exam if you have never been examined, or you have a personal or family history of skin cancer.

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Skin Cancer Awareness Month

Thursday, May 16th, 2013

May is the month of Melanoma Awareness and Don’t Fry Day. The latter day was created by Dr. Jeff Ashley through his non-profit organization Sun Safety for Kids. This organization promotes sun safety awareness to children and their schools. I sit on the executive board of this organization. If you know of any teachers who would be interested in educational materials for their students or any members of the PTA who are on their school safety committees, please have them visit

Although we all tend to protect ourselves more during the summer months, a friendly reminder that even UVA rays penetrate through clouds. The scary thing is that we are all exposed to flourescent lighting and now, UV-C lighting in our workplace and home, and we tend to forget our constant exposure in these settings as well.

At the same time, I have read that the JAMA has published that surgery for nonmelanoma skin cancers may not be beneficial for certain elderly patients. While I agree that treating a skin cancer on someone who has a life expectancy of less than one year may not make sense, we have treated a number of very elderly patients in our practice and have contributed to their well-being and comfort. Dr. Bennett recently saw a 108 year old, who saw him when she was 98, asking if her skin cancer should be treated! Today I spoke to a patient who lost 2 friends not to melanoma, but to squamous cell carcinoma. Dying from SCC is not a pleasant way to go, particularly of the head and neck. In some cases it is miserable and difficult to watch someone losing the ability to chew, speak, talk and swallow. What I am afraid of is our loss of access to a good procedure like Mohs surgery which, while expensive, does provide the highest rate of cure for skin cancer treatment. Mohs surgery is not necessary for all tumors in all locations, at the same token. An ethical and competent dermatologist should be able to steer one in the right direction when it comes to treatment. Make sure you know all of your options and why a treatment may be recommended to you. I have seen cases where Mohs surgery should have been done, and had not been recommended, to the opposite, where Mohs was probable overkill, and should only have been done if the patient had chosen that option.

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Skin Cancer Myths and Facts

Friday, February 8th, 2013

Skin Cancer Myths and Facts

The Skin Cancer Foundation has a wonderful page about the most controversial and confusing issues regarding sun protection. Check it out! And hey, I finally figured out how to create a link on Word Press (it’s that red link above). That alone should encourage you to check it out. Woo hoo!

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Skin cancer incidence

Friday, January 25th, 2013

The Skin Cancer Foundation put out a statement that the incidence of skin cancers is higher than that of breast, lung, colon and prostate combined. This does not include just melanoma, but also non-melanoma skin cancers including basal cell cancer and squamous cell cancer. Preventative exams are key! Not only should you have a dermatologist look at you, but get to know what your skin looks like. This can be tough in certain places, so have a loved one help, and/or use two mirrors. Things can change fast. I just had a patient who had a full exam in August, and now has multiple suspicious moles that just popped up in the past 6 months.

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Squamous cell carcinoma. What is it?

Saturday, October 13th, 2012

My beautiful girl

A lot of patients ask me what is squamous cell carcinoma (and how do you spell it)? SCC is the second most common type of skin cancer. Basal cell cancer is first. SCC is potentially more problematic because a small percentage of them metastasize (can travel to other parts of the body) and cause serious problems or death. SCC’s can spread, break apart and travel more easily. I wrote a review paper on metastatic SCC in Dermatologic Surgery, our main journal, and the cases I’ve seen can be absolutely devastating. Luckily with proper treatment and an eagle eye, many lives can be saved. We think SCC’s come from cumulative sun damage, while BCC’s may be due to long intense exposures, but it is not clear. It has been proven that sunscreen use prevents SCC’s and their precursors, actinic keratoses, better known as “precancers.”

Luckily, most SCC’s are caught early enough to not be a long term problem. SCC in-situ (those on the surface of the skin which have not invaded the middle layers microscopically) have an excellent long-term prognosis, provided they are properly treated. If on the head, neck, genitals (men and women get them usually from a past history of genital warts) or other critical places, Mohs surgery is the best choice. Let’s just hope the Affordable Care Act lets us continue with this option. Otherwise, most cases are treated with burning and scraping (electrodessication and curettage) or “ED&C” or an excision. Other non-FDA approved options include imiquimod cream and photodynamic therapy. Cryotherapy in my opinion, is not reliable.

For invasive SCC’s, if the lesion is very small (less than 5 mm) then ED&C or excision may be acceptable if the lesion is off the head and neck. I personally believe that no matter the size of the lesion, if the SCC is on the head and neck regardless if in-situ or invasive, or if the lesion is recurrent, Mohs surgery is the superior choice. Recurrent SCC’s can spell trouble, and I strongly recommend Mohs surgery in those cases.

To read more about the differences between Mohs surgery and excision with frozen sections (“fake Mohs”) please refer to this section on my website

On a lighter note, loved taking my girls to the pumpkin patch last week.

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Did you know?

Thursday, March 1st, 2012

There may be a link between UV light used during manicures and skin cancer? A recent study mentioned by the American Academy of Dermatology this week may have found a link? Next time, consider just letting your nails dry naturally.

Also, I cannot stress enough how important it is to protect your lower legs from sun exposure, especially to the women out there. I have a number of lovely senior ladies who now suffer from squamous cell cancer after squamous cell cancer due to the sun damage they’ve received as well as recent trauma. There are enough fake tanners/sprays out there!

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Skin cancer, the gift that keeps on giving

Saturday, February 4th, 2012

…well at least it’s not genital warts (see previous post). Once you get a skin cancer, unfortunately, you often will get more. The younger you are when you get one, the more likely you will have more in your lifetime. Almost everyone we treat with Mohs surgery has had a previous skin cancer elsewhere. It is important to prevent skin cancer in the first place by avoiding prolonged sun exposure and practicing common sense sun protection. Does that mean you have to be a recluse? No, but purposefully sunbathing is not very smart.

An experienced dermatologist can often recognize a skin cancer in its earliest stages, though every dermatologist has missed something at some point in their careers. (And if they claim they have not, they are big fat liars!). Therefore, we rely on patients to do their own self exam and observe any suspicious lesions for changes in color, shape, size and border, and to come in for periodic exams. Don’t let anyone freeze any lesions more than once without discussing the possibility of a biopsy for any persistent or recurrent lesion. The person that set the record in my office for the longest time spent in Mohs surgery in one day was a celebrity in his 40’s who had had a lesion frozen twice with two different dermatologists. He pulled through wonderfully and took it very well considering, but we were both dumbfounded at the extent that this tumor had grown.

I love what I do and I get the most satisfaction from educating my patients on their skin lesions and skin cancer, but I would rather not be cutting off parts of your nose, eyelids, lips, etc for your sake. Preventative care is really important.

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Lots of skin cancer news

Friday, October 28th, 2011

There has been a lot of new data on skin cancer lately.
-There is a link between melanoma and breast cancer
-Women who drink 3 cups of coffee a day may lower their risk of basal cell carcinoma by 20%. Sorry, men, only 9% for you.
-After just 4 tanning bed visits, the risk of basal and squamous cell carcinoma increases by 15% and of melanoma by 11%. The younger the patient is, the higher the risk of basal cell carcinoma
-Melanoma rates have increased for women under 50 for Caucasians, Asians and Hispanics
-Melanoma remains the #1 cancer in white women from the ages of 25 to 29 and #2 for women 15 to 30 years old

It is not common knowledge that non-white people can get skin cancers. Some of the worst basal cell cancers I have seen are in Hispanics and Asians. The two worst nose cases I’ve seen lately were in two Korean people in their 60’s to 70’s.

I would not be surprised if I get a basal cell carcinoma one day considering that my friends and I spent a lot of time frying in the sun trying to tan ourselves and swimming at the Swim Club! I remember my blonde friend turning as red as a lobster, and I was disappointed that I just couldn’t tan. Baby oil, Hawaiian Tropic and Coppertone SPF 4-we used it to try to get tan, not to protect ourselves! I escaped the signs of sun damage until I moved to San Diego in the late 90’s. Too much outdoor fun on the weekends led to a lot of freckling. I wish I knew then what I know now.

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