Skin cancer whack-a-mole (II)

This is part two of this week’s skin cancer post. The firstpart describes my experiences with skin cancer. This part explains the difference between actinic keratosis and the three types of cancers:

• Actinic keratosis: a pre-cancerous patch of thick, scaly, or crusty skin. Though they are considered pre-cancerous, less than 1% develop into squamous cell cancers per year (per person). The usual treatment for actinic keratosis is to freeze them off with liquid nitrogen. 
• Basal cell carcinoma: the most common kind of skin cancer and the most common kind of cancer in humans. Basal cell carcinoma is simply cancer of the basal cells in the skin—the cells in the lowest layer of the epidermis. (See illustration below.) They grow slowly, but should be treated because they can grow into nearby areas and invade the bone or other tissues beneath the skin. Basal cell cancers are surgically removed.

• Squamous cell carcinoma: like basal cell carcinomas, they are cancers of a layer of skin cells—the squamous cells. Squamous cell cancers are more likely to grow into deeper layers of skin and spread to other parts of the body than basal cell cancers, although this is uncommon. At any rate, they’re considered more dangerous than basal cell carcinomas. Apparently 60% of squamous cancers arise from pre-existing actinic keratosis. These cancers are surgically removed.
•  Melanoma cancers: develop from melanocytes, the pigment-making cells of the skin. Melanocytes can also form moles--benign (non-cancerous) growths. Melanomas are much less common than basal and squamous cell cancers, but they are more likely to grow and spread if left untreated.

You can find plenty of pictures of these kind of cancers on the internet, but I don’t recommend it.

Next week: Some dermatological surgery rip-offs

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Skin cancer whack-a-mole (I)

The one and only doctor I see about once a year is my dermatologist, darn it. In fact, I have both a dermatologist and a dermatological surgeon! I’ve gotten quite good a diagnosing the various types of cancers—some, even, that are barely visible. So far, I’ve only been wrong once in my diagnoses.

My skin is awful and it’s entirely because of sun damage, probably because, as a teenager, I was intent on having a fabulous tan. I still tan easily and rather like being tan, but it’s a dumb thing to do. I get the cancers in places where my skin has been exposed to the sun—face, legs, ears, etc.

Me, getting started.

 The “whack-a-mole” reference has to do with my own skin cancer situation. I’ve got tons of those crusty pre-cancerous actinic keratosis all over the place, plus recurring eruptions of basal cell and squamous cell cancers (never melanoma, thank goodness). The cancers keep popping up and the docs keep whacking them. (This week I’ve posted two entries, I and II. The second one explains the difference among the cancerous conditions.)

The treatments I’ve received have been various. My first surgery was on my nose. After determining that the spot was basal cell carcinoma, the dermatologist (not my current one) sent me off to a plastic surgeon to have it removed. After removal, however, an examination of the tissue showed that the edges were not clean. In other words, they had not gotten it all. So I had radiation on my nose—two weeks of daily treatments, as I recall. Incidentally, this dermatologist mentioned a treatment called Mohs surgery but said he didn’t know how to do this. Then he warned me that, should I find someone who would use the Mohs procedure, I might end up with a big nostril. That was the last time I went to that dermatologist (who now regularly performs Mohs surgeries).

Mohs surgery is one in which the doctor removes little bits at a time, checking the bits under a microscope between each removal while you wait. This process continues until the edges are clean. In this way, the surgeon removes just what’s necessary. I now have an excellent dermatological surgeon. He has performed four Mohs surgeries on my face, but doesn’t use this method on other parts of my body. For cancers not on my face he just performs simple incisions. 

Because I have so many incipient cancers, I have also used topical creams, which are quite effective in getting rid of pre-cancerous lesions (which may or may not turn into cancer). Two products work for this: Efudex and Aldara (these are trade names, not generic, which are really hard to spell). Efudex attacks problematic cells and prevents them from producing daughter cells. Aldara stimulates your immune system within the skin to attack the offending cells. After a few days, I start getting sores then scabs, after which the spots disappear.

Next week: dermatological surgery ripoffs

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

Blue light and sleep

The information in this post comes from a newsletter sent by friend of mine, Enid Fox, who is a fitness and nutrition guru. She is a careful researcher and I trust her information.

Our sleep/wake cycles are regulated by the hormone, melatonin, which is produced by the pea-sized pineal gland located in the brain. The melatonin it produces circulates in the blood. Production of melatonin is triggered by darkness, and its level in the blood usually peaks in the middle of the night. The highest levels of melatonin are between midnight and 8:00. One reason teenagers have trouble getting up is that, for this age group, the nightly schedule of melatonin release is delayed, a situation that leads to later sleeping and waking times.

The thing is, melatonin not only regulates our sleep, it is also a powerful anti-oxidant and anti-inflammatory chemical. One study has shown that people who work the graveyard shift have an increased rate of cancer. So you want to keep your levels of melatonin up. Unfortunately, melatonin production decreases as we age—like so much else, dang it.

What’s important for melatonin production is not sleep itself but darkness. The pineal gland responds to signals transmitted by our optic nerves. When it gets dark, a cascade of nerve signals from the eye to the pineal gland triggers the release of melatonin. But if we bombard our eyes with bright light at night we inhibit the usual surge of melatonin at night, thus lowering the overall production of melatonin.

Dim light has little effect on melatonin, but bright lights, especially the blue lights emitted from electronics can stop the pineal gland from releasing melatonin. One study looked at how melatonin levels were affected by looking at an iPad at night. Researchers found that one hour of exposure to the light didn’t significantly curtail melatonin release, but two hours did. Here’s something else to think about: red-lighted alarm clocks don’t disturb melatonin production very much. But clocks with bright light should never be placed at your bedside.

For a while now I have started reading books on my iPad. Now I’m thinking I need to get out my ancient Kindle, which is not back-lit.

Next week: skin cancer whack-a-mole

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

A sleep survey

My mother, Margaret Stoppel, who died in 1991 at the age of 85, wrote a weekly column for her local newspaper, the Sequoia Sentinel. In the year that she died she wrote a column that describes her own sleep habits as well as those of her friends. I think they'll be familiar to many of you. Here’s the column:

"I recently asked a few of my friends about their sleep patterns—my women friends. It didn’t seem proper for me to ask my gentlemen friends.

The principal fact that surfaced was that not a great deal of sleeping was going on among my age group. Most of them sleep four or five hours, with wakefulness plaguing at different times.

A couple of my friends doze off around eight o’clock, just when they want to watch television and then are bright-eyed later when their favorite shows are over. All of them, with one amazing exception, make one or two trips to the bathroom during the night.

Some of them fall asleep promptly only to be wide awake later for two or three hours. Most of them read during their wakeful hours, some play solitaire, but one, who usually is awake between two and four o’clock finds that she does her best thinking at that time.

Some take naps in the afternoon, varying in duration from 15 minutes to two hours. I am a fifteen minute napper. I have been doing this for many, many years. It has become such a fixed habit that when I am socializing in the afternoon I yawn and my eyes glaze over.

When I was working and knew that I had to get up by six, hours of sleeplessness distressed me to no end, which, of course, compounded the problem.

At that time I read an article that suggested saying aloud, or in a whisper, over and over again, the word, “hemlock,” the theory being that the breathing required to do this would induce sleep. I tried it but it didn’t work. It only served to depress me, because the word evoked pictures of Socrates drinking hemlock and dying."

Next week: Blue light and sleep

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.

The dangers of sleeping pills

People often worry about sleeplessness—which is exactly what drug companies encourage. Using their influence, five pharmaceutical companies managed to establish a National Sleep Foundation that labeled sleeping problems as “public health crisis” and a “national emergency.”  The primary pharmaceutical sponsors of this so-called non-profit organization, founded in 1990, all manufacture sleeping pills.

Naturally, the pharmaceutical companies launched ad campaigns to deal with this “public health crisis.” Their campaigns were wildly successful: between 2001 and 2005 sleeping pill prescriptions grew by 55 percent, to 45.5 million; by 2011, the number was 60 million.  By 2012, 4% of our population was taking sleeping pills.

But here’s the thing: Sleeping pills, such as Ambien and Lunesta aren’t even especially helpful. In a 2007 study financed by the National Institutes of Health, these “hypnotics” reduced the average time to fall asleep by 12.8 minutes and increased total sleep time by only 11.4 minutes. One drug, Sonata, did not extend sleeping time at all. (Test subjects slept six hours and 20 minutes whether they had taken a sleeping pill or a placebo.) Such a paltry benefit doesn’t begin to compensate for the dangers of sleeping pills—which are considerable.

In a 2012 study reported in the British Medical Journal researchers compared medical records of 10,529 people who used hypnotic drugs with 23,671 who used none during the same period. They found that patients taking the sleeping pills on a regular basis were nearly five times as likely as non-users to die over a period of two and a half years. Heavy users were more likely to develop cancer. Previous studies performed in Norway, Canada, and Sweden had also found a link between sleeping pills and increased risk of death. The Swedish study, which followed people for 20 years, found that regular users of hypnotics were 5.6 times as likely to die during the study period, while women were twice as likely to die.

Best to count sheep, I think.

Next week: A sleep survey

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.