A couple of years ago, I was injecting the spider veins on the legs of my patient, Hannah*, when I noticed a dark, irregular mole on her calf. I biopsied it that day.
Microscopic examination revealed it to be an atypical nevus - a pre-cancerous mole with a significant risk of eventually developing into melanoma, the deadliest form of skin cancer. Fortunately, the mole was small enough that a minor surgery with no more than a couple of stitches took care of it and saved Hannah any further problems. From then onwards, I've given Hannah a complete skin examination twice a year, so that I can identify and remove any suspicious moles at an early stage.
Mention preventive health to most people and they're likely to think of mammograms, prostate exams and Pap smears. In my office, there is another preventive health measure that I have resolved to focus on, and that is skin cancer screening. I offer it to all my patients annually or semi-annually, along with counseling regarding sun protection - even to those patients who would otherwise see me only for purely cosmetic purposes. This Spring, I am also offering two free skin cancer screenings in my offices in conjunction with the American Academy of Dermatology.
Even if you think you've been "careful" about the sun, the chances are that you've received far more sun exposure than those of previous eras. One reason is changes in lifestyle, which find us spending much more time outdoors, not just on the beach or by the pool but also on the tennis court or golf course, in the car and on the Little League field. The other reason is that the atmospheric ozone layer, which protects us from the sun's damaging ultraviolet rays, has thinned dramatically in recent years.
We're exposed more and protected less than ever before. And the results are plain to see, in the ever-increasing number of patients who are being diagnosed with skin cancer or pre-cancerous growths by dermatologists like me.
The statistics are stunning: The National Cancer Institute and the Centers for Disease Control and Prevention (CDC) report that skin cancer is now the most common cancer in the United States, with more than 1 million cases diagnosed annually. According to the American Cancer Society, 1 in 5 Americans and 1 in 3 Caucasians will develop skin cancer in the course of a lifetime. Since pretty much all skin cancer is curable if caught at an early enough stage, the importance of regular screening is obvious.
Hannah always brings a smile to my face every time she walks into my office. It's not just her engaging personality, her unfailing courtesy to even my most junior staff and how beautifully her results from my outer ministrations reflect her inner beauty. As much as I love the aesthetic side of my practice, with its heady blend of artistry and high technology, it's immensely satisfying to save a life - or, at the very least, to save someone considerable stress, worry and future surgery.
As you ponder the importance of healthcare reform in determining your presidential vote, I hope you will spare a thought for preventive health. Though it's far less sexy than some of the other issues that are being debated, there is no doubt in my mind that it should be a priority in the upcoming election. The deeper issue for your consideration is how to provide these services to those who are uninsured or underinsured - and how much government control there should be over this process.
*Patient's name has been changed to protect her privacy
Published On: February 13, 2008