Skin Cancer Awareness Month: How to detect and prevent this deadly disease

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Skin cancer affects people of all ages and races, and it most often develops on the areas of a person’s skin most exposed to the sun.  It is the most common form of cancer diagnosed in the U.S., with more than 3.5 million diagnoses annually.  According to the American Cancer Society, skin cancer diagnoses equal more than the new diagnoses of breast, prostate, lung and colon cancers combined.  

There are three major types of skin cancer: basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and melanoma.  BCC is the most common form of skin cancer and most often occurs on the most sun-exposed areas of your body (i.e. face and neck).  It often appears as a pearly or waxy bump, or a flat, flesh-colored or brown scar-like lesion.  SCC also often occurs on sun-exposed areas of your body, but it presents as a firm, red nodule or a flat, scaly or crusty lesion.  

Melanoma, on the other hand, can develop anywhere on your body – even on skin that is not often exposed to the sun.  In men, it most commonly appears on the trunk, head or neck – and in women, the lower legs.  It often presents as a large brown spot with dark speckles; a mole that changes color, size or texture; a small lesion with irregular borders; or dark lesions on your palms, fingertips, soles or toes.  It is from these signs that the “ABCDEs of Melanoma” were developed:

A: Asymmetry of the mole.  If you were to draw a line across the mole, the two halves will be very different.

B: Borders of the mole are uneven.

C: Color varies throughout the mole.  This can include different shades of brown, tan, black or even red, blue or another color.

D: Diameter of the mole is greater than 6 millimeters (or the size of a pencil eraser); melanomas tend to be larger than benign moles.

E: Evolution of the mole, in size, shape, color, and texture can be indicative of melanoma.

It is estimated that one in five Americans will develop skin cancer, so the chance of you or someone you know developing skin cancer is more real than you may think.  Fortunately, there are some easy tips to help prevent skin cancer.  

First, wear at least SPF 30 sunscreen and protective clothing (e.g. long sleeve shirts, pants, wide-brimmed hats, sunglasses, etc.) every day – even on cloudy days.  Reapply your sunscreen every two to three hours, especially if you are swimming or sweating.  Seek shade during the sun’s harshest hours: between 10 a.m. and 4 p.m.  

Second, avoid tanning, tanning beds and sun burns.  Also, be watchful for any new or changing spots on your skin.  If you do see any spots that are new, have changed, are itchy or are bleeding, see your dermatologist immediately. Not all changes are caused by skin cancer, but it’s always best to speak with your dermatologist.  Early detection affords you the greatest likelihood of successful treatment.

Dr. David B. Samadi is the Vice Chairman of the Department of Urology and Chief of Robotics and Minimally Invasive Surgery at the Mount Sinai School of Medicine in New York City. He is a board-certified urologist, specializing in the diagnosis and treatment of urological disease, with a focus on robotic prostate cancer treatments. To learn more please visit his websites RoboticOncology.com and SMART-surgery.com. Find Dr. Samadi on Facebook.

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Woman removes colon to prevent deadly cancer

By the time she was 34, Lynne Fisher had already experienced incredible tragedy.

Her uncle Charlie had died at the age of 33, followed by her father a year later at the age of 47.  More significantly, both of their lives had been claimed by the same disease – colon cancer.

While the episode was very traumatic, a connection between their deaths was never made, until 10 years later when the unthinkable happened.  Fisher’s brother was diagnosed with colon cancer, also called bowel cancer, at the young age of 28 – and passed away two years later.

“My brother Mickey died, which was really traumatic,” Fisher, 51, who lives in Nottingham, England, told FoxNews.com. “I’d seen my uncle, my dad, my brother all die.  And I was really close to my brother; there was only a two-year age gap.  Watching your younger brother die is just horrible.”

Realizing that the family had a connection of some kind, doctors warned Fisher she could possibly develop the disease and that the increased risk was most likely passed down from her father.  However, genetic screening wasn’t available then, so Fisher, her two brothers and sister started having colonoscopies every three years in order to check for signs of the developing disease.

During this time, Fisher had a small nervous breakdown, feeling that everyone around her was dying of the same disease.  She vowed that if she ever contracted colorectal cancer, she wouldn’t pursue treatment, believing nothing could be done to save her, and that she should try to enjoy the time she had left.

Then in 2006, 13 years after Mickey’s death, Fisher’s older brother Clive was diagnosed with colon cancer at the age of 38.

“While he was in the hospital, he had lots of tests, and they told him he had a mutated gene that runs in our family,” Fisher said. “They explained it to him, and then he rang me and said, ‘They can’t save my life, but Lynne, you should get yourself tested, and then at least you’ll know.’”

Doctors had identified in Clive a faulty gene that is linked to a condition called hereditary nonpolyposis colorectal cancer (HNPCC) – also known as Lynch syndrome.  First discovered by Henry T. Lynch in 1966, Lynch syndrome is one of the most common hereditary causes of colon cancer, causing 3 percent of all cases.

People with Lynch syndrome develop polyps – abnormal growths of tissue – in their colons.  However, unlike in individuals without the faulty gene, the progression from a small polyp to full-blown cancer is a lot quicker for these kinds of patients.

“If (the polyps) are removed when they’re small, a lot of patients can keep their colons,” Dr. Anish Sheth, a gastroenterologist at the University Medical Center at Princeton in New Jersey, who did not treat Fisher, told FoxNews.com.   “If you catch it later where the polyps are too big, you have to have surgery and some people will remove the majority of the colon.”

The lifetime risk of someone with Lynch syndrome developing bowel cancer is 70 to 80 percent.

At first, Fisher said she didn’t want to know if she had the gene.

“They gave me lots of options: Did I want to know? What would I do if I did have it?” Fisher said.  “I nearly didn’t want to know, because I thought, ‘What difference would it make?’  But all my family urged me to have the test, and I got the results that I’ve got it.”

According to Sheth, a person with Lynch syndrome can have multiple mutated genes that contribute to the development of cancer.

“They all fit into this category of mismatched repair genes,” Sheth said.  “As our cells are dividing and replicating as we grow, there are just inevitable errors along the way.  There are genes we have that are designed to identify these mistakes and then correct them.  However, these genes which are responsible to repair these mismatches are actually abnormal (in people with Lynch syndrome) , so you get these cells who incorporate all these errors” – ultimately leading to cancer.

Upon the discovery of her genetic mutation, Fisher was presented with a very complicated surgical option.  Her doctor recommended she have a subtotal colectomy, in order to remove a large part of her colon.  He told Fisher he was 100 percent sure she would get bowel cancer if she didn’t have the procedure done.  But initially, Fisher didn’t want it.

“Because no one could save Clive’s life, and no one could save Mickey’s life, so I felt a bit guilty that they could save mine,” Fisher said.

But finally the urgings of her family convinced her to have the surgery – as well as inspiration from one of Fisher’s idols: Sharon Osbourne.  Osbourne announced she had colon cancer in 2002 and had surgery to remove part of her colon.  

“I read a story on Sharon Osbourne – she’s my idol; I have my hair like her,” Fisher said. “Sharon had some colon removed cause of some bowel cancer, and it made me realize that famous people are just normal people.  Just because she’s very famous, she still has these things going on in her family that I’ve got going on in my family, we have similar paths we’re following… So I thought she did it, other people have it, I might as well do it too.”

Surgeons ended up removing a large portion of her colon and reconstructed her small intestine to essentially function as her large intestine.

“My small intestine is sewed onto my rectal stump,” Fisher said.  “Normally you have the colon – well that’s gone.  I haven’t got a bag, but it means when I eat, within half an hour I need to go to the toilet.  And there are lots of things that go through; I don’t digest things as much.”

While she still experiences pain and frequent visits to the hospital, Fisher is thankful she had the surgery, as her risk of developing colon cancer has been decreased to 30 percent.   Also, Fisher is a mother of three, so she also knows her children are at risk of having the mutated gene and they will need to get tested soon.  

Overall, Fisher urges anyone to see a doctor as soon as possible if they have any change in bowel habits – albeit an uncomfortable subject to talk about.

“A doctor has seen lots of things,” Fisher said. “They’re there to save your life, and if you do not go to the hospital and get it checked out – you’re someone’s mom, dad, brother, sister, son, daughter, etc.  There’s someone who doesn’t want to lose you.  It’s important to get yourself checked.”

Fisher is involved with the charity Beating Bowel Cancer, located in England.  To learn more about the charity and how to contribute, visit www.beatingbowelcancer.org.

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Iron and zinc may prevent PMS

Women who feel bloated, irritable or depressed before getting their periods — classic signs of premenstrual syndrome, or PMS — may want to pay attention to the amount of iron in their diets, according to a new study.

Researchers at the University of Massachusetts at Amherst found that women with an iron intake of more than 20 milligrams a day had about a 35 percent lower risk of being diagnosed with PMS than women who had the lowest iron intake, about 10 mg a day. To get the higher amount, a woman would only have to eat one cup of iron-fortified cereal, which typically contains about 24 mg of the mineral.

PMS affects anywhere from 8 to 15 percent of women during their childbearing years and is characterized by physical and emotional symptoms ranging from breast tenderness and food cravings to fatigue and moodiness.

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Other research has shown that diet affects the development of PMS or may ease the severity of its symptoms. For example, diets high in calcium-rich foods have been shown to lower the risk of PMS, but little was known about the role other minerals might play in preventing the symptoms.

For the study, researchers reviewed three sets of food frequency questionnaires collected over a 10-year period from more than 3,000 American women, ages 25 to 42. All the women were enrolled in the ongoing Nurses' Health Study II, which is exploring the influence of diet and lifestyle on women's health.

Researchers compared the mineral intakes from food as well as supplements for nearly 1,060 women who had been diagnosed with PMS against those of roughly 1,970 women who had few if any PMS symptoms.

The scientists also considered other factors linked to PMS, such as a woman's age, weight, pregnancy history, use of oral contraceptives and her smoking and exercise habits.

"We were somewhat surprised by our findings for iron since no previous studies had observed this relationship," said study author Elizabeth Bertone-Johnson, Sc.D., an associate professor of epidemiology at UMass Amherst.

But not all forms of dietary iron are the same. It was primarily the iron found in plant foods and in supplements, non-heme iron, that reduced a woman's chances of developing PMS. The heme iron coming from animal sources, such as red meat and poultry, did not have the same effect.

Bertone-Johnson suspects that non-heme iron had a stronger relationship with PMS because it's easier to eat a diet rich in plant and supplement sources. For example, three-quarters of a cup of fortified cereal has 18 mg of non-heme iron, and a cup of lentil or beans has between 3 and 7 mg. But a 3-ounce serving of beef has only 2 to 3 mg of heme iron, so you would need to eat a large serving of beef to meet your daily iron needs, which is not advisable considering its saturated fat content.

The study, which was published online today (Feb. 26) in the American Journal of Epidemiology, evaluated data for eight different minerals.

Potassium: A Surprising Finding

Iron was not the only mineral linked to an improvement in PMS symptoms. The study found some evidence that a zinc intake of more than 15 milligrams a day was associated with a lower risk of PMS. But this effect was only seen for zinc supplements and not for food sources of the mineral.

Although the role zinc may play in PMS needs to be evaluated in greater detail, deficiencies of the mineral may be linked to mood-related symptoms like depression and possibly menstrual cramps, Bertone-Johnson said.

Researchers found no connection between intakes of sodium, magnesium or manganese and PMS. But it was a completely different story for potassium; high intakes of this mineral were linked to a greater risk for PMS.

"We saw a 46 percent increase in the risk of PMS only among women with the highest level of intake, which was approximately 3,700 milligrams a day. This was compared to women consuming the lowest amount, or roughly 2,300 milligrams," Bertone-Johnson said.

Potassium, found in foods such as sweet potatoes, bananas and orange juice, may increase a woman's chances of developing PMS by boosting levels of a hormone linked to water retention. The mineral may also contribute to other physical and emotional symptoms, such as bloating, depression and irritability.

"We were surprised to find that potassium intake was associated with a higher risk of PMS, as this was contrary to our expectations," Bertone-Johnson said.

Because the effects of potassium on PMS need further investigation and the mineral is an important component of a healthy diet, Bertone-Johnson said she would still encourage women who have PMS to consume the recommended daily allowance (RDA) for potassium, or 4,700 mg a day. But they should not go considerably higher than that amount.

"Our findings suggest that minerals, including iron and zinc, may be involved in PMS, but this needs to be replicated in other studies,"  Bertone-Johnson said.

For now, she suggests that women experiencing PMS symptoms meet the RDA for these minerals: 18 mg a day for iron and 8 mg a day for zinc. She also recommends getting 1,000 mg of calcium daily, the RDA for this mineral.

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