I recently had the opportunity to interview Dr. Piasecki to learn more about skin cancer and about the Skin Cancer Center. As you know if you’ve been reading Fab Over Forty for awhile that I am a big believer in wearing sunscreen and protecting the skin against sun damaging and cancer causing sun rays. It’s great to learn more about skin cancer and the advances there may be on protection, treatment etc.
Where Dr. Piasecki stands out in the field as he is not only a skin cancer doctor, he is a plastic surgeon as well and his Skin Cancer Center is a one stop center to treat and repair the damages of skin cancer. Many times one doctor will treat the skin cancer with removal of the cancerous area and then go to another doctor to repair the damage left behind. That’s where Skin Cancer Center is different in that he does both. People from all over the world come to him to be treated.
Is skin cancer just caused by the sun? No, but around 98% of basal cell and squamous skin cancer is caused by the sun. It can also be caused by chronic inflammation and radiation therapy, but we concentrate mostly on the sun being the main factor as it’s such a high percentage rate.
You talk about basal cell and squamous skin cancer, but what about melanoma? Basal cell and squamous are much more common skin cancers, but melanoma is much more lethal. At times melanoma has a genetic component to it along with large amounts of sun use and burning. But, it can appear in places like the intestine and in the back of the eye.
There is no “best” sunscreen – the best one for you is the one you can afford, is convenient and comfortable.
Can diet and activity increase or decrease skin cancer? There is no solid scientific answer to that, but of course, more frequent outdoor activities will increase chances of skin cancer because of the sun exposure. It can’t be stressed enough the many benefits of diet and exercise to decrease the overall risk of cancer, and you’ll always do better with treatment if you already have a healthy diet and exercise.
Tell us about your Skin Cancer Center and what makes it different? I am a Mohs Certified doctor, which means I have been trained in this particular way of removing skin cancer. This technique is used to preserve as much tissue as possible and removing cancer with the smallest defect as possible. Unfortunately the places on our body that are most exposed to the sun is where skin cancer appears most often – on our face and hands. Because of that visibility, when removing skin cancer in these areas it’s important to do the Mohs surgery. But I take it further in that you don’t need to go anywhere else to have plastic surgery to repair the defect once the cancer is removed, I do it all in one facility. I compare it to driving a car and getting a flat tire – you take it into the shop and they guy tells you that he fixed your problem and removed the tire, only to go out to your car and discover that there isn’t a new tire in its place, he just took off the tire. The problem isn’t really fixed at all.
What types of sun protection is there? There are 3 types -
- Shade – including wearing a hat and sun protective clothing
- Chemical – this type of sunscreen absorbs UV rays from the sun and turns to heat instead of damaging the skin
- Physical – Titanium dioxide and zinc oxide – which offers the most complete chemical protection.
Zinc oxide is what we may commonly think of a lifeguard with the white lotion on the nose – that’s zinc oxide, not practical or good looking. But now the particles are much smaller making it more wearable.
What’s the best sunscreen to use? There is no “best” sunscreen – the best one for you is the one you can afford, is convenient to use and is comfortable. I like to use and encourage my patients to use a powder sunscreen if they don’t like a lotion. It’s one that is easy to apply, meets airplane security when you travel and it’s so convenient to reapply and it won’t mess up your makeup either. Don’t forget about clothing and swimwear with UPF. It’s not practical to reapply sunscreen to the full body when out in the public, so protective clothing is practical as well.
The biggest mistake is not reapplying sunscreen every few hours. The heat and sun deactivates sun protection after a few hours. And sunscreens labeled waterproof or water resistant does not mean you can go swimming or sweat in the sun and not have to reapply.
Are sunscreens in BB creams and makeup good enough to wear for your sun protection? It depends on the makeup and how your using it. If you have a desk job and you commute in the dark, the SPF in your makeup is good enough. But if you’re going to the beach or spending time outdoors it is not enough what is in your makeup. You should be wearing an SPF of 30 or higher in those situations.
What’s the best advice you can give us? I have three bits of advice:
- Sun protection needs to be on your mind and you need to be proactive. It doesn’t need to be hard, just use common sense. It’s not “sexy” to report on, but skin cancer is more common that all cancers combined.
- Avoid tanning beds all together. They increase the risk of melanoma. It’s an urban legend that you need to prep the skin by going to a tanning bed before going to the Caribbean.
- If you are diagnosed with skin cancer, don’t take the easy way out! The most common place is the face and hands and don’t do the freeze or burn removal method. The cure rate is lower and the deformations are greater. Surgery has a higher cure rate, healing is better and the cost is lower in the long run.