While skin cancer is less common in African Americans, experts say death rates from melanoma are much higher in the African American community. Melanoma, which often presents as an irregular mole, can spread much quicker and easier than most other skin cancers and can produce worse outcomes. Melanoma is often found in later stages in African Americans when treatment can require more intensive surgery or even radiation or chemotherapy. Knowing the signs and symptoms can help catch melanoma early, when the cancer can be cured.
African Americans are up to four times more likely to be diagnosed with advanced melanoma and 1.5 times more likely to die from melanoma, according to the Melanoma Research Alliance. This is alarming, considering African Americans account for a small portion of melanoma diagnoses.
Skin cancer is the most common type of cancer. The three major types of skin cancer are basal cell carcinoma, squamous cell carcinoma and melanoma. Basal cell carcinoma and squamous cell carcinoma can present as pink or scaly lesions that are not healing or spots that are bleeding, itchy or painful. These forms of cancer are largely treatable and less severe than melanoma, which presents as an irregular mole.
UV rays from the sun and tanning beds are responsible for most cases of skin cancer. While sun exposure from UV rays may contribute to some degree of skin cancer in African Americans, the genetic makeup plays the largest part in melanoma diagnoses.
“Melanoma shows up in areas that typically are not exposed to the sun, like the toes, tips of the finger or under fingernails and toenails,” said Dr. Tiffany Alexander, dermatologist, ECU Health. “When identified and treated early, most melanoma cases are curable.”
However, melanoma can spread quickly into the blood and to other organs if not found early, and can even be deadly. Knowing that African Americans are more likely to be impacted by advanced melanoma, Dr. Alexander recommends learning the signs and symptoms and taking early action to detect and treat melanoma in its earliest stages.
“African Americans typically present in a more advanced stage because there is not a lot of awareness of melanoma occurring in African Americans, and the perceived risk of melanoma among African Americans is typically low,” said Dr. Alexander. “Many people also neglect to check areas that are not typically exposed to the sun frequently.”
Completing regular self-exams of areas both exposed to the sun and areas not exposed, like fingers and toes can help catch irregularities early. The ABCDEs of melanoma can help in identifying odd or suspicious moles that may need a second look by a dermatologist.
- A: Asymmetric, irregular shape
- B: Borders that are irregular and not round
- C: Color – a mole that is differently colored than other moles
- D: Diameter more than 6 mm in size
- E: Evolving, growing rapidly, a mole that becomes symptomatic
One of the most common misconceptions is that people with darker skin do not get sunburned, according to Dr. Alexander.
“A common myth I hear from my patients is that people with darker skin do not get sunburned,” said Dr. Alexander. “While those with more melanin in their skin have more protection against the sun, I encourage everyone to wear sunscreen with a minimum 30 SPF, no matter skin color.”
Most importantly, Dr. Alexander says, pay attention to your body.
“Get out of the sun if you feel yourself burning,” said Dr. Alexander. “If there is a mole that fits in the ABCDEs of melanoma or a lesion that is not healing or spots that are bleeding, itchy or painful, see a dermatologist.”
Dermatologists provide professional and thorough skin checks and can identify potentially cancerous areas early, when treatment options are great and the cancer is curable. To find a dermatologist near you, please visit ECUHealth.org/dermatology.
The Brody School of Medicine at East Carolina University has experienced recent success in recruiting a diverse group of patients to participate in clinical trials for new medications and treatments.
Data shows that from March 2019 to March 2020, 202 patients participated in oncology clinical trials in ECU’s Division of Hematology and Oncology; 50 percent of them represented races other than white. The following year, 419 participants were accrued, and 56 percent represented races other than white. That year, 50 percent of clinical trials participants were Black or African American.
“Our patient population, as well as Brody’s mission, has led to our success,” said Susan Eubanks, clinical trials nurse specialist in Brody’s Division of Hematology and Oncology. “Part of our core values is to cultivate a clinical environment of robust learning, innovation and discovery. There have been trials with participants here in eastern North Carolina that have led to new treatments in diseases and in some cases where there were few options.”
Now, researchers and providers hope to build on that momentum for future clinical trials studies.
Providers and researchers in the school continue to seek minority participants in clinical trials for new and potential pharmaceuticals — and to collect invaluable information on how some treatments impact patients of various races.
Doctors want to ensure that the drugs they are studying match the demographics for all the patients who could rely on those medicines in the future — by including people from a wide variety of backgrounds and races in the studies.
“We all agree that as much as possible, the drugs we give should be approved through clinical trials that match the demographics they will be prescribed to,” Eubanks said. “There has been chemotherapy that has shown promising results in one country but doesn’t carry the day in another. So, overcoming this disparity — whatever the cause — is essential.”
One of the latest innovations in oncology is the use of immunotherapy, the treatment of disease by activating or suppressing the immune system. Data that reviewed participation in those trials showed that less than 4 percent of participants in key immune therapy trials were African American.
“This is a problem,” Eubanks said. “Given the low representation we can’t predict if there will be a differences in outcomes related to differences in response from tumor biology. It is not highly understood why we see differences in drug efficacy and toxicities among different ethnicities, but it drives the point home, we need to do all we can to include the best representation of our population when bring new therapies to market.”
Dr. Darla Liles, professor and division chief of ECU’s Division of Hematology and Oncology, said diseases like prostate cancer and colorectal carcinoma see more African Americans impacted than other races, and the diseases begin earlier in those patients as well.
“Also, the distribution of the DNA mutations are different across races,” she said. “We might have a drug that works wonderfully well in Caucasians but not so well in African Americans or Hispanic individuals because of these different DNA changes. But we only know that if enough minorities participate.”
Recruiting challenges
Even with the critical need for data that better illustrates potential patient outcomes, recruiting minority participants in clinical trials can be difficult.
“Accruing to clinical trials in general is difficult, but minorities are typically underrepresented in clinical trials,” Eubanks said. “This can be an access issue, a reluctance issue and, at times, both.”
There can be many reasons recruiting minority participants to clinical trials can be a challenge, Liles said, but keeping those reasons in mind and understanding that they vary from person to person help build trust.
Brody’s mission draws heavily on a theme of access for all: to a medical education, to health care, and to resources that can sustain health and wellness. That’s one reason access to clinical trials in the medical school is vital to the study and approval of novel treatments.
“Part of our commitment to the health care of all eastern North Carolinians is ensuring the pharmaceuticals and treatments that we study are safe and effective for every patient who may need them in the future,” said Dr. Michael Waldrum, Brody’s dean and CEO of ECU Health. “Our efforts to widen the participant base in our clinical trials programs reflects the importance of thorough and inclusive studies that yield results that we are confident meet our mission.”
Liles said that people are more likely to trust providers and those running clinical trials if they feel they share common bonds with them.
“Several times when I presented a trial to a patient, afterwards the CRA has told me that they went to high school with the patient or knew them from church,” she said. “Being able to relate to the people who are treating you is essential.”
Education is key as well, Liles said.
“When I offer a trial to a patient, I often understand this is starting a conversation over several visits to ensure patients know about and understand what they are signing up for,” she said. “The consent forms for clinical trials are jam-packed with important information about the treatments, and sometimes people use that as a starting point for knowing what to ask about their treatment. I never regret giving a patient a consent form and talking to them about a trial. Even if they eventually decide not to do it ,they are better informed by participating in the process.”
Eubanks said the COVID-19 pandemic and reluctance by some to take the vaccine are a reminder of how to approach building trust in clinical trials.
“We must think beyond just education in the office,” she said. “We must reach people where they are.”
One way Brody is working to reach many different patients is having trials open for a variety of specialty care areas.
“The biggest step is understanding your population and having trials open for the specialty areas you see,” Eubanks said. “Brody has trials open with many specialties. In adult hematology/oncology we use databases and the tumor registry when approached about upcoming trials to help us determine if a trial is potentially feasible in our area. We also have the benefit of having local resources such are the University and Medical Center Institutional Review Board (UMCIRB) and leaders such as our associate dean for research and graduate studies, Dr. Russ Price, that provide expertise and infrastructure needed to offer clinical trials.”
Liles uses word of mouth to share clinical trial opportunities to patients.
“I often tell my patients about new and innovative trials that are on the horizon, even if they do not fit the criteria for the trial,” she said. “I think it is important for patients to understand that there are new things being developed all the time. Education is our best way to ensure patients know about and participate in trials.”
Liles also believes the combination of specialties and resources in the creation of the ECU Health brand will have a positive impact on the clinical trials program. With close to 1.4 million people in the system’s service area, there is promising potential to reach people through improved infrastructure for research opportunities.
Read more from ECU News Services.
Regardless of the world around us, cancer does not pause for anything. Colorectal cancer screenings have severely decreased during the COVID-19 pandemic, and doctors are worried this will lead to more cases of advanced stages of colorectal cancer.
In general, colorectal cancer starts as an overgrowth of the tissue in the colon, called a polyp. There are different types of polyps, some of which change into cancers in the future.
“We want to find out about colorectal cancer before there are any signs or symptoms,” said Dr. Warqaa Akram, colorectal cancer surgeon for ECU and Vidant Health. “We want to catch it when a person is healthy because colorectal cancer is very treatable when caught early. Some polyps are small and won’t give you many symptoms, if at all, when it starts.”
Providers aim to find polyps and remove them before they progress into cancer. More advanced tumors can cause bleeding and obstructions. That’s why doctors are recommending screenings five years earlier, at age 45. However, that age may be lower for those who are high-risk, meaning they have a close relative such as a parent or sibling who has been diagnosed with colorectal cancer.
“If you have a family history of cancer, we begin screenings at age 40 or 10 years before the diagnosis of a family member, whichever comes first,” said Dr. Akram. “For example, if the father was diagnosed at age 45 with colorectal cancer, children should begin screenings at age 35. If a father was diagnosed at age 60, children should begin screenings at age 40.”
Overall, the instance of colorectal cancer is decreasing, likely due in part to screenings. However, the incidence of colorectal cancer in younger people is on the rise. Although the reasons are not completely known, an increase of processed foods, poor diet and lack of exercise are all contributing factors. While the causes of colorectal cancer are unknown, and some are unmodifiable like genetics, some of the largest contributing factors are eating a diet high in processed foods and red meat. Experts encourage a high-fiber diet to help prevent cancerous polyps.
It is important to note that colorectal cancer disproportionately affects Black Americans more than any other race in the country. In eastern North Carolina, the incidence of cancer is 20 percent higher in African Americans than any other race, and the risk of death is higher by about 40 percent. Socioeconomic status and lack of access to health care are some of the reasons incidences in colorectal cancer are higher in the African American population.
“Knowing that younger people and the African American population are having higher incidences of colorectal cancer, it is very important to get regular screenings,” said Dr. Akram. “We know a lot about colorectal cancer, and it is a type of cancer we know how to treat and we know how to defeat. The earlier we catch colorectal cancer, the better the results and possibility of being cured.”
During the COVID-19 pandemic, colonoscopies decreased by 90 percent at Vidant Health.
“This is very alarming because incidences of more advanced colorectal cancer could be in our future in eastern North Carolina,” said Dr. Akram. “We are learning about less incidences of cancer and risking that people will present with more advanced stages of cancer.”
“I know no one wants to hear a cancer diagnosis, but thanks to early detection through screenings, colorectal is mostly preventable, treatable and often curable,” said Dr. Akram. “Colorectal cancer does not have to be a death sentence.”
For more information about the risks, prevention and screening resources for colorectal cancer, or if you do not have a primary care provider, please contact the Prevention Clinic at ECU Health Cancer Care at (252) 816-7475.
Vidant Beaufort Hospital, a Campus of ECU Health Medical Center and ECU Health Women’s Care, located in Washington, offered free breast cancer screenings on Friday, Feb. 25 for uninsured women 40 years of age and older with at least one year since their last mammogram.
“Some of these patients have never had mammograms before, and some of them haven’t had one in many years,” said Caddie Cowin, DNP, FNP-C at ECU Health Women’s Care – Washington. “All of these patients are either uninsured, or their insurance does not cover breast cancer screenings.”
Patients received a clinical breast exam, mammogram and education on signs and symptoms of breast cancer to watch for. Mammograms are one of the greatest tools to screen for breast cancer, and early detection is proven to save lives. Even with monthly physical exams at home, mammograms can catch warning signs that go undetected. Yearly mammograms are recommended to begin at age 40, or age 35 if you have close family history of breast cancer. Breast cancer can be treated with better outcomes if caught early.
According to the Department of Minority Health, Black women were just as likely to be diagnosed with breast cancer, however, they were almost 40 percent more likely to die from breast cancer, as compared to non-Hispanic white women from 2014-18. An explanation for that gap, according to the 2020 census, could be health insurance. The percentage of the Black population with no health insurance coverage for the entire calendar year was higher than for non-Hispanic Whites, at 9.6% compared to 5.2%, according to the 2020 census. Bridging the health care gap to provide early clinical interventions is important in eastern North Carolina, where Vidant and the future Vidant Health serves a large, diverse region.
“The biggest challenge is access to care,” said Cowin. “We know that patients with a lower socioeconomic status struggle more with access to health care and insurance. The disparity is challenging, but this program can help address the need. Just because they cannot pay out of pocket doesn’t mean they can’t get as good care as anyone else.”
“The last clinic we did, a couple of patients ended up needing biopsies, so we were able to catch potentially dangerous things early,” said Cowin. “We could save somebody’s life with what we are doing.”
If a patient does have abnormal findings, the Breast and Cervical Cancer Control Program (BCCCP) from the county health department funds follow-up appointments and connects women to treatment if diagnosed. BCCCP is designed to help uninsured or under-insured women pay for mammograms and pap smears, according to Sherri Griffin, RN, BCCCP nurse navigator, Beaufort County Health Department.
“If we do have any ladies unfortunately diagnosed with breast cancer, we help them apply for breast and cervical cancer Medicaid, which pays for their treatment,” said Griffin. “The women that we have treated today are in a gap where most cannot qualify for Medicaid but cannot afford health insurance. They typically put off health screenings because they have to pay out of pocket. At this event, we fill in gaps for the women who may need additional imaging after the initial screenings.”
Screenings at this event were funded by the Shepard Cancer Foundation and Vidant Health. For more information on cancer screenings, please visit VidantHealth.com/Cancer. More information about BCCCP can be found at BCHD.net.
Read more in The Washington Daily News.
March is Colorectal Cancer Awareness Month and there is no better time to ensure you are keeping up with recommended screenings. One of the best ways to take care of yourself is by taking preventative steps with your physical health and well-being through regular visits to your health care provider.
Early detection and prevention can be life-saving for certain types of cancers, including colorectal cancer. Here in the east, ECU Health Cancer Care (VCC) is a leading provider in colonoscopy and colorectal cancer care and screening.
With colorectal cancer being the third most common cancer in the United States, one of the most important and preventative measures you can take for early detection of colorectal cancer is to be regularly screened. Many people do not experience symptoms in the early stages of colon cancer, so it is especially important to get regular preventative screenings. Screenings can be done in a variety of ways, some of which include colonoscopies and fecal testing. Early detection and prevention means that if cancer is detected, treatments can begin earlier.
Regular screenings for colorectal cancer are recommended to begin at age 45. If you’re eligible for a screening and do not have one scheduled, take the opportunity during Colorectal Cancer Awareness Month to talk to your primary care provider, obstetrician-gynecologist, or gastroenterologist about scheduling the procedure.
Vidant Health also hosts events, including screenings, across the East. The Vidant Oncology Outreach can also be contacted at 252-847-9507 for more information on screenings and events in your area.
Learn more about ECU Health Cancer Care’s services and how to connect with us on the Cancer section of VidantHealth.com
More Information
October marks Breast Cancer Awareness Month and Vidant Health took the opportunity to promote the importance of early detection, recognize all the fighters and survivors, and honor those lost who lost their lives to the disease.
According to the National Breast Cancer Foundation, breast cancer is the most common cancer in American women, and it is estimated that in 2021, approximately 30 percent of all new cancer diagnoses in women will be breast cancer.
Early detection
Early detection is crucial and Vidant provides access to advanced screening tools like 3D mammography – the most advanced imaging tool available to detect breast cancer.
Dr. Mahvish Muzaffar, a medical oncologist at ECU Health Medical Center (VMC), sat down with WITN to discuss the importance of these screenings. According to the American Cancer Society, screenings have dropped significantly since the start of the COVID-19 pandemic.
Dr. Muzaffar said according to one study, there was a nearly 90 percent drop in breast and cervical cancer screenings. She said the drop was substantial in rural America and among ethnic minorities.
“We know that this may translate into an additional 10,000 lives lost, by conservative estimates, just because of that delay (in screenings),” Dr. Muzaffar said.
She said there are many safety measures in place to protect against COVID-19 when visiting doctors and getting regular cancer screenings.
Women between age 40 and 44 have the option to start screening with a mammogram every year. Women age 55 and older can switch to a mammogram every other year or they can choose to continue yearly screenings.
Visit Vidant’s Events page to see upcoming screening events throughout eastern North Carolina.
Know the risk factors
Knowing your risk factors for any illness or disease is crucial. Understanding what to look for if you are high risk can help save lives. Jennifer Lewis, outreach coordinator with ECU Health Cancer Care, said breast cancer is no different as she joined WITN to discuss risk factors.
“When you do have a first-degree relative which is a sister, mother or daughter, that does double your risk of developing breast cancer,” Lewis said.
Other risk factors include age, as the likelihood of developing breast cancers increases as you get older, alcohol consumption, smoking, weight and lifestyle, and hormone therapies after menopause.
While these steps are important in limiting your chances, the most important thing you can do is contact your primary care provider if you notice any changes.
Wear Pink Day
Each year, Vidant team members across the health system participate in Wear Pink Day to celebrate all breast cancer survivors and to show support and solidarity to those who are still in the fight.
The East Carolina University women’s basketball team showed their support by stopping by VMC to hand out pink ribbons to team members, patients and families at the Eddie and Jo Allison Smith Tower.
View photos from the event below.
To learn more about Vidant’s breast cancer services and connect with care teams, visit ECU Health Cancer Care’s web page.
The COVID-19 pandemic caused the disruption of life as we know it, even some health care was put on hold.
Now, more than a year later, health care providers are concerned with the noticeable drop in the number of people seeking cancer screenings. Dr. Darla Liles, chair of Vidant’s Commission on Cancer Committee joined WNCT to discuss this challenge.
“We want to find cancers in their earliest stage,” Dr. Liles said. “They’re obviously much more curable when they’re stage 1 or stage 2. If we are not screening appropriately, we may end up with cancers that we find more in later stages where they’re not as curable.”
When and where can I get screened?
Regular cancer screenings are available at Vidant Health and Power Up events occur frequently as a way for community members to get screened close to home.
Below is a list of recommended cancer screenings for adult men and women. Use this as a guide, remembering that your health needs are as unique as you are. It’s important to talk with your doctor about how your family history, personal history and lifestyle could affect when you need certain screenings or tests.
Male Adults
All ages:
- Skin cancer: Keep watch on moles and talk about changes with you doctor
After 45:
- Colorectal cancer: Starting at age 45, talk with your doctor about different screening options
- Lung cancer: If you are a current of former smoker and at least 50 years old, there are lung cancer screenings available to you
- Prostate cancer: When you turn 45, talk to your doctor about the need for PSA testing for prostate health.
Female Adults
All ages:
- Breast cancer: Know how your breasts normally look and feel, and talk about changes with your doctor.
- Skin cancer: Keep watch on moles, and talk about changes with your doctor.
Age 19-39
- Cervical cancer: Starting at age 21, you may need regular pap smears. At age 30, continue regular pap smears, and talk about HPV testing with your doctor.
Age 40-64
- Breast cancer: Begin talking about options for regular mammograms starting at age 40.
- Cervical cancer: Continue regular pap smears as recommended by your provider.
- Colorectal cancer: Starting at age 45, talk with your doctor about different screening options.
- Lung cancer: If you are a current or former smoker and at least 50 years old, there are lung cancer screenings available for you.
Tillis announcement serves as reminder
Recently, U.S. Sen. Thom Tillis announced he is seeking treatment for prostate cancer. Doctors are hopeful this high-profile case will serve as a reminder that otherwise healthy individuals still need to keep up with regular screening so that it can be caught early.
“I see a lot of patients who are around Sen. Tillis’ age, who are in general in very good health and have taken care of their bodies and they are not even thinking about having prostate cancer. It’s not on their mind because they are overall doing well,” said Dr. M. Sean Peach, director of brachytherapy services at Vidant Beaufort.
Prostate cancer is the second most common cancer in American men, according to the American Cancer Society, with about one in eight men being diagnosed in their lifetime.
Stay safe in the sun this summer
With the days growing longer and warmer, many people are outside enjoying the sunshine more often. However, prolonged exposure to unprotected skin comes with risks. According to the American Cancer Society, skin cancer is by far the most common type of cancer. It is important to know how to protect your skin as well as the risks, prevention and treatments for skin cancer.
Because exposure to UV rays is one of the most common risk factors for skin cancer, the most important way to lower your risk of skin cancers is to limit your exposure to these rays. Look for ways to reduce sun exposure by using and diligently reapplying sunscreen (with an SPF of at least 30), wearing protective clothing including hats and sunglasses and limiting sun exposure when the rays of the sun are strongest between 10 a.m. to 2 p.m. Also, avoid tanning lamps which give off UV rays and damage the skin.
Dr. Nasreen Vohra is a surgical oncologist and associate professor of surgery at ECU/Vidant Health.
“Remembering the A, B, C, D, E rule for skin cancer, particularly melanoma, is an important step in a skin self-exam,” Dr. Vohra said. “For A, look for asymmetrical shapes to skin lesions. For B, check the borders of these lesions; irregular borders are more concerning. C is for color, take notice if the lesion is unevenly pigmented or if there are changes in color. D is for the diameter of the lesion, and if it is greater than 6 millimeters, or the size of a pencil eraser, this could be concerning. Finally, E is for evolving, so pay attention if the lesion is changing in any noticeable way.”
For more information about the risks and prevention of skin cancer, or if you do not have a primary care provider, contact the Prevention Clinic at ECU Health Cancer Care 816-RISK (7475).
Learn more about cancer prevention, including Vidant’s wide range of services on VidantHealth.com.
As members of the Alliance, Vidant and ECU can offer cancer patients access to a larger pool of state-of-the-art clinical trials at Vidant and ECU clinics. These trials include treatment for breast, gastrointestinal and genitourinary cancers, as well as leukemia, lymphoma, myeloma, neuro-oncology and respiratory cancers.
Health care providers typically must demonstrate their ability to meet an annual average enrollment of at least 15 patients in specific clinical trials for rare cancers over a three-year period in order to become Alliance members. However, the ECU and Vidant organizations combined for 17 patient accruals last year and already have 17 this year, which prompted the Alliance to grant ECU and Vidant membership earlier than expected.
“This is a good thing, because it means that throughout the network here at ECU and Vidant, we are offering more and more trials to our patients, especially patients with more unusual diseases,” said Dr. Darla Liles, chief of the Division of Hematology/Oncology at ECU’s Brody School of Medicine. “Hopefully this encourages more people to consider a clinical trial, because I think there is some hesitancy. I think the more people learn that we have these trials — and they don’t have to go to UNC and Duke for these trials, they can get it done right here — the more they will realize that these are really good things that offer cutting-edge treatments for cancer patients.”
Dr. Emmanuel Zervos, surgical oncologist and director of ECU Health Cancer Care, said the partnership between Vidant and ECU along with gaining membership to the Alliance is crucial to providing more high-quality care to patients in the East.
“Whether in Greenville or at any of Vidant’s Commission on Cancer-accredited community hospitals, the Alliance partnership between ECU and Vidant represents the shared vision of providing state-of-the-art cancer care in our region, regardless of where or by whom that care is delivered,” said Dr. Emmanuel Zervos, surgical oncologist and director of ECU Health Cancer Care. “Cancer services has been at the forefront of collaboration because of the profound impact that cancer has on our region — validation of this collaboration through accelerated full and unrestricted membership into the Alliance assures that these patients will continue to be served both now and into the future.
Visit ECU’s Office of Clinical Trials website or Vidant Health’s Cancer Clinical Trials website for more information on available clinical trials.
Read more about the partnership at ECU News Services.
There are differences in the forms of skin cancer and some, like basal and squamous cell skin cancers, are most common. They start in the top layer of skin and are often related to sun exposure. These cancers grow in the epidermis, the top layer of skin, and are usually removed completely to avoid spreading to other areas. Skin cancers like melanoma, while less common, are more likely to spread if left untreated.
Because exposure to UV rays is one of the most common risk factors for skin cancer, the most important way to lower your risk of skin cancers is to limit your exposure to these rays. Look for ways to reduce sun exposure by using and diligently reapplying sunscreen (with an SPF of at least 30). Also, avoid tanning lamps which give off UV rays and damage the skin.
Knowing your own skin is important to finding skin cancer early. Any spots on the skin that are new or changing in size, shape or color should be checked by a doctor. Any unusual sore, lump, blemish, marking or change in the way an area of the skin looks or feels may be a sign of skin cancer or a warning that it might occur.
“Remembering the A,B,C,D,E rule for skin cancer, particularly melanoma, is an important step in a skin self-exam,” said Dr. Nasreen Vohra, surgical oncologist and associate professor of surgery at ECU and Vidant Health. “For ‘A,’ look for asymmetrical shapes to skin lesions. For ‘B,’ check the borders of these lesions, irregular borders are more concerning. ‘C’ is for color, take notice if the lesion is unevenly pigmented or if there are changes in color. ‘D’ is for the diameter of the lesion and if it is greater than 6 millimeters, or the size of a pencil eraser, this could be concerning. Finally, ‘E’ is for evolving, so pay attention if the lesion is changing in any noticeable way.”
Some doctors and other health care professionals do skin exams as part of routine health check-ups. If the doctor thinks a suspicious area might be skin cancer, the area will be removed and sent to a lab to be examined.
There are different types of skin biopsies. The doctor will choose one based on the suspected type of skin cancer, where it is on your body, its size and other factors. Spread of the cancer deeply below the skin or to other parts of the body is uncommon for squamous cell cancers and rare for basal cell cancers, so most people with one of these skin cancers do not need imaging tests. However, imaging tests such as MRI and CT scans may be done if your doctor thinks you might be at risk for the cancer spreading outside the skin.
Fortunately, most of these cancers and pre-cancers can be cured with fairly minor surgery or other types of local treatments. It is important to discuss all of your treatment options, including their goals and possible side effects, with your doctors to help make the decision that best fits your needs.
“One of the most important factors to remember is skin damage is cumulative and the negative effects on your skin during your early years makes an impact on your skin health as you age,” Dr. Vohra said.
Given this, you should be mindful of ways to reduce your exposure to harmful UV rays, such as avoiding direct exposure when they are the most intense, between 10 a.m. and 2 p.m. Also, wear protective clothing such as hats and sunglasses with prolonged sun exposure. These are important, proactive steps for avoiding skin damage and maintaining skin health.
For more information about the risks and prevention of skin cancer, or if you do not have a primary care provider, please contact the Prevention Clinic at ECU Health Cancer Care at (252) 816-RISK (7475).
Recently, the guidelines for when someone should begin having screenings for colorectal cancer have been updated, and it is now recommended people at average risk for colorectal cancer begin screenings at age 45. The American Cancer Society lowered the age to start screening from 50 because studies show rates of colorectal cancer among people younger than 50 are on the rise and expected to almost double by 2030. Screenings starting at age 45 could help save more lives.
For people of average risk and no family history of colorectal cancer, the first screenings establish a baseline and depending upon the results, will determine the recommended time for the next screening. Regular screenings should continue for people who are in good health through the age of 75.
For people at higher risk for colorectal cancer, there may be reason to start screening before age 45. They may also need to be screened more often or get specific tests. Dr. Drew Honaker, colorectal surgeon & clinical assistant professor, Brody School of Medicine, ECU/Vidant Health, said, “Factors that put those with higher risk include having a strong family history of colorectal cancer or certain types of polyps. Another factor of family history that should be taken into consideration is the presence of a hereditary syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome.”
It is recommended that people ages 76 through 85 should decide with their health care provider whether to continue to get screened. Factors that should be considered include their personal preferences, prior screening results, overall health and life expectancy. People beyond the age of 85 should no longer be screened for colorectal cancer.
Someone’s personal history may determine an earlier need for colorectal cancer screening. If a person has inflammatory bowel disease, such as ulcerative colitis or Crohn’s disease, if certain types of polyps are present or if there is a history of radiation to the abdomen or pelvis to treat a prior cancer, these conditions will put someone at higher risk.
People who think or know they are at higher risk for colorectal cancer should talk to their health care provider, who can help choose the best screening option and schedule. There are several test options for colorectal cancer which include stool-based screenings and visual exams. Though an invasive procedure, a colonoscopy is the most thorough procedure for preventing colorectal cancer.
In terms of proactive, preventative practices, there are steps you can take to reduce your risk for colorectal cancer. It’s important to maintain a healthy diet that is low in red and processed meats and high in fruits, vegetables and whole-grain fiber. A balance between a healthy diet and lifestyle includes:
- a diet low in red and processed meats and high in fruits, vegetables and whole-grain fiber
- physical activity to help maintain a healthy body weight
- limiting alcohol and tobacco use. Quitting smoking should be a top priority for helping prevent colon cancer and if alcohol is consumed, it should be in moderation
Even if you take all of these steps to reduce your risk of colorectal cancer, you cannot eliminate the risk entirely. That’s why everyone 45 or older should talk to their medical provider, choose a screening test, and get screened routinely.
For more information about the risks, prevention and screening resources for colorectal cancer, or if you do not have a primary care provider, please contact the Prevention Clinic at ECU Health Cancer Care (252) 816-RISK (7475).