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When I was a kid I spent many wonderful summer days at cold, sparkling lakes in Minnesota, followed by agonizing blistered and peeling sunburns. We just didn't have the knowledge or the waterproof sunscreens that we do now. So when, at 26, I noticed a little sore on my left thigh that never quite seemed to heal, I asked my surgeon brother-in-law to check it out. "It's probably nothing to worry about," he said, but when I pushed him, he agreed to biopsy it. That's when I learned how important it is to trust your instincts. It was a basal-cell carcinoma.
And soon enough there would be more. I learned to watch my skin for any changes. A couple of years later a crusty spot on my left upper arm also turned out to be a basal cell. Surgery along with a couple of stitches took care of it. But not all skin cancers are created equal. A spot on my forehead was a much more aggressive basal cell. After I had surgery on it, the cancer came back with a vengeance. "It's like a tree," says my dermatologist, David Kriegel, MD, director of the Division of Dermatologic and Mohs Micrographic Surgery at Mount Sinai Medical Center. "If you leave part of the roots of skin cancer behind, over time those roots are going to cause the cancer to grow back." I was only 30. That one required Mohs surgery, followed by plastic surgery, and it left a large scar.
Then about five years ago I noticed some red irritation developing in the small scar from my previous surgery on my left arm. Dr. Kriegel biopsied it and sure enough, that skin cancer recurred, too. Scary. He performed Mohs surgery to make sure he got it all, then stitched me up. This time I had a 2-1/2-inch scar.
During my skin check in April (which I let LHJ film), Dr. Kriegel did a biopsy on a suspicious spot on my scalp that turned out to be nothing. He also found two precancerous actinic keratoses, one on my forehead and one on my chest, which he froze off in a simple and almost-painless procedure. Woo-hoo: That's prevention! I'm hoping there will be no more cancers, but I've got to remain vigilant.
Actinic keratoses More than 10 million Americans have these scaly or crusty growths; one in 10 may become a squamous-cell cancer.
Dysplastic nevi, or atypical moles They're benign, but having them increases your risk of melanoma. Because their irregular borders and multiple colors mimic the deadly skin cancer, you should have them checked by a dermatologist.
Seborrheic keratoses These skin growths have a warty surface or waxy appearance. A dermatologist can confirm if they're benign.
Treatment Your dermatologist can shave, freeze, or cut off a growth that's precancerous. He can also prescribe a chemo cream such as Zyclara, which was approved by the FDA in March for treating actinic keratoses (side effects include redness, scabbing or crusting, and sores or ulcers). Ask about photodynamic therapy, which involves treating the skin with a chemical that lets a certain wavelength of light destroy the precancerous cells without harming healthy ones.