LUPUS AND SKIN CANCER
What does skin cancer have to do with lupus? Well, people
with lupus are more prone to skin cancer or at least those ones who take
immunosuppressant drugs. It is a fact that cyclophosphamide (Cytoxan) and azathioprine
(Imuran) cause skin cancer. I have accepted this as the price of doing business
(ie treating my organ threatening lupus). I have taken these chemo therapy
drugs for the last 9 years and I have just had my sixth basal skin cancer
lesion removed from my skin. Maybe my light skin and hazel green eyes make me
more susceptible to this affliction but then my childhood days at the beach in
sunny Saskatchewan probably have also played a part.
And my family history could have some bearing on it. Three
out of seven immediate family members have also had skin cancer. It is worth
noting that when one member of a family gets skin cancer, the other members of
the immediate family are advised to also get checked out.
I consider myself lucky that I have only got basal cell skin
cancer. It is the relatively benign kind of skin cancer which is usually confined
to the outer layers of the skin if caught early. It is not as serious as
squamous skin cancer which can spread if it is not caught in time. However, I
had a friend who was not treated in a timely manner and he died from it
squamous skin cancer last fall.
And then there is the most serious kind of skin cancer, that
is, melanoma, which definitely needs to be removed early because it goes spread
internally and does kill people. I know four people who have had that type of
skin cancer and because it was caught early they are still alive and well.
However, melanoma skin cancer kills one person every minute in the US and the
incidence of it is increasing.
Any kind of skin cancer can be disfiguring. Again I am lucky
in this regard because the two instances of skin cancer on my face have been handled
by a plastic surgeon that specializes in the Mohs method. There are not that
many doctors who specialize in this kind of surgery and I was fortunate to be
referred to the Skin Care Clinic at the Vancouver General Hospital where some
of the pioneers in the field work. Thus I have escaped, so far, relatively
unscathed.
Here is a picture of the wound on my shin. It is quite the gash! The size of this cut surprised me
but I have been assured that was what was needed to:
a) remove the tumor
and the adjacent area around it
and b) leave me with
the least obvious scar.
As the plastic surgeon explained, the incision needs to be 3
times as long as the widest section of the tissue removed. He is taking the
tumor plus healthy looking tissue bordering it. Thus the spot that I had
removed from my shin that looked like the size of a pencil eraser, has left me
with a 5 stitches and a scar 2.3 inches long.
Now if I earned my livelihood from modeling pantyhose I am
sure they would have elected to do the Mohs method to remove the cancer. In
this case, I would have had a lot more invisible stitches and probably a less
visible scar. But there are no guarantees with scars, because everyone heals
differently. The conventional wisdom is that people with lupus heal more slowly
or at least for incisions above the waist (according to my last plastic
surgeon).
This is really no big
deal at my age. I wear my scars as a warning to others to take care of their
skin. And every time I see my young nephew, the one who balks at wearing sun
screen, I trot out my portfolio of scars to serve as a reminder to not follow
in my footsteps.
So how has this changed my behavior? Well, I cover up with a
long sleeve shirt, a floppy hat, and wear 100% Neutrogena sunscreen on my face
and a lower number on other exposed skin. I have to say that in the summer I
like to wear tennis skirts when I play tennis but I guess that is going to have
to change too. There is nothing like a new scar to hide, in order to make me
cover up.
And I have recently read that certain foods including
coffee, fish, beans, carrots, Vitamin C and beta carotene may protect people
from getting skin cancer. Now I am going to make a point of eating more of
these foods. Unfortunately though, I damaged my skin a long time ago. Thus even
these protective measures do not guarantee that I will not get more skin
cancer. For this reason, I need to see my dermatologist once a year for skin
cancer checks. And if I recognize any more lesions between checkups then I will
be in to see him as soon as possible.
The people with lupus in the crowd are probably questioning
my sanity in going out in the sun at all these days. Even those lupus sufferers,
who are not photosensitive, are not supposed to be hanging out in the sun. The
doctors will tell you any exposure to sun light affects the immune system and
increases the risk of a lupus flare. So I am more cautious and don’t suntan or
stay out in the midday sunshine. But feeling the warmth of the sun and being in
bright light makes my life worth living so I am not going to live in a cave for
the rest of my life.
http://umm.edu/health/medical/altmed/condition/skin-cancer
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