HANCOCK - Mercedes Maki sees three or four patients a month with some sort of lesions on their skin, and 35 to 40 lesions are removed a year, but most of them are benign. About 10 are cancerous, however.
Maki, who is a certified physician's assistant at Portage Health, said most of the skin cancers she sees in the office are basal cell or squamous cell carcinomas, which have a very high success rate for removal.
Many of the patients she sees for whatever reason also ask her about skin issues, Maki said.
Certified physician’s assistant Mercedes Maki checks the skin of an assistant for possible skin cancer in her office at Portage Health. May is Skin Cancer Awareness Month, and Portage Health is hosting a free skin cancer screening clinic Saturday. (Houghton Daily Mining Gazette photo by Kurt Hauglie)
"Probably once a day I have a skin issue complaint come in," she said.
When she does routine physicals, Maki said she also checks the patient's skin for any problems, and often she finds them.
"I do at least three or four excisions a month," she said.
When she examines a patient for possible skin problems, Maki said she follows a guideline called ABCD, or asymmetry, borders or bleeding, color and diameter. If there have been recent changes in those factors in a mole or other skin lesion, they could indicate some sort of skin cancer.
"I'll say we should biopsy it or remove it," she said.
Old moles that have gone unchanged for years probably won't become problematic, Maki said, but new moles may or may not be a problem.
"Just because a mole is new doesn't mean it's cancer," she said.
May is Skin Cancer Awareness Month, and Dr. Jennifer Baldwin, and Dr. Milton Soderberg, board certified dermatologists with Marquette General Health System, will conduct a free skin cancer screening clinic at Portage Health Saturday. The clinic is filled, however.
Baldwin said skin problems can be stopped from becoming cancer if they're found early.
"The earliest stage is just a small scaly area that's painful," she said.
However, Baldwin said it's important such changes be checked by a doctor as soon as possible, because the problem may not be skin cancer.
"There are a number of benign lesions," she said.
Areas of eczema or psoriasis that don't clear could be problematic, Baldwin said.
"That may be the start of skin cancer," she said. "What we like people to look out for is a lesion that stands out."
Other anomalies to look out for are dark pigment or black moles, Baldwin said.
The most common form of skin cancer is basal cell carcinoma, Baldwin said. That is distinguished by a clear to pink growth with prominent blood vessels, and it bleeds easily.
"Basal cell carcinoma grows slowly," she said.
The second most common is squamous cell carcinoma, which presents with a thickened scaly area, with a nodule or ulceration, Baldwin said.
If a doctor suspects basal or squamous cell carcinomas, Baldwin said he or she may take a biopsy, which requires taking a small part of the growth using a local anesthesia. If the growth is determined to be cancer, it will be removed surgically, particularly basal cell carcinoma.
"That has the highest cure rate," he said.
The most serious form of skin cancer is melanoma, Baldwin said, which is also removed by surgery.
"The size of the incision is determined by the seriousness of the melanoma," she said.
When the melanoma is removed, Baldwin said a doctor may look at any lymph nodes in the area of the growth.
"If they do spread, it's difficult to treat," she said.
The five-year survival rate for melanoma that hasn't spread to the lymph nodes is 98 percent, Baldwin said. If it enters the lymph nodes the survival rate is 62 percent, and if it enters the lymph nodes and one or more organs, the survival rate is 16 percent.
Baldwin said in 2011, there were almost 9,000 deaths in the United States attributed to melanoma.
A recent study conducted by the Mayo Clinic in Rochester, Minn., showed an eight-fold increase in the number of melanoma cases in the United States over the last 40 years. The reasons given for the increase were the depletion of the ozone layer, which blocks out ultra-violet rays, and an increase in the use of tanning beds, which use ultra-violet lamps to provide the tanning.
Baldwin said Australia is significantly affected by the depletion of the ozone layer and it's had a serious impact there.
"They have the highest melanoma rate in the world," she said.
As for tanning beds, Baldwin said some American states don't allow children younger than 18 to use them, and some states require parental permission for children younger than 18 to use them.
Tanning beds can present problems for long-term users of any age, Baldwin said.
"My recommendation is never to start," she said.
There are various risk factors for developing skin cancer Baldwin said. Fair skin color is the number one risk, and those with blue or green eyes who easily develop sunburns are also significantly at risk. People with a history of blistering sunburns are at risk, also.
However, Baldwin said many of those risk factors can be overcome.
"Changing of behavior at any point in life helps a lot," she said.