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Skin Checks Are Critical To Your Health

Several years ago, I was telling a patient about the importance of doing routine screening for skin cancer – by far the most common type of cancer in the U.S., affecting over a million people a year. She volunteered that she was covered, that she was seeing a dermatologist routinely for Botox injections. “Does he do a complete head-to-toe exam?” I asked. Her pause and sheepish expression told me all I needed to know. She wasn’t at all covered – because she was never uncovered.

Fortunately, the majority of skin cancers found each year are basal cell or squamous cell – the types that have a very high chance of being cured. The National Cancer Institute estimated that fewer than 1,000 people died from these “non-melanoma” cancers in 2008. Melanoma is another story, affecting over 62,000 Americans a year and causing over 8,400 deaths. The majority of melanomas occur in older patients but almost 1 percent are diagnosed under age 20 and almost 8 percent are found between ages 20 and 34. So you’re never too young to start thinking about ways to prevent skin cancer and ways to keep track of what’s happening with your skin.

Since I was in medical school in the mid-’70s, the number of yearly cases in the U.S. has more than doubled. Early detection is likely one reason for the increase but nobody is exactly sure what has been causing the dramatic rise. What is clear, however, is that early detection is the name of the game when it comes to curing melanoma. The earlier a lesion is found, the better the chance of cure – which brings us to the main point of this blog. Everybody should be getting routine head-to-toe skin exams. This means looking from head to toe at every millimeter of your body, including where the sun doesn’t shine. Skin cancers can occur in any location of the body, including the armpits, scalp, between the toes, in the groin or anogenital area – anywhere! Routine self-exam should be part of your screening regimen. If a partner is available who can examine hard to see areas such as the small of the back – all the better.

In addition, I feel that routine screening should include a well-trained health professional who is interested in performing a careful skin exam. This is where it can get tricky. We live in a time when sub-specialists abound – even among dermatologists. A patient may see a cosmetic dermatologist several times a year for Botox injections. The dermatologist may glance at areas of exposed skin but the patient should not feel that a full screening skin exam is being routinely performed. The patient I described at the top of this blog had magical thinking – somehow reasoning that she’d received skin cancer screening just because she’d seen a dermatologist, even though she hadn’t taken her clothes off! Trust me: no doctor is good enough to detect skin cancer without examining the skin.

When the CBS Doc Dot Com team was brainstorming for segment ideas recently, producer Jessica Goldman came up with the idea of following her through a complete evaluation with a dermatologist. That brings us to today’s episode with New York City dermatologist Dr. Francesca Fusco, who covers a wide range of skin issues, from cancer prevention to cosmetic dermatology.


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*This blog post was originally published at cbsdoc.com*

What Happens After You Call 911?

Dr. Jon LaPook takes a trip as a pseudo-patient to Columbia Presbyterian Medical Center’s Emergency Department. See part 1 of the adventure here.


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**This video was originally published at www.cbsdoc.com**

In Case Of Emergency: How To Prepare For The Unexpected

Would you know what to do if you needed an ambulance or if you had to go to an emergency room?  During 2005, an estimated 115 million visits were made to emergency rooms in the United States – up 31 percent from 1995. About 14 percent of patients arrive via ambulance. Emergency rooms across America are overloaded – partly because many of the almost 50 million uninsured use the emergency room as their primary physician (and partly because we tend to focus on treatment of illness rather than prevention – but that’s another blog post).


During the next two segments, I will take you way behind the scenes and give you tips on how to be prepared in case the unexpected happens and you end up on your way to an emergency room.  This week I play the part of a patient with chest pain and take you inside a New York City ambulance with paramedics Ray Cordi and Hanan Cohen.  Next week my colleague, Richard Schlesinger, and I continue your tour inside the emergency room at New York Presbyterian Hospital/Columbia University Medical Center, the first time this institution (where I am on staff) has ever allowed such inside access to the media.


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**This blog post was first published at CBSDOC.COM**

Neuroticism Versus Hypochondria: Dr. Jon LaPook Explores The Differences

In this week’s CBSdoc.com video, Dr. Jon LaPook conducts a two-part interview with a colleague who thinks he might be a hypochondriac. I miss New York.

Male Sexuality: Myth Busting With Dr. Jon LaPook

I’d like to welcome Dr. Jon LaPook, medical correspondent for the CBS Evening News with Katie Couric, to the Better Health team of bloggers. Jon will be contributing video interviews on engaging consumer health topics on a weekly basis. This first contribution is a video interview with male fertility expert Dr. Harry Fisch, combined with some entertaining “man on the street” discussions in Columbus Circle, NYC. Let me know what you think!


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See Dr. LaPook’s home page: cbsdoc.com

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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