Podcasts about merkel cell carcinoma

Send us a textDid you or someone you love ever ask: What exactly is cancer? Why did I get cancer? Did I do something to cause it, or was it just bad luck? Noble laureate Dr. Harold Varmus says, "The prevention of cancer requires us to look not just at genetic predisposition but at how our lifestyle choices and environmental exposures interact with our biology to affect cancer risk.”We talk about how cancer develops, lifestyle and environmental factors that contribute to the risk, and empower you with steps you can take for prevention. https://bit.ly/4aNslCP#cancerprevention #understandcancer #knowyourrisk #cancer #knowledgeispower #publichealth #hoosier #clinteastwood #pokerface #jimmybuffett #everyonedies #everydayisagiftIn this Episode:03:41 - Recipe of the Week: Hoosier Sugar Cream Pie05:03 - Perspective on the Glass Half Empty/Full...How Can You Refill the Glass?08:03 - Deep Dive Into Cancer: Why Did I Get Cancer?09:32 - What Exactly is Cancer?12:41 - What Causes Cancer to Develop?13:48 - Lifestyle Choices that Contribute to Cancer18:04 - Environmental Factors that Contribute to Cancer20:01 - What You Can Do To Reduce Cancer Risk30:35 - Jimmy Buffett: Grief Is Like a Wake Behind a Boat31:09 - OutroWith this episode, we are starting our deep dive into cancer itself and we will move on to the details of staging, different types of cancers, and treatment options.Related EpisodesS5E25: The Important Role of the Microbiome to Your Health and Immune FunctionS5E4: Inflammation: What it is, How It Causes Disease, and How You Can Decrease ItS4E46: What You Need to Know about Stomach Cancer – Part 1S5E16: Colorectal Cancer is Increasing in the Young: What You Need to KnowS4E27 – The HPV Vaccine: Important Cancer Prevention for Your ChildS4E23: Skin Cancer, Merkel Cell Carcinoma, and Easy Prevention Steps You Can TakeS5E27: Preventable Death – Learn the Factors to Better Your OddsSupport the showGet show notes and resources at our website: every1dies.org. Facebook | Instagram | YouTube | mail@every1dies.org

In part two of a two-part series, Dr. Justin Abbatemarco and Dr. Nicolás Lundahl Ciano-Petersen discuss the associated paraneoplastic syndromes they saw from a neurologic perspective. Show reference: https://www.neurology.org/doi/10.1212/NXI.0000000000200260 

In part one of a two-part series, Dr. Justin Abbatemarco and Dr. Nicolás Lundahl Ciano-Petersen break down Merkel cell carcinoma and discuss what all neurologists need to know about it. Show reference: https://www.neurology.org/doi/10.1212/NXI.0000000000200260 

Dr. Justin Abbatemarco talks with Dr. Nicolás Lundahl Ciano-Petersen about the clinical and immunologic profile of patients with paraneoplastic neurologic syndromes associated with Merkel cell carcinoma. Read the related article in Neurology: Neuroimmunology & Neuroinflammation. Disclosures can be found at Neurology.org.

As a dermatologist who treats skin cancers, I can't stress enough how important it is to understand skin cancers and how to prevent them. Skin cancers are one of the most common types of cancer, but with the right knowledge and actions, it's also one of the easiest to prevent and treat.  Regular check-ups, protecting your skin from the sun, and knowing your treatment options are key to keeping your skin healthy. If you have any concerns about your skin or need advice on how to treat or prevent skin cancer, it's important to talk to a dermatologist. Don't miss this week's podcast with Dr. Abigail Waldman, where she covers common and rare skin cancers, prevention and treatment methods. Key Takeaways: - The majority of skin cancers have a good prognosis when treated with surgery. - Sun exposure during childhood and cumulative sun exposure increase the risk of skin cancer. - Starting good sun protection habits early is really important for keeping your skin healthy in the long run - Discussing treatment options and preventive measures with a dermatologist is crucial. - Mohs surgery is considered the 'gold standard' for skin cancer treatment especially on the head and neck area. - If you need advice on how to treat or prevent skin cancer, it's important to talk to a dermatologist.  Check out Dr. Mina's top picks for skin care here. Download the free eBook 'Skincare Myths Busted' here. In This Episode: (9:52) Importance of Sun Protection (11:46) Nicotinamide and Sun Damage (13:49) How to Get Vitamin D (16:11) Laser Treatment for Pre-cancers and Early Skin Cancers (18:39) Merkel Cell Carcinoma (22:08 )Radiation Therapy for Skin Cancer (26:56) Overview of Mohs Surgery (34:33) Top Three Takeaways Dr. Abigail Waldman Abigail H. Waldman, MD, FAAD Director, Mohs and Dermatologic Surgery Center Director, Mohs Surgery, VA Boston Healthcare System Assistant Professor, Harvard Medical School Dermatology Leadership Title Director, Mohs and Dermatologic Surgery Center Director, Mohs Surgery, VA Boston Healthcare System Follow Dr. Waldman here: https://www.instagram.com/abby.waldmanmd/ https://www.youtube.com/@doctor-abby https://www.tiktok.com/@drabby6?_t=8otzFxFpbUF&_r=1 Follow Dr. Mina here:- https://instagram.com/drminaskin https://www.facebook.com/drminaskin https://www.youtube.com/@drminaskin For more great skin care tips, subscribe to The Skin Real Podcast or visit www.theskinreal.com Baucom & Mina Derm Surgery, LLC Email - scheduling@atlantadermsurgery.com Contact - (404) 844-0496 Instagram - https://www.instagram.com/baucomminamd/ Thanks for listening! The content of this podcast is for entertainment, educational, and informational purposes and does not constitute formal medical advice.

Welcome to Season 4, Episode 25 of Winning Isn't Easy. In this episode, we'll dive into the complicated topic of "ERISA Disability Claims - What Celebrities Can Teach You." Host Nancy L. Cavey, a seasoned attorney with extensive experience in disability claims, discusses what the disability cases of certain celebrities can teach you about the ERISA disability claims process. Celebrities; they're just like us. We might view celebrities or social influencers as being invincible, which simply isn't true. While they might be able to afford better medical care than the average man, celebrities are not impervious to illness or accidents; just see Lady Gaga discussing her struggles with migraines in Nurtec advertisements. In this episode of Winning Isn't Easy, Nancy L. Cavey will explore three celebrities and their illnesses to give you, the listener, an insight into claiming disability.In this episode, we'll cover the following topics:1 -  What You Can Learn from Keala Settle, and Getting Your ERISA Disability Benefits for Moyamoya Disease2 - What You Can Learn from Jimmy Buffett, and Getting Your ERISA Disability Benefits for Merkel Cell Carcinoma3 - What You Can Learn from Natalie Merchant, and Getting Your ERISA Disability Benefits for Spinal Degeneration with OPLL  Whether you're a claimant, or simply seeking valuable insights into the disability claims landscape, this episode provides essential guidance to help you succeed in your journey. Don't miss it.Resources Mentioned In This Episode:LINK TO ROBBED OF YOUR PEACE OF MIND: https://caveylaw.com/get-free-reports/get-disability-book/LINK TO THE DISABILITY INSURANCE CLAIM SURVIVAL GUIDE FOR PROFESSIONALS: https://caveylaw.com/get-free-reports/disability-insurance-claim-survival-guide-professionals/FREE CONSULT LINK: https://caveylaw.com/contact-us/Need Help Today?:Need help with your Long-Term Disability or ERISA claim? Have questions? Please feel welcome to reach out to use for a FREE consultation. Just mention you listened to our podcast.Review, like, and give us a thumbs up wherever you are listening to Winning Isn't Easy. We love to see your feedback about our podcast, and it helps us grow and improve.Please remember that the content shared is for informational purposes only, and should not replace personalized legal advice or guidance from qualified professionals.

In this episode for SurgOnc Today, Jeffrey Farma, MD, from Fox Chase Cancer Center/Temple Health in Philadelphia, PA, interviews James Jakub, MD, from Mayo Clinic Jacksonville, FL and Luke Rothermel, MD, MPH, from University Hospitals-Cleveland Medical Center Cleveland, OH.  We will review the current updates on the evaluation, workup and treatment of patients with Merkel cell carcinoma.  This will include the surgical management, current trends on both neoadjuvant and adjuvant therapy, recurrence and surveillance strategies.

Paul Nghiem, MD, PhD, FAAD interviewed by Olayemi Sokumbi, MD, FAAD

One of the things that sets neuroendocrine tumors apart from other kinds of cancer is that they can occur almost anywhere in the body. Those different locations — or primary sites — can mean the NET takes on different characteristics, and requires different kinds of treatment. In previous episodes of this show, we've talked about […] The post NETWise Episode 29: Merkel Cell Carcinoma appeared first on NETRF.

Merkel cell carcinoma (MCC) is a lesser-known but increasingly deadly skin cancer. The recent passing of singer Jimmy Buffett from MCC in September 2023 has drawn attention to this previously unfamiliar cancer, raising awareness. While MCC is 40x more rare than melanoma, it is the 2nd most deadly skin cancer after melanoma. It's important to schedule regular skin checks with a dermatologist to ensure there are no worrisome skin spots. If you spot a new skin lesion, don't wait—get it checked out ASAP! Tune into this week's podcast episode where I delve into the topic of Merkel Cell Carcinoma. Follow Dr. Mina here:-  https://instagram.com/drminaskin?igshid=OGQ5ZDc2ODk2ZA== For more great skin care tips, subscribe to The Skin Real Podcast or visit www.theskinreal.com  Baucom & Mina Derm Surgery, LLC  Email - scheduling@atlantadermsurgery.com Contact - (404) 844-0496  Instagram - @baucomminamd Thanks for listening! The content of this podcast is for entertainment, educational, and informational purposes and does not constitute formal medical advice.  

This week we celebrate the life of Jimmy Buffett as we also learn about Merkel cell carcinoma, the type of skin cancer that caused his death.  While we share his search for that lost shaker of salt, we also advocate for smart behaviors when exposed to the sun. Follow us on Facebook | Instagram | Email us at mail@every1dies.orgClick on this link to Rate and Review our podcast!

The doctors discuss the passing of Jimmy Buffett and the details of his skin cancer Merkel cell carcinoma. Vibrio vulnificus and "flesh-eating bacteria" from the ocean, what this is, and who might be at risk. And the fall of the Biotech firm Amyris and what might happen to beloved brands like Biossance. 1:25 - Dr. Shah's trip to Japan. 3:54 - Jimmy Buffett and Merkel cell carcinoma 13:36 - Trending topic - Flesh Eating Bacteria 20:21 - The Biz of Beauty - Amyris files for bankruptcy Disclaimer: This podcast is not intended to provide diagnosis, treatment, or medical advice. Content provided in this podcast is for educational purposes only. Please consult with a physician regarding any health-related diagnosis or treatment.

KMOX Health Editor Fred Bodimer spoke with Wash University and Siteman Cancer Center oncology surgeon Dr. Ryan Fields to find out more about Merkel Cell Carcinoma that took the life of Jimmy Buffett at the age of 76.

Dr. Aileen Marty, Infectious Disease Specialist and Professor at Florida International University, joins Bob Sirott to talk about the latest health news. Dr. Marty talks about the increase of COVID cases and the possibility of another lockdown. She also explains what Merkel cell carcinoma is and how someone is likely to get it. Singer Jimmy […]

Featuring perspectives from Dr Omid Hamid and Dr Evan J Lipson, including the following topics: Introduction: Immunology of Melanoma (0:00) Melanoma (8:26) Cutaneous Squamous Cell Carcinoma (43:15) Basal Cell Carcinoma and Merkel Cell Carcinoma (52:55) CME information and select publications

Lsten to a soundcast of the March 22, 2023 FDA approval of Zynyz (retifanlimab-dlwr) for metastatic or recurrent locally advanced Merkel cell carcinoma.

Too busy to read the Lens? Listen to our weekly summary here! In this week's research summary we discuss the influence of gender and race in keratoplasty for Fuchs' endothelial corneal dystrophy, the impact of optimal search engine practices, the relevance of Merkel cell polyomavirus in Merkel Cell Carcinoma, and metformin usage as it pertains to age-related macular degeneration. To subscribe to our weekly newsletter visit https://lensophthalmology.com

Welcome back to our Nurse Debriefing no. 24! For this week, we will be sharing our nursing stories. I, for one, had my longest shift for the week. I ended up working a 16-hour shift, which was an interesting experience.

Welcome to the emDOCs.net podcast! Join us as we review our high-yield posts from our website emDOCs.net. Today on the emDOCs cast with Brit Long, MD (@long_brit), we look at two posts: recognizing skin cancer and new onset hyperglycemia. To continue to make this a worthwhile podcast for you to listen to, we appreciate any feedback and comments you may have for us. Please let us know!Subscribe to the podcast on one of the many platforms below:Apple iTunesSpotifyGoogle Play

After listening to this podcast, learners will be able to: Describe common etiologies of MCC List risk factors for MCC Recognize classic presentation of MCC Develop a differential diagnosis for an asymptomatic growing nodule Outline the diagnostic work-up for MCC Describe therapeutic options for MCC

This week's episode covers the topic of Merkel Cell Carcinoma - a favourite question in the exam.  We have added the discussion we had with Dr Julie Howle onto the end of this episode. Dr Howle a surgical oncologist from Westmead Hospital who has an interest in these rare cancers.We cover:- background- risk factors- pathogenesis- presentation- diagnosis- staging- histopathology- and management DisclaimerThe information in this podcast is intended as a revision aid for the purposes of the General Surgery Fellowship Exam.This information is not to be considered to include any recommendations or medical advice by the author or publisher or any other person. The listener should conduct and rely upon their own independent analysis of the information in this document.The author provides no guarantees or assurances in relation to any connection between the content of this podcast and the general surgical fellowship exam.  No responsibility or liability is accepted by the author in relation to the performance of any person in the exam.  This podcast is not a substitute for candidates undertaking their own preparations for the exam.To the maximum extent permitted by law, no responsibility or liability is accepted by the author or publisher or any other person as to the adequacy, accuracy, correctness, completeness or reasonableness of this information, including any statements or information provided by third parties and reproduced or referred to in this document. To the maximum extent permitted by law, no responsibility for any errors in or omissions from this document, whether arising out of negligence or otherwise, is accepted.The information contained in this podcast has not been independently verified.© Amanda Nikolic 2022

Interview with Paul Nghiem, MD, PhD, author of Recurrence and Mortality Risk of Merkel Cell Carcinoma by Cancer Stage and Time From Diagnosis. Hosted by Adewole S. Adamson, MD, MPP.

Interview with Paul Nghiem, MD, PhD, author of Recurrence and Mortality Risk of Merkel Cell Carcinoma by Cancer Stage and Time From Diagnosis. Hosted by Adewole S. Adamson, MD, MPP.

Dr. Baumann sheds light on the incidence, prognosis, and treatment of patients with Merkel cell carcinoma, ongoing clinical research, and strategies to raise awareness for this rare disease.

Due to the highly aggressive nature of Merkel cell carcinoma, accurate and timely diagnosis is essential to ensure optimal management. Although our understanding of the biology of the disease has advanced significantly in recent years, a clinical conundrum still exists regarding the ideal therapeutic strategy for each patient.In this podcast, our multidisciplinary panel discuss:the pathology of Merkel cell carcinomadifferential diagnosesclinical presentationthe role of surgery and its importance in diagnosis, staging and salvagehow radiotherapy is used in the definitive and adjuvant settingsthe role of systemic therapyemerging therapies and the importance of clinical trials.In addition, the panel reviews two case studies to put learnings into practice.This podcast is suitable for Medical Oncologists, Surgeons, Dermatologists, GPs, Nurses and other healthcare professionals.Please note that this podcast was accurate at the time of recording (March 2021) but may not reflect the rapidly evolving treatment landscape and approvals in Australia.SPEAKERS:Dr Robert Rawson - Pathologist, Melanoma Institute Australia and Royal Prince Alfred HospitalDr Kerwin Shannon - Surgical Oncologist and Head and Neck Surgeon, Melanoma Institute Australia and Chris O’Brien LifehouseProf Angela Hong - Radiation Oncologist, Melanoma Institute Australia |Clinical Professor, The University of SydneyDr Ines Silva - Medical Oncologist and Researcher, Melanoma Institute Australia | Fellow, Westmead Hospital

Mahtab Samimi, MD interviewed by M. Laurin Council, MD, FAAD

In this bonus episode of Oncology Data Advisor, learn more about emerging evidence on immunotherapeutic strategies for advanced MCC and multidisciplinary approaches to monitor and manage immune-related adverse events in patients with advanced MCC in this activity presented by Shaildender Bhatia, MD, and Ciara Kelly, MBBCh, BAO. Listen now to earn CME/NCPD! To claim CME/NCPD credit for this podcast, visit i3health.com/advanced-merkel-cell-carcinoma

Brian Gastman, MD, Plastic Surgeon and Medical and Surgical Director of the Melanoma and High-risk Skin Cancer Program at Cleveland Clinic, joins Cancer Advances to discuss the latest in Merkel Cell Carcinoma. He touches on treatment options, research and results, along with what we can expect to see in the coming years.

Jeffrey Klein, MD, speaks with Drs. Gensuke Akaike and Tomoko Akaike about their article, "Imaging of Merkel Cell Carcinoma: What Imaging Experts Should Know". Find the article here at the following link: See Akaike et al, RadioGraphics 2019; 39:2069–2084.

This episode covers the basics of biology and treatment for Merkel Cell Carcinomas and Sebacceous Carcinomas

Lets Talk about skin cancer... On this week's episode of the Lunch and Learn with Dr. Berry we have Dr. Candrice Heath. Dr. Heath is a board-certified dermatologist and actually comes tripled boarded in Pediatrics, Dermatology and Pediatric Dermatology. She is a nationally recognized best selling author, and speaker and this week she lends her expertise to the Lunch and Learn Community for National Skin Cancer Awareness Month. Dr. Candrice gives us the ABCDs of skin cancer, teaches us what to expect when we go see the dermatologist and helps me try to break down some of the misconceptions associated with skin cancer and people of color. Dr. Candrice also lets us in on some exciting upcoming news about her company My Sister’s Beauty. Remember to subscribe to the podcast and share the episode with a friend or family member. Listen on Apple Podcast, Google Play, Stitcher, Soundcloud, iHeartRadio, Spotify Sponsors: Lunch and Learn Community Online Store (code Empower10) Pierre Medical Consulting (If you are looking to expand your social reach and make your process automated then Pierre Medical Consulting is for you) Dr. Pierre's Resources - These are some of the tools I use to become successful using social media Links/Resources: Facebook – https://www.facebook.com/drcandriceheath/ Instagram – https://www.instagram/drcandriceheath Dr. Candrice’s Clinical Pearls - www.drcandriceheath/clinicalpearls Skin Care Line – www.mysistersbeauty.com Social Links: Join the lunch and learn community - https://www.drpierresblog.com/joinlunchlearnpod Follow the podcast on Facebook - http://www.facebook.com/lunchlearnpod Follow the podcast on twitter - http://www.twitter.com/lunchlearnpod - use the hashtag #LunchLearnPod if you have any questions, comments or requests for the podcast For More Episodes of the Lunch and Learn with Dr. Berry Podcasts https://www.drpierresblog.com/lunchlearnpodcast/ If you are looking to help the show out Leave a Five Star Review on Apple Podcast because your ratings and reviews are what is going to make this show so much better Share a screenshot of the podcast episode on all of your favorite social media outlets & tag me or add the hashtag.#lunchlearnpod Introduction Dr. Berry: And welcome to another episode of the Lunch and Learn with Dr. Berry. I’m your host, Dr. Berry Pierre, your favorite Board Certified Internist. Founder of drberrypierre.com and as well as Pierre Medical Consulting. Helping you empower yourself for better health with the number one podcast for patient advocacy. This week we bring you an episode with Dr. Candrice Heath, who is an amazing person and most importantly is going to be talking to us about skin cancer. And you know, just to kind of caveat before we get into her bio and how amazing this person is. For those who may be listening, especially Lunch and Learn community. I've kind of referenced this before on a previous episode where we talked about skin cancer. I felt like this time I wanted to bring an expert and kind of get their expert opinion on to disorder, right? And if you want to know why this topic is so important, we're actually in skin cancer awareness month and when we talk about the number of cases of skin cancer that occur per year, it outnumbers the number of cases of lung cancer, breast cancer, prostate cancer, colon cancer combined, right? So it's an extremely important topic that I think a lot of times doesn't really get the fan fair especially because a lot of times when we think about dermatology tend to think about the aesthetic aspect of dermatology. But we really don't think about the fact that they are really in high demand when it comes to pathology and disease process and education, which is why I felt, you know what, let me bring this amazing guest here. And again. I just want to kind of read her bio just so you guys can understand, how important and how specialized this person is, Dr. Heath. She is a highly respected dermatologist. She's board-certified in Dermatology, Pediatrics and Pediatric Dermatology. And ladies and gentlemen, I mean she is triple certified in her specialty, right? Just so you can guys can get an idea of how amazing, especially she is. She got her undergrad degree at Wake Forest University. Her medical degree at the University of Virginia and her pediatric training at Emory. And then she ended up getting her dermatology training at Mount Sinai Beth Israel in New York City. She was elected to achieve dermatology resident during her final year of training and she went on to serve a role at John Hopkins University, Department of Dermatology. And as well as a pediatric dermatology fellow as well as a dermatology instructor. If you didn't get that right, just understand that this is definitely a very highly specialized person that we're bringing onto the podcast, really to educate the Lunch and Learn community. And most importantly, and this is what I love. She’s the founder of My Sister's Beauty, the official skincare line of the woman of color and founder of a vibrant online community associated with skincare and beauty tips for women of color. So amazing person, Dr. Candrice Heath. Again, she is a personal friend of mine as well. And she has blessed us with the opportunity to talk to us today just about skin cancer. And really, you know, what we should be thinking about when it comes to skin health, right? Because I think when we talk about empowering ourselves for better health, right? We got to understand that the whole body has to be working in unison, right? And I think a lot of times we forget about the skin. Again, I talked about the numbers, more cancer cases worldwide and the majority of these cancers put together. So you know, ladies and gentlemen, get ready an amazing episode. Again, I have Dr. Candrice Heath and we're going to be talking about skin cancer and skin cancer awareness. If you have not had a chance, remember, subscribe to the podcast, leave me a five-star review. And you know, when we leave the links for Dr. Candrice, go ahead and follow her and let her know how she did an amazing job this week. Episode Dr. Berry: All right, Lunch and Learn community. Again, thank you for joining us for another amazing episode. Again, this month being, you know, skin cancer awareness month. I was thinking long and hard and I said, you know, who can I get to really educate you to get us on far, to get us, get those bad thoughts that really shouldn't be in our mindset when we talk about skin cancer but really educated us and you know, kind of go through a lot of the fluff that I know that's out there. So of course if you listened to the bio, you know, we have Dr. Candrice here who is an amazing person in general. This is just an amazing person, an amazing physician. And I was just glad that, you know, she was able to give us some time to talk to us today, Dr. Candrice thank you. Dr. Candrice: Oh, thank you so much for having me today, Dr. Berry. Dr. Berry: We did a little bit of your bio in the introduction, but you know, for people who may not know you and you know, this is their kind of first entry into your world. Who is our Dr. Candrice? How are you going to get us together today? Especially when we talk about this discussion of skin cancer that even when I was doing like, you know, the little research that I did on skin cancer, I didn't realize how serious it was. Still the people a little bit about you that, you know, they may not have gotten from your bio, but you know, they will get, just have to listen to this episode today. Dr. Candrice: So I guess, I mean there are lots of things out there about Dr. Candrice, but what people really want to know or need to know is that I truly love being a dermatologist. I've learned on my journey that not a lot of people can say that they're passionate about what they do. They love it. But I truly love being a dermatologist and I enjoy all aspects of that from the education to what happens in the exam room, with the patients. And I realize that not only am I providing a diagnosis, treatment education but that I am actually impacting how someone feels about themselves. And that is a huge win for me. Dr. Berry: I love it. I love that. And of course, especially for Lunch and Learn community who may not realize, like when we talk about medical specialties, dermatology is one of those upper echelon specialties that if you're able to get through the rigors of medical school and conquer and do what you need to do, right? Like you can attain it, right? So again, this isn't a specialty that people just kind of walk into. Like they really have to put some work in. And again, I know Dr. Candrice as a person. I know her, I noticed she's an amazing person. I do want to really illuminate the fact that we got really a special person to talk to us today about skin cancer, right? Which again is, first of all from the numbers. Just from a sheer numbers standpoint, it was common cancer in the world, right? Boom. Like if that alone doesn't get your ears up and ready to educate yourself on this topic, I'm not sure what is. But Dr. Candice again, I’m an internist. I'm a hospital physician and you know, they've kind of heard the back story of how I got into there. What made you fall in love with dermatology? Like what was the path that kind of led you here to be able to grace us today? Dr. Candrice: Growing up, my older sister has something called nevus of Ota and it's actually a green birthmark that covers one side of her face. And so not only did we spend time going to our regular checkups with our pediatrician. We also would yearly visit our dermatologist in our local town. And I can still recall how excited and with anticipation. We would anticipate these visits because we would hope that they would have something to share that could take this birthmark away. And year after year, appointment after appointment, we were met with disappointment because there were, the technology hadn't really caught up so people with skin of color were not able to use the laser devices that were coming out to take away things on the skin such as my sister's birthmark without leaving significant scarring. But despite the answer being, "no, not yet," there's no solution yet, the dermatologist would take time to address my sister's self-esteem. And those few minutes actually really made the difference to me. And I said, wow, you know, dermatology, that is true, this is a different kind of doctor’s experience. So I could definitely experience what it was like to have a family member that had an ailment on the skin that everyone can see. So it's not like diabetes or having a heart problem where people may not be able to tell from your exterior that you're having issues inside of your body. But to be able to walk around with something that the general public can see. Man, that is an experience. Okay. So I took those observations and thoughts and also that experience that we had in the exam room. And then that's when I became interested in this whole dermatology, this skin disease. So if you can imagine, you know, 10-year old walking around and saying, hey, I want to be a dermatologist. That was me. I did not know about the uphill battle that we're following at it, know about how challenging it would become. And yes, I did set that goal based on my personal experience and I persevered to cross the finish line, but it wasn't easy. So people have to continue to follow me as I share more about that story. The great news is that yes, I am a dermatologist today and I'm so grateful for that so that I can live in my passion. But it was definitely a journey of perseverance to get here. Dr. Berry: I think that's telling because I think a lot of times when I think the common person, kinda hears about dermatology. I think they get kind of skewed, right? Because, they kind of think of more of the aesthetic, the Botox, that type of feel not realizing like no, there’s a lot more things that you know, it's scary. Right? You know, it can be disheartening especially from a self-esteem standpoint. So the pathology alone, right? Like and when we were talking about mythology, we talk about like disease courses, right? The amount of diseases that either originates from the, that show up on the skin is so vast. Again, I'm always impressed that you know, by my dermatologist because I know how much work, when did they put to get there as well as how much work they got to do while they there. Right? Like it's not a nine to five, you just chilling your junior year injecting people and then you're kind of keeping them, you know, a beautiful and healthy whole day. Right? There's a lot of clinical diagnostic procedures and treatment and discussions that go on a day to day basis. Right. Which is why I'm definitely such a fan of the field in general. Not so much offended. I wanted to be a dermatologist but enough that I can appreciate it from the outside. Dr. Candrice: And I definitely, thank you so much for highlighting that I think our other physician colleagues understand the scope of what we do. Yes. I do have colleagues who only do aesthetics, the only botox and fillers and things like that, but there is a large breadth of things that we do under the dermatology umbrella and I'm happy that our physician colleagues are excited that we can actually help them with their patients. Now the general public may just see us as, you know, a skin doctor or pimple popper or something like that, but in actuality, on a day to day basis, I am taking care of people who have severe disease and like brought up Dr. Berry as a dermatologist. It's amazing. I can go into the exam room, I can look at someone's skin and I can say, hmm, I wonder if this patient has diabetes. I wonder if this patient has thyroid disease. I know this patient has an autoimmune disease. And so it's amazing because, you know, the medical students are thinking, how would you know all of this stuff? My mind is trained to look at the skin, look at the hair, look at the nails, and come up with conclusions based on the patterns of recognition that I've seen over the years. So it is amazing. And yes, we do more than just acne and dry skin. We do lots of things and we take care of patients who have a serious disease. Dr. Berry: That was interesting. I know, and I know we're definitely gonna talk about it, you know, a little bit late on this show is the fact that you were introduced to the field very early. Cause I'm being honest, right? Like I've never been to a dermatologist, right? Like I'm 35 years old. No, don't hate me. Don't hit me. Right? I know, I know. I'm bad. I know. Trust me. You know, doctors make the worst patients, right? But I've always felt like, well, what am I going to do it here? This my skin looks okay. Right? So, I'm actually very happy that, you know, you guys were very introduced very early because I think a lot of times we hear, well, you know, let's say, skin color, you know, your dark skin, it is really nothing after you to do, there isn't nothing that he can tell you. I read the books, right? A lot of times when I'm reading books and I'm trying to get the description and I'm like, well what does this look like on a black person? Right? What does it look like on me? I don't know what this rash would look like on myself. Right? So I always kind of struggle with that. And again, we're definitely gonna talk about that later on. But I'm definitely kind of happy that, you know, you got introduced very early. Dr. Candrice: Yes, it is. It definitely has been a passion for a long time and yes, we do need more educational resources that highlight people with skin of color who had these specific things that we're trying to educate our colleagues about and the general public about. Dr. Berry: So with, with me, right, obviously we're recording this right? This is a skin cancer awareness month. I'll kind of all wrapped into one when we talk about skin cancer awareness. Like why for one. Right. Because this is the question I always get when we have these like health-related month. I like why does it stay made a whole month? Right? So like that I, I post you, right? Like why does skin cancer really need a whole month for us to be aware of? And what kind of says, you know what, I need to take this mantle and make sure I'm educating everyone about like skin cancer. Not to say that all your packages are nothing but skin cancer. I, but why is this like particular subjects such an important, I think for everyone to kind of know about it. Dr. Candrice: Skin cancer awareness month is a very important topic and yes, it should span the entire month of May and as a dermatologist, every day is skin cancer. Well you know, I could be a little biased. I mean, the thing is we all have skin and so sometimes we have been ingrained with these things that say, Oh, if you have brown skin, you don't have to worry about, you know, getting skin cancer. You don't have to worry about these things. So you just kind of tune it out. But I hope that every year when the month of May rolls around that people, regardless of their skin tone, learn something new about something that can potentially affect them, which is skin cancer. So it's all about educating, educating, educating. And if we only get 30 days out of the month to do that, or 31 days out of the month and do that, I say, let's go forward. We all have skin and we can all be infected regardless of skin tone. Dr. Berry: When we talk about just like the sheer numbers, right? I kind of alluded to it being the most common type of cancer in general, which is funny, right? Because me being an internist, I hear a lot about long, right? I hear a lot about the prostate, right? I hear a lot about breasts, I hear a lot about those things, but then when I'm looking at the numbers and they're like, whoa, those skin cancers, like I was pulling it out of water. Like I think that was more shocking to me. Obviously, you're in the field so we're probably not gonna be a shocking you. But like I thought that kinda hit me. I was like, oh I have this many people like dealt with like skin cancer. What are some of like the numbers, the stats, you know, Lunch and Learn community loves numbers from a statistic standpoint. Like, like how many people like are dealing with cancer and especially on a worldwide basis. The United States, you know, black folks, some women. Like what are some of the numbers that you kind of run across? Dr. Candrice: So I'm really, the numbers are usually broken down into the number of cases of melanoma that are diagnosed every year, which is a specific type of skin cancer than the most deadly type of skin cancer. There is the other group which is non-melanoma skin cancers. And often non-melanoma skin cancers, you're going to probably get about 5.4 million cases that had been treated in an average year. So that is a lot of cases of cancer. And then if you dive deeper into the statistics, you will find that one in five Americans by the time that their age 70 they're going to develop skin cancer that's taking all comers, all ages, all races of people putting them in the pot and you're coming up with the one in five Americans. So yes, it is definitely way more common than you think. And even when we really dissect out to the most deadly type of skin cancer, which is melanoma, it is predicted that there will be an increase in the year 2019 unfortunately by almost 7.7% so this is something that is not going away and it is definitely increasing. So we have to be on the lookout for it. The prediction of the number of cases for 2019 is over 190,000 cases are predicted to be diagnosed this year. So we definitely enough to be on the lookout for this. Dr. Berry: And what's interesting especially, and I am not sure if it's because it doesn't get the fanfare right? Like again I know we talked about breasts, we were talking about lung and just for Lunch and Learn community just from a number of sake, you know she was talking in the millions, right? When we talk about cases I'm like lung cancer, breast cancer, those are like in the 150 to 200 thousand. Just to give you an idea from a sheer numbers standpoint. How much more common it is right to have skin cancer than it is the other cancers, right? Not to say that no one is better than the other, but just when we talk about media and we talk about the influence of it, but then we had Dr. Amber Robins talked about the influence of media on our health care. This is one of the things that we see, right? Like we, we see like this is an issue that probably should get like more than a month if this many people, right. Ideally, with a skin cancer wet, you know, we got a month so we're gonna focus on and kind of do it here. And you talked about the different types of skin cancer, right? Like especially in your training when you're dealing with the melanoma and again, melanoma, we, you know, I know as an internist, you know, that's a bad word for us, right? We were as the one that's kind of scary for us as one, we tend to see exhibit an in a lot of different functions and especially when we're talking about when it starts spreading everywhere. When you're talking about melanoma versus the non-melanomas type skin cancers, right. And you just kind of start breaking those down. What is it that people should be doing? Right? Like again, what should I do? Should I start like scan to my skin now? Because now I'm getting kind of scared, right? All these people are against cancer, I'm getting kind of scared. I need to be worried about it. Dr. Candrice: Well definitely really the first step is to educate yourself. So you landed in the right spot. So we talked about melanoma being the most aggressive, a type of skin cancer. And then there are also those types which include Basal Cell Carcinoma, Squamous Cell Carcinoma, and even a rare to very rare type that we don't talk about that often called Merkel Cell Carcinoma. So there are various types. And the best thing that you can do is to definitely see a dermatologist once a year to get a head-to-toe, a skin check. But then right in your home you can actually go ahead, advocate for yourself, taking a mirror and looking at your own skin. The first step is to really get to know what is living on your skin already. You know, time and time again, I may ask a patient, how long has this been there? And they, so I don't know. I haven't seen my back in two years. That’s unacceptable. I want you to get to know what is on your skin regularly. That way you can be a better, this hectic just in case something changes or comes up, you can say hey you can go to your primary care doctor and say look I need a referral to a dermatologist because this is changing. This was not there before I'm concerned. Dr. Berry: Okay, get in tune with what your skin is so you know what their baseline is and you do recommend just like once a year? Like I said clearly I'm overdue. Right? So you're just saying just like you're doing your regular annual checkup, you should be seeing your skin screening as well? Dr. Candrice: Yes, I do recommend that people get skin checks and definitely you know if you had lesions on the skin, moles, etc. They should be checked. And people with skin of color, of course, we have to be very very careful because skin cancer can happen on areas of the body that you may not expect. So for people with skin of color that means anyone with non-Caucasian skin, non-white skin, the risk of your skin cancers are going to be higher. When we were talking about melanoma on the soles of the feet, the palms of the hand inside of the mouth. So those are areas that people may not even think about that can be effect by skin cancer. And yet that's where we find the most deadly type of skin cancer in people of color. Dr. Berry: Are we've already dealing with more aggressive types of skin cancer or is it our lack of, you know, just being aware and following up on the skin cancer? Like what would you, if you had to lean one way or the other? Dr. Candrice: The number one thing for skin cancer and people with skin of color is late detection and delayed diagnosis. The patient doesn't believe that they can ever have skin cancer, so that may delay treatment. Also, there are some primary care physicians who are uncomfortable with things on the skin and that stems from just, you know, how physicians are taught and what they're exposed to. So they may not actually get a lot of teaching in dermatology during their training. So it's an area that they may not feel as comfortable with. So it may not be on their radar to even look at the hands and feet of someone with the skin of color and to refer that patient. So basically, usually by the time that patient with the skin of color lands in my office, regardless of the cancer type, it is usually at a higher stage. So it is going to be the worst case scenario I'm walking in. So versus someone else who may have been trained from a child to say, you know, we can get skin cancers, you have to protect your skin from the sun, you have to do this, you have to do that. So they're more aware that things can go wrong on the skin. But if you have no clue that 'that' could happen, you have definitely, there's a long time lapse between when that appeared on the skin when you can actually get your diagnosis. And that definitely affects your prognosis. Dr. Berry: Wow. Okay. All right. Dr. Candrice, she's getting us together. So yeah, I'll know until right now, next week, I am scheduling my dermatology exam because it is clearly serious. And again, this is if, if you, if you had one month to choose to like do your routine skin screening exams, why not let it be in the month of May when you know, skin cancers around us. The spotlight is on from a media standpoint is on it. So this is definitely the month you should be thinking about, you know, calling your primary care doctor like right now. And if you're in Florida, fortunately in Florida, you don't even have to get a referral. You can go straight to your dermatologist. Thank you for Congressman Wasserman for that standpoint there. That's great. So I taught, I hear about skin cancer, I read Baskin cancer a lot. And I always see this is the A, B, C, D, E of the skin cancer. Right? What is that? And you know, how could my Lunch and Learn community, you know, derive and be educated and you know, get on the ball with, in the car and in regards to at ABCD’s of skin cancer. Dr. Candrice: The ABCD’s are really A, B, C, D, E. Now we've actually added E to that as well. (Okay.) It is a reminder for you when you're looking at your skin, what are some of the things that I should look for as warning signs or things that are going wrong on the skin? So let's say you have a mole on the skin and if you were to look at, if you were to imagine splitting the mole in half with, you're just with your eyes a little line. If one side does not look exactly like the other side, we say that that is asymmetrical and that is a warning sign. That lesion should be checked. So A stands for asymmetrical. One side doesn't look like the other, that could be significant. The B stands for border. So if it has a round, nice, crisp border, then we're not going to worry as much. But at the borders brace squiggly and not a very crisp, that could be a problem. Also, the C stands for color. So if your mole all of a sudden goes from being brown to having brown, gray, pink, white, basically changing in color, that could be a problem. So that's something that could trigger you to get that checked out. D stands for diameter. So typically, melanomas are in other things that are going to be problematic are the greater than this, the head of an eraser. Now I've definitely diagnosed things that were smaller than that. But anyway, it's part of the warning signs. So that may be something else that can prompt people to come in. And then the last E has been added in the last several years and that stands for evolving. So basically what that means is even if you don't remember the A, the B, the C, the D with those things stand for if you have a mole that is evolving or changing in any way that may be one that we need to look at more promptly. Dr. Berry: Okay. All right. They added E. I've been out of school for a few years. So when it was my time and they just stopped that d and maybe even add something new. Again, this is why, Lunch and Learn community I tell you all the time I get just as educated from my guest as you guys also. Like I said, I'm getting myself together, get myself mentally prepared, to see this dermatologist, right? So when I do not, again, just like when I go to see this dermatologist, like what happens? Right? I know what happens when I go and get my wellness check and I talked to my doctor about the flu. But what happens when I go to see different charges? I've never been to. So what happens when I go to the dermatologist for the first time? Dr. Candrice: Well, you have to expect to show your skin. I was not born with x-ray vision. So we have to get you out of those clothes and into a gown. Now they usually will ask you, you can leave your undergarments on if you like to make you feel more comfortable and then you will be placed in a gown. And during that visit with my patients, what I do in a very systematic way is that I look over the entire surface of the skin from head to toe looking for anything that stands out. That could be something that is an abnormal and abnormal lesion on the skin. So I definitely will take a look at every area in the extremities, the back, the chest, the scalp, the face, all of that looking to take a look to see if there's anything that looks unusual that needs to be biopsied. So yes, number one is to do expect to actually get out of your clothing, including your shoes and socks and get into a gown. And I think some people… Dr. Berry: Is that something you run into, like people in that really unexpected that part? Dr. Candrice: Yes. Roll up the sleeve, will pull up the pant leg and I said, look, I'm a dermatologist. I need to see the complete picture. You know, that part is very helpful because everybody's moles may not be textbook the same as someone else's. So I need to know your body is making molds and that can actually help me to determine. Is that something that needs a biopsy? Is this just how your body's making them? I need to get a sense of all of that. So I need to see your entire body surface area. Dr. Berry: Okay. I like that. And anything, out there, tips and tricks, get our patients to have it? To get them a full dermatology evaluation? Dr. Candrice: Sure. You know, don't ever be afraid to ask or you know about things that you may be concerned about. Sometimes dermatologist, you know, we lay over the completely benign things, but I often use that as a teaching moment. So I do give those things names and I educate the patient about what those lesions are. But it is important that you get your questions answered as well about specific things that you're concerned about. I think, you know, one of my, some of my favorite instances as a dermatologist is to walk in and you know, there's a someone there for an exam and I start to examine their skin. I see like five circles on their skin with a marker and I'm thinking, hmm. Basically, every time I inquired, basically it's usually a wife that has circles, these lesions because she wants to know exactly what those are and what's the, make sure that those species are okay. So even if you don't have a wife, this makes circles on your skin and there are a few things that you are concerned about. It’s okay to make a list of those things so that we can make sure that we address those specifically so that you leave feeling empowered about your skin. Dr. Berry: I love it. We love empowering here. Because especially when they come to see, you know, the general family practitioner or internist and they're asking a lot of questions. Like I do wonder like what type of leeway do they have when they go in to see their dermatologist? Right? Because again, obviously, you're the expert, right? And you know, if something's like, oh no, that's nothing, but they just want to know, right? Like they read it in a book, they read a blog, they've heard a podcast and they say, oh no if it looks like this, you're supposed to do something about it. Do you run into a lot of that where patients are, you know, they're empowering themselves to be an advocate for themselves. But sometimes you almost have to educate them away from doing extracurricular things that you wouldn't necessarily need to do. Dr. Candrice: Absolutely. I think that's our job as physicians to provide the education and say, this is by all accounts, this is a something that it's benign. It's something that can be observed, you know, you don't have to remove it. So I think just spending time to educate also can be helpful for them as well. Dr. Berry: All right. So I'm in the dermatology again and just kind of preface it. Because again, I remember when I was studying in dermatology type questions for boards and everything else and my number one question was always, well you know what? Like yeah, I understand like how it looks, raised, bordered, redness. Like I already understand how that looks. But like for a person that looks like me, right? Like how does that look? Does it look the same? Should I be worrying? Like is it different? Is it the opposite? I don't know. Do you, when you take care of patients of color and they're coming to you with skin related issues as well, do you tend to find that more difficult or is that just feed your training? You're aware of it? Like I always, because I always want to know, cause obviously when I'm reading a book I don't tend to see too many skin colors and I looked like mine that is examples. Dr. Candrice: Yes. I have specifically sought out training in the skin of color. So I was excited to be able to do my dermatology training with some skin of color experts. And actually my program had a skin of color center as well, so we were known for that. So that allowed me to be able to see dermatology on multiple different skin types. And you're right, yes. Some things do not follow the descriptions in the book at all. So you have to go to someone if you do have the skin of color, go to someone familiar with your skin type so that you can get a more expert exam when it comes to that. Dr. Berry: And when we talk about this is skin cancer in general, especially for skin of color. I know you talked about us 10 being caught later. So does that mean like we're from skin cancer total wise, we're dealing with it a lot more frequently or we just happen to catch it at a much later stage? What are some of the numbers especially for skin color and people with skin of color when we talk about skin cancer and diseases of alike? Dr. Candrice: And this is actually really sad, but people of color, we are less likely to get skin cancers. But for an example with melanoma, the one that is the deadliest tight. When we think about the five-year survival rate after someone has cancer, they, you know, was always these statistics. They go out to say, well, in five years, you know, what's the likelihood this person being alive for an example. So for melanoma, when you compare black patients to white patients, white patients have, you know, it's like over 91% of those patients will have a five-year survival rate. And for blacks, it's only a little over 60% or about 65% or so. So that is drastic, a very drastic difference. And so that goes back to the point of late diagnosis. Particularly when we talk about the most deadly type of cancer. Yes, we don't get skin cancer that often, but man, when we do get it, the prognosis is horrible because it's often caught very late and it has spread beyond just the skin at that point. Dr. Berry: And I can tell you from an internist standpoint, some of the patients I've taken care of, unfortunately in a hospital, you know, we've had skin cancer shows up in the lungs, we've had skin cancer show up on the GI system, we’ve had skin cancer show up in the brain, you know, Lunch and Learn community, give you an idea like this isn't a benign disease that you know a little, you know, biopsy cuts and get outta here. Like once if it does what it's, you know, set to do, it can really cause some problems. Dr. Candrice: Yes, it is very devastating and it definitely will be called metastasizes, which is what you definitely explained. It can go all over the body. Dr. Berry: So, and when we talk about this, some of the reasons why we're coming late, right? The reason why we're not seeing Dr. Candrice earlier, basically for people of color. Like I honestly, I was like, oh, what do I need? Like I'm protected, right? Like, well, you know, I'm protected from the sun, like from it from my peers and my skin color. But what are some of the biggest misconceptions that are out there? People like me, it's getting people of color really need to like kind of erased from their mind when it talks about, you know, just skin cancer and skin disease in general. Dr. Candrice: Please erase the fact that your brown skin and your melanin can embrace all potential harm. Is not true. You can get skin cancer. Let me just hit on my mic to make sure they heard me. Look with brown skin, yes, you too can get skin cancer. Take it from me. If you don't believe the statistics. I am triple board certified dermatologist that looks exactly like you. And yes, I see devastating cases. So please, please, please. It's just, it's not true when people say that it doesn't affect us, it's just not true. Dr. Berry: Lunch and Learn community I hope you I heard that. She’s a triple boarded, right? So again, this is, this isn't just you're running the mill like a physician who was trying to like, no, this is a person who really knows what they're talking about and especially for, I have a lot of listeners of color. You know, if you have not, right, again, don't be like me, right? Like, get just skin check done ASAP. Right? The month of May, get it done by the end of this month. Like, make sure that happens like today. And then make sure you bring family members too right. We didn't talk about, but make sure you bring your family members and get them some chopped too. Because I know a lot of us, a lot of y'all don't already like coming to see us for the world has visited. Right? So if y'all already not seeing us for the wellness visit, I know. Yeah. Not going to see yourselves for that, the skin can visit. So please do that. And you know, kind of get out of that mindset. Right. So, you know, Dr. Candrice can kind of help get us together and get us earlier. Again, that's sad though. 60% of us on a little bit over two-thirds of us are actually making it within five years once we're diagnosed just because we're not being seen early and it has a problem. Dr. Candrice: Yes. Devastating statistic. Dr. Berry: So let's talk about skincare, self-care and I wanna know, right? Like I wanted to know because obviously again for Lunch and Learn community even those who don't know, Dr. Candrice and I, we've been friends for about, like three years now. You know, medical always together. I know how amazing this person is and as she does so much education. That's why I wanted to bring her on the show. Right. So Dr. Candrice tell us about skincare, self-care, and why we need to be with it ASAP? Dr. Candrice: You know, I see so many manifestations of stretch in the skin, in hair disorders, lots and lots of things. And so what I thought about was sometimes for people the moment in the morning before the day gets crazy and they're in the bathroom doing whatever they need to do, that may be their only time for self-care. So I developed this concept, this really kind of mindset that yes, skincare is self-care. So focusing on your skin is a way of taking care of yourself. You walk around with your skin all day, every day, so why not take a few minutes to take care of your skin in those moments of the day when you actually have time to do it. So that really was the impetus to all of this. Just, you know, people stressing out and a lot of, and seeing all these diseases on the skin that all you have to do is cleanser or moisturizer. It's like a really quick fix, right? But people were not taking those few minutes of the day because they said, oh, that takes too long. I don't have time for that. I'm busy. I'm this, I'm that. Well, you at least can you give me three minutes a day to be able to care for your skin? And man, what I saw happening was that yes, people, skin disease improved, but also their attitudes improve. Once I started to pitch it as a self-care, their self-care moments of the day, things began to change. They saw it from being something that was cumbersome that they had to do to something that they actually look forward to doing. Dr. Berry: A highlight of their day to take care of this again. Dr. Candrice: Right, exactly. And you say that with some hesitation, but it’s dermatologist, yes. Dr. Berry: Oh no, my way, she’s about to make up that now. So I already know that when she's in that mood. I don't even mess with her. Go ahead, do whatever. I'll wait. I'm in no rush. I ain't going nowhere anyway. She got a whole routine. It's funny because she's got a morning routine, she's got to go on the bed routine as I'm like, wow. Oh, and of course I'm naive, right? And like I gotta ask you a question like, especially when it comes to men, I'm naive, right? And I'm like, why can't you just wash your face? And they're like, no, you gotta do this and this and it's so it's too funny. That's good care. So can we definitely here for that. I got to ask, right? Because I know obviously Lunch and Learn community what about the men, right? Like how much men are you seeing in your practice? How can we get, and we just, we have this issue just getting them to do their wellness checks, right? Like how are you getting them to come to check their skin out? Dr. Candrice: I see men all the time in the office and as soon as I walk in, I know whether they are there by choice or force. I don't care how you land in there. I'm just happy to see the men when they do come in because it is important for me to have those conversations with them. And then we talk about some of the things that they don't really like. People talk about how, Oh, if I wear sunscreen and, and I'm working out or doing something, and I sweay, it gets in my eyes and this, that and the other. So we have conversations about, okay, well how can we overcome some of those things? Some have been cumbersome for you to get around to kind of get on the bandwagon of protecting your skin. So I really enjoy those conversations. And so I had that segment of men that come in for skin checks. But then also what I'm finding is that even just for general skincare things that men actually care about the way they look. They may not tell you or emphasize it and you know, but they do care about it. They may be coming in for ingrown hairs on the face or a little bit of dry skin here, there. Just you know, things that cap into, to happen to come up. And I've definitely given my male patients permission to actually ask about those things. I'm very active on social media and when I look at the statistics and some of my followers, I was surprised that like 20 to 30% of my followers are men. And no is not because I'm so fabulous myself. Right? (Part of it, maybe.) No, it does not because I am definitely an, I make it a point to really give tips along the way about really, really realistic, you know, short steps that you can do to really take care of your skin. And I said, wow, you know, the guys are actually benefiting from this as well. And they make me feel good that my information can be valuable for both women and men. Dr. Berry: Okay. I love it. Before we get you out of here, I always ask my guest, how can what you do really help empower people to take better control to skincare? Dr. Candrice: I understand that my words are powerful. I understand that my interaction with every patient is important. I can remember being a child in the exam room with my physician and if that physician gave some words of encouragement to me. Oh, you want it to be a doctor? Oh, that's great. Blah, blah, blah, blah. You may have understood that depending on where on the neighborhood that you work in, that you may be the only physician of cover that this patient ever sees. I may be the only physician that ever takes a second to encourage a child, encourage their child. And that one piece of information can be the thing that drives them through their entire schooling to become a doctor because somebody told them that they could. So I always had that in my mind. So I know that I'm empowering that way. And then also empowering beyond the exam room currently. So I know that when I'm giving information to women who come in with hair loss and brown spots and this and that and the other, that I encouraged them to talk to their families about it, talk to their girlfriends about it, talk to other people at the hair salon about it so that my words can travel just beyond, beyond well beyond just my patient, but also to a community. And so I love it when patients come in and say, oh so and so referred me or Oh I heard about you at the hair salon. Oh, I heard about you at church. I love it when that happens because it means that I've done a great job of taking something that can be very scientific and complex and making it very simple enough or just my patients to be able to say, look I saw this dermatologist and she told me x and you should get into. That to me is super empowering. I have now turned my one to one patient experience into a one to many experiences. Dr. Berry: Oh, I love it. Absolutely love it. So Dr. Candrice, how can someone follow you, get educated. Like I said, again this is just one episode but this isn't, this is more of like a blip. Like cause you're doing this all the time and I want to make sure my Lunch and Learn community kind of follow along with you. Where can people find you? When's your next speaking engagement? Let us know some details so we can make sure we get you right. Dr. Candrice: I can be found @drcandriceheath on all social media platforms. That's @ D, R, C, A, N, D, R, I, C, E, H, E, A, T, H, that's @drcandriceheath on all social media platforms. Also. I have launched a beauty line called My Sister's Beauty. So I hang out there a lot as well www.mysistersweetie.com. What we really focused on simple skincare. That is also of course self-care. You know my motto, love that. Very simple. You have to tell your wife about that. And then for my people in the medical community who are always asking me about how do you get these speaking gigs, how do you do that exactly? Why are you so comfortable? How do you do that? I finally put everything into a portal. Okay. So I am debuting very soon, www.drcandriceheath.comf/clinicalpearls. So that you can actually be able to go right there. www.drcandriceheath.comf/clinicalpearls to find out what I am doing in the speaker realm for medical professionals. Dr. Berry: And Lunch and Learn community, all of this link will be in the show notes. So you know, if you're driving, take a shower, whatever you do it, you'll be able to get access to it. And I was just about, I let you go, but you gotta tell us you gotta you can't just like a drop that, you know, beauty line comes and just let you go. Right? What about that right? I know we're talking about skin cancer, were on the self-care now. Let's get us right. Dr. Candrice: I am so, it brings tears to my eyes because this has a long journey to launch this line. And really the primary focus is based on all these experiences that I've had with women. Like I told you before, you know, people feeling overworked, too busy to, you know they have the kids hanging off of one arm, the job doing this and you know the taking care of the home depot, all of these things but yet and still they want to look great, they want to feel great. And one of the main things that people often come in about it, they talk about brown spots on the skin. So I know I wanted to develop something that could definitely help to brighten the skin, give people more, even skin tone. All those things they look for so that they do look refreshed and feel refreshed. So I'm excited about the cleanser that we have. It is amazing. I cannot wait for you all to try it and it is packed with a fruit acid called Mandelic Acid and it definitely helps address those dark spots. And I'm really thrilled about it. It's packed full of botanicals so you will see ingredients that you recognize and like in the line including bringing tea. But moisturizer is my group, My Sister’s beauty. Recovery cream is packed full of aloe and it is just amazing. Like I'm so super excited about this. I have a launch party coming up in my city. I cannot wait. So it's, it's been amazing. It has definitely been a long journey and amazing journey and basically, the best is yet to come and I am just excited to finally be able to birth the thing that has been, working on for so long. And yes that really the focus of all of this is about self-care and that's the most amazing part of this whole thing. So I'm ecstatic. Dr. Berry: I love it. Whenever the launch date we'll make sure we promote. We'll make sure we let the world know Lunch and Learn community where they can get that because that's awesome. Absolutely amazing. Dr. Candrice: I would love that. Thank you so much, Dr. Berry. I would love that. Dr. Berry: So again, Dr. Candrice thank you for really enlightened us, educate as getting us together. I'm like, I said next week this skin care is being made. I'm not sure I'm going to see. I know dermatologist is busy. I might not see off for a month, but the appointment will be made at least. So we were going to get us together. Dr. Candrice: Wonderful. Wonderful. Dr. Berry: And again Lunch and Learn community, you know, this person's amazing. Please. Her information will be in the show notes. Please follow her again @drcandriceheath at all social media outlets. Wherever she's at, wherever you're at, she's likely at as well. Or she'll get there so you know, please make sure. This is a person, a friend that I value her opinion or her expertise or knowledge. And now she's about to drop a line and we're going to make sure we get some from the wife because we're going to get everyone together. Dr. Candrice: Yes. Wonderful. Thank you so much Dr. Berry and your awesome Lunch and Learn community. You really know who I am at this point. I am Dr. Candrice, your favorite fun board-certified dermatologist. I am your go-to girl for everything - healthy hair, skin and nails. Dr. Berry: I love it. Thank you. Have a great day. Dr. Candrice: Thank you.   Download the MP3 Audio file, listen to the episode however you like.

MERKEL CELL CARCINOMA This is a neuroendocrine tumor which is aggressive, locally invasive and has a high rate of metastasis. Five-year survival is 88% for stage 1 disease, but 0% when there are distant metastases. Order a CXR to rule out pulmonary primary tumor because tumor pathology resembles small cell carcinoma of the lung. The lesion generally appears as a red or purple papulonodule or indurated plaque. It has characteristic positive immunocytochemical staining for CK-20. Treatment is wide local excision with 1-2 cm margins with sentinel lymph node biopsy. Radiation should be performed to the primary site and nodal bed, if the latter is involved. Use of adjuvant chemotherapy is controversial if node-positive disease is discovered. The regimen in this case would be similar to that used for small cell cancer of the lung.

This JCO Podcast provides observations and commentary on the JCO article Durable Tumor Regression and Overall Survival in Patients with Advanced Merkel Cell Carcinoma Receiving Pembrolizumab as First-Line Therapy by Paul Nghiem, MD, PhD et al. My name is Reed Drews, and I am a member of the Cutaneous Oncology Program at Beth Israel Deaconess Medical Center in Boston, MA. My oncologic specialty is non-melanoma skin cancers.   Merkel cell carcinoma is a rare, aggressive neuroendocrine skin malignancy with high propensity for local recurrence and regional lymph node and systemic metastases. Its incidence rises exponentially with aging and is 10-fold higher in chronically immunosuppressed patients. When Merkel cell carcinoma is advanced and/or unresectable, historical 5-year overall survival rates are low, from 14 to 27%. Cytotoxic chemotherapies, like platinum plus etoposide used in other high-grade neuroendocrine malignancies, have not yielded durable response rates.   The cutaneous cell (or cells) of origin in Merkel cell carcinoma remains controversial. Nevertheless, scientists have identified 2 pathogenetic pathways leading to Merkel cell carcinoma. In 80% of cases, clonal integration of a polyomavirus leads to Merkel cell polyoma virus-positive Merkel cell carcinoma. In the other 20% of cases, ultraviolet light-induced DNA damage leads to polyoma virus-negative Merkel cell carcinoma. Polyoma virus-negative Merkel cell tumors display predominant cytosine to thymine transitions, a signature of DNA damage from UV light, and they have a 100-fold greater mutational burden than virus-positive Merkel cell cancers. For both subtypes, loss of immune surveillance, as with aging or chronic immunosuppression, contributes to Merkel cell carcinoma development, with diminished non-self-antigen recognition of UV-induced neo-antigens in virus-negative tumors and viral oncoproteins in Merkel cell polyoma virus-positive tumors.   Given these factors, investigators have recently studied whether immune checkpoint inhibitors might hold promise for managing advanced Merkel cell carcinoma. To date, 3 antibody inhibitors of the programmed cell death-1 pathway (abbreviated PD-1), including anti-PD-ligand-1 avelumab, anti-PD-1 nivolumab and anti-PD-1 pembrolizumab, have been tested in patients with chemotherapy-refractory and/or treatment naïve Merkel cell carcinoma. The 62% objective response rate from avelumab in treatment-naïve Merkel cell carcinoma was nearly twice that observed in chemotherapy-refractory disease. In 2017 avelumab became the first immune checkpoint inhibitor approved by the FDA for advanced Merkel cell carcinoma. Nivolumab yielded similar results, as did pembrolizumab according to a 2016 report from Nghiem and colleagues of a multicenter, phase 2, non-controlled study with 26 patients.   As reported in this JCO publication, Nghiem and colleagues have now increased their cohort to 50 patients through the multicenter expanded phase 2, Cancer Immunotherapy Trials Network-09/Keynote-017 trial. They administered pembrolizumab 2 mg/kg intravenously every 3 weeks for up to 2 years. Median follow-up time was 14.9 months, with a range from 0.4 to 36.4 months. This represents the longest follow-up to date of any anti-PD-1 pathway inhibitor for first-line treatment of advanced Merkel cell carcinoma. The 50-patient cohort included 43 patients with (stage IV) distant metastatic disease and 7 with stage IIIB recurrent locoregional disease not amenable to definitive surgery or radiation therapy. All patients had normal organ and bone marrow function and an Eastern Cooperative Oncology Group performance status of 0 to 1. Key exclusion criteria were previous systemic therapy for unresectable Merkel cell carcinoma, immunodeficiency or systemic immunosuppressive therapy, active autoimmune disease, concurrent second cancer, and active central nervous system metastases.   The median age of enrolled patients was 70.5 years, with 80% age 65 or older. 64% of patients had Merkel cell polyoma virus-positive tumors. For previous management of their primary Merkel cell carcinoma, 42 patients had had surgery, and 35 patients had had radiation treatment. While no patient had previously received systemic therapy for advanced Merkel cell carcinoma, 3 patients had received adjuvant chemotherapy greater than 6 months prior to study enrollment.   Patients received a median of 10.5 doses of pembrolizumab – range 1 to 35 doses—and the median treatment duration was 6.6 months – range 1 day to 23.6 months. Radiographic responses were assessed centrally per Response Evaluation Criteria in Solid Tumors, version 1.1. Responses were generally rapid and durable with 2.8 months as the median time to response – range 1.5 to 9.7 months. The objective response rate to pembrolizumab was 56%, with complete and partial responses of 24% and 32%, respectively; 10% had stable disease; and 32% had progressive disease.   At time of data analysis, 20 of 28 responses were on-going, and the median durability of response had not been reached. The Kaplan-Mier estimation of response durability at 24 months was 79.1%. Median progression free survival was 16.8 months, and the Kaplan-Mier estimation of progression free survival at 24 months was 48.3%. Median overall survival had not yet been reached. The Kaplan-Mier estimation of overall survival rate at 24 months was 68.7%.   Tumor viral status, as determined by small T-antigen specific antibodies in serum or large T-antigen expression in tumor biopsies by immunohistochemistry, did not correlate with any study outcomes, such as progression free survival or overall survival. However, a trend towards improvement of these outcomes appeared in patients with PD-L1-positive tumors, as defined by cell-surface PD-L1 expression on at least 1% of tumor or immune cells.   The safety profile of pembrolizumab in advanced Merkel cell carcinoma was similar to that in other studies of anti-PD-1 pathway inhibitors: 28% of patients had grade 3 or greater treatment-related adverse events, causing 14% of patients to discontinue treatment. A 73-year old male patient with widely metastatic Merkel cell carcinoma and pre-existing atrial fibrillation died after developing pericardial and pleural effusions 1 day after one infusion of pembrolizumab. Other adverse events were generally manageable and typical of complications of anti-PD-1 pathway inhibitors, including adrenal insufficiency, colitis, hyperthyroidism, hypothyroidism, infusion-related reaction, myocarditis, pancreatitis, pneumonitis, maculopapular rash and thyroiditis.   With such impressive rates of durable tumor regression and overall survival, on December 19, 2018, the FDA granted accelerated approval to pembrolizumab for treating patients with recurrent locally advanced or metastatic Merkel cell carcinoma. Today’s standard of care for advanced Merkel cell carcinoma is an anti-PD-1 pathway inhibitor, and the NCCN Clinical Practice Guidelines in Oncology in 2018 recommended avelumab, nivolumab and pembrolizumab as preferred first-line therapy for advanced Merkel cell carcinoma, ahead of cytotoxic chemotherapy.   Future studies must determine what role anti-PD-1 pathway inhibitors will play in the neo-adjuvant and adjuvant settings when managing early stage Merkel cell carcinoma with high-risk features. Prior to immune check point inhibitors, neo-adjuvant and adjuvant chemotherapy were considered case-by-case, absent strong evidence for benefit.  However, now with impressive results from anti-PD-1 pathway inhibitors in advanced Merkel cell carcinoma, adjuvant nivolumab and avelumab are being evaluated in 2 randomized phase II trials. Nivolumab is also undergoing study in the neoadjuvant setting, and researchers presented promising preliminary results of a phase I/II study at the 2018 American Society of Clinical Oncology Annual Meeting. We look to Nghiem, his colleagues and other investigators to keep us informed regarding future advances, including insights into mechanisms of resistance to the immune checkpoint inhibitors.   This concludes this JCO Podcast. Thank you for listening.

In this edition of the “Peer to Peer” audiocast series with Dr. Vincent DeLeo, Dr. Sean Branch provides an overview of Merkel cell carcinoma (MCC), an uncommon neuroendocrine tumor of the skin. He discusses the clinical presentation, incidence, and pathogenesis of MCC and also highlights a case of spontaneous regression in a 96-year-old woman.

Dr Paul Nghiem speaks with ecancertv at AACR 2016 about his research to treat MCC, a virally induced cancer, using pembrolizumab. The Merkel cell polyoma virus can inhabit human skin, infecting a site in childhood and not become pathogenic until decades later, leading to Dr Nghiem describing the likelihood that its reawakening is caused by immune quiescence in later age. Reversing this immune suppression with pembrolizumab is reported as an effective treatment, and helps to re-established host immunity as potent even after the age of 65.

Dr Kaufman speaks with ecancer at AACR 2017 about the effectiveness of anti-PD-L1 avelumab in treating Merkel cell carcinoma (MCC) in patients who had been previously treated with chemotherapy. He describes results from 88 patients with metastatic disease, who at 6 months follow-up had 31% response, and 33% response at 1 year. Dr Kaufman notes the recent FDA approval of avelumab in this setting, and considers other possible applications.

Dr Kaufman presents results at AACR 2017 of a trial administering avelumab to patients with advanced Merkel cell carcinoma who had not responded to chemotherapy.

FDA D.I.S.C.O.: Avelumab in Merkel Cell Carcinoma FDA medical oncologists discuss the agency's March 23, 2017, approval of avelumab the treatment of patients 12 years and older with metastatic Merkel cell carcinoma.

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

FDA medical oncologists discuss the agency’s March 23, 2017 approval of avelumab for the treatment of patients 12 years and older with metastatic Merkel cell carcinoma. Released May 22, 2017

Dr Kaufman speaks with ecancertv at ASCO 2016 to discuss the results of phase II JAVELIN Merkel 200 trial, in which patients with metastatic Merkl cell carcinoma received avelumab, a PD-L1 checkpoint inhibitor. Merkel cell carcinoma (MCC) is an aggressive skin cancer associated with Merkel cell polyomavirus, with limited therapeutic options after 1st-line chemotherapy. Dr Kaufman describes the results of the JAVELIN trial in which, of a cohort of 88, six patients (9.8%) achieved complete responses, 12 (19.7%) had partial responses, and 7 (11.5%) had stable disease (83.3% responses were ongoing). He also details the ongoing progression free survival data, and offers that additional clinical evaluation of avelumab for is warranted.

This was audio was recorded at the 2012 Summer conference in Seattle Washington