Do Non-Melanoma Skin Cancers Differ in Diverse Patient Populations?
Do Non-Melanoma Skin Cancers Differ in Diverse Patient Populations? from Patient Empowerment Network on Vimeo.
Can non-melanoma skin cancers vary in diverse patient populations? Expert Dr. Silvina Pugliese explains how the occurrence and treatment of squamous cell cancer and basal cell cancer can differ in diverse population groups and advice for patients to help ensure their best care.
Silvina Pugliese, M.D., is a Clinical Assistant Professor of Dermatology and Attending Physician at the Stanford Medicine Outpatient Center and Stanford Cancer Institute. Learn more about Dr. Pugliese.
[ACT]IVATION TIP
“…be aware that some common skin cancers can present looking very different in skin of color patients. To know that skin of color patients can develop these skin cancers so that you feel empowered to ask your doctor to take a look at something and to really feel like you can advocate for yourself if you are worried about something, to ask for biopsy or just monitoring or whatever you feel most comfortable with so that we don’t allow some of these skin cancers to go undiagnosed for a longer period of time, unnecessarily.”
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Transcript:
Mary Leer:
Do non-melanoma skin cancers differ in a diverse patient population, and how does that difference if there is one, impact treatment?
Dr. Silvina Pugliese:
So there is a lot to talk about with this question. I think that one aspect of this question is the clinical appearance difference. And the answer is sometimes yes. So in certain patient populations, I’m talking primarily about skin of color currently, certain skin cancers like basal cell cancer can look different. They can have a more purple or blue appearance as opposed to the classic shiny pink red bump that you might hear about or be educated about. Another skin cancer presents a little bit differently in certain patients and specifically in a skin of color patients is squamous cell cancer. So there’s a higher likelihood of having a squamous cell cancer and in a chronic wound or on a scar in patients who are Black as opposed to lighter skin patients. And also, squamous cell cancer can present in different locations, like the genitals, perianal skin, or the lower legs. This is really important in terms of impacting treatment because you can imagine that if a lesion is not picked up early, the way something may be when it has a classic presentation, by the time that it’s diagnosed, it can be much larger or much more advanced. And this impacts treatment because that could mean a larger surgery, it could mean in certain cases needing to do treatments beyond surgery to completely get rid of the skin cancer.
But even just with surgery alone, having a larger surgery can cause a larger scar. It can cause some functional impairment after surgery, or it can even cause some other problems like impaired nerve sensation, for example. So it’s really important that we think about the different presentations of skin cancer across all skin types, and be mindful of both looking for those different kinds of skin cancers when we’re doing our skin checks as doctors, but also be really mindful of how can we educate all of our patients for what to look out for, because often our education is be mindful of sun-exposed areas, wear sunscreen, make sure that you’re looking at your ears and your nose and your face, but we’re not really educating about examining the genital area for skin cancer or being mindful of burns or being mindful of scars.
So my activation tip for this question is to be aware that some common skin cancers can present looking very different in skin of color patients. To know that skin of color patients can develop these skin cancers so that you feel empowered to ask your doctor to take a look at something and to really feel like you can advocate for yourself if you are worried about something, to ask for biopsy or just monitoring or whatever you feel most comfortable with so that we don’t allow some of these skin cancers to go undiagnosed for a longer period of time, unnecessarily.
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