Skin Cancer: What Is It?

Everyone is talking about skin cancer; about how to prevent it, how to treat it, who gets it, and who doesn’t, but no one seems to talk about what it is. I think if we explore a few simple ideas, we will fear it less, and also learn where the real breakthrough in treatment is.

Whenever we read about skin cancer, we tend to think about it as something we “get”. It is not unusual to hear a friend say, “Betty was at the doctor’s office and found out that she got skin cancer”. After a while we come to think of skin cancer as something you “get”, like a gravy stain on your favorite necktie. Ooops, skin cancer!

You may be surprised to learn that cancer is a very ordinary part of living in this fallen world of ours. Cancer is a word that describes a process of degeneration that can happen to living cells in which the DNA language of the cell gets garbled, causing the cell to misbehave, sometimes replicating wildly (tumor), sometime wandering off to distant parts of your body and causing trouble (metastasis or spread of cancer). It all begins with some damage to the language library that controls what the cell is normally supposed to do. This degeneration of the DNA happens all the time, and to everybody.Sometimes it is a virus that damages the DNA, sometimes a chemical substance, sometimes radiation.Your body has been producing cancer cells since before you were born!

You may ask, “Well, Dr. Lappert, why aren’t we all dead from cancer?” That is the heart of the issue! The reason why we aren’t all dead from cancer is because we are blessed with an immune system that is constantly rooting out cancer cells and killing them. Doctors call that the “Immune Surveillance System”. We have specialized white blood cells that are constantly sniffing around looking at the surfaces of cells, trying to detect if that cell is making weird proteins that would suggest deranged DNA. If those watchdog cells smell trouble, they will mark that cell for destruction. Other specialized “killer” cells will come along, see the mark, and destroy the cancer cell.

Then why do we get cancer at all? As with all other abilities that we are blessed with, we don’t all have them in equal measure. Some people inherit a tremendous resistance to skin cancers. Other people, particularly later in life when all of our strengths diminish, get skin cancers constantly.

A few years ago, some very clever scientists discovered a molecule that your body uses to communicate between the watchdog cells and the killer cells. It turns out that if you apply that molecule to your skin, your immune response to skin cancer is very greatly amplified. The medicine is called Imiquimod. If you put it on normal skin, nothing happens. If you put it on skin that has even pre-cancer, the skin will redden, and after a period of about 2 months, the cancer is gone!
It hasn’t been proven to work in all cancers, or in all people, but about 93% of the time, it solves the problem.

I’ve been using Imiquimod at Lappert Skin Care for years. It is helpful for making the diagnosis, treating the cancer, or making cancer surgery more effective. I have my patients apply it to any little growth on their skin that is suspicious. If I see it turn red after a week, I have them apply it every evening for a total of one month. If it is still there, after turning red, I will remove it and send it to the lab. If they apply the medicine and there is no reaction, we will watch it. If it is still suspicious looking, we will remove it.

Imiquimod is one of a new class of medicines called Immune Response Modifiers. They are being tested and developed for a whole host of cancers including cervical, lung, and gut cancers. It is one of the most promising areas of cancer care.

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