Friday, July 12, 2013

SKIN CANCER AND LUPUS


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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