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- [00:00]
Noah Michelson
A real Lemonade Pet insurance review by.
- [00:02]
Madison H.
Madison H. You know, I thought it was a little ridiculous to get pet insurance, but I really didn't want to not take my little kitten to the.
- [00:08]
Raj Panjabi
Vet because of money.
- [00:10]
Madison H.
In the last eight months, I've taken him in six times because of ear infections and saved literally hundreds of dollars. He may even need to get surgery.
- [00:18]
Raj Panjabi
And I couldn't consider it without lemonade's help. I recommend lemonade to all my friends constantly.
- [00:23]
Madison H.
And now I'm recommending it to you.
- [00:26]
Noah Michelson
Check it out@lemonade.com pet hold that serve. There's no time for pickleball because you're gonna want to hear this. NOOM now has GLP1s.
- [00:35]
Raj Panjabi
No way. Oh, yes. Wayfred Psychology and meds.
- [00:39]
Noah Michelson
That's how Noom helps you lose the weight and keep it off.
- [00:42]
Raj Panjabi
That's really smart.
- [00:43]
Noah Michelson
Oh, Danny.
- [00:44]
Madison H.
It's Noom smart.
- [00:45]
Noah Michelson
And they start at just 149 bucks, and they're shipped to your door in seven days.
- [00:49]
Madison H.
Holy smokes, that's fast.
- [00:50]
Noah Michelson
But not as fast as my service game.
- [00:52]
Raj Panjabi
Hey, who's ready to get pickled? Get started with Noom GLP1 today. Not all customers will medically qualify for prescription medications. Compounded medications are not reviewed by the FDA for safety, efficacy, or quality. When the energy is high and the music is right, pushing past your limits becomes that much easier. Take a reggaeton run or strength class on the peloton Tread and you'll quickly see why these are the workouts you've been searching for. Every day brings new challenges from expert coaches who train and speak the same language as you do. Level up your workouts with Peloton tread. Find your push, find your power. Peloton. Visit1peloton.com hi, I'm Raj Panjabi, head of identity content at HuffPost.
- [01:41]
Noah Michelson
And I'm Noah Michelson, head of HuffPost Personal.
- [01:44]
Raj Panjabi
Welcome to Am I Doing It Wrong? The show that explores the all too human anxieties we have about trying to get our lives right.
- [01:50]
Noah Michelson
So, Raj, today's question is a little heavy. How good do you think you are at skin cancer prevention?
- [01:58]
Raj Panjabi
Yeah, that's heavy. You know what? I thought I was superwoman when I was younger, so I just had all kinds of reckless behaviors. But I would say now I'm pretty good at it. I wear my sunscreen. I try to, you know, be cognizant of sun exposure. But I think I could be doing more, especially because I know that, like, a good sun protection routine can keep you healthy and young. Looking.
- [02:20]
Noah Michelson
What is that twofold thing?
- [02:22]
Raj Panjabi
Yeah.
- [02:22]
Noah Michelson
Yeah. I'm freaked out about skin cancer, actually. A good friend of mine just had two surgeries to remove some, and that's not fun.
- [02:29]
Raj Panjabi
Yeah.
- [02:30]
Noah Michelson
And so I don't want to go through that. So I'm pretty good about it.
- [02:33]
Raj Panjabi
Okay.
- [02:34]
Noah Michelson
But I feel like I'm probably doing some things not great same, or I could do them better. So today we have a friend of the show back. It's Dr. Anthony Rossi. He was on for the SBF show, and he's a dermatologist and a surgeon at Memorial Sloan Ketteran cancer center.
- [02:48]
Raj Panjabi
Amazing. Dr. Anthony, save us from ourselves.
- [03:04]
Noah Michelson
Dr. Anthony, thank you for coming back.
- [03:07]
Madison H.
Good morning. Thanks so much for having me back.
- [03:09]
Noah Michelson
Let's start at the very beginning. What is skin cancer?
- [03:13]
Madison H.
That's a great question. Skin cancer is the actually number one type of cancer in the world, believe it or not. So it's really common because, you know, your body is made up of a lot of skin, Right. And it's exposed. And so skin cancer can come in multiple different forms. I think probably the most common one that people know is melanoma. Right. They hear about melanoma and they get very afraid of it, obviously, because it can be deadly. So when people think of skin cancer, they think of melanoma. But that's probably the third most common type of skin cancer. The first most common type is basal cell carcinoma. And then the second most common type is squamous cell carcinoma. And those can come in multiple different forms. They can be really tiny, and they can actually be quite large, depending. Basal cells carcinoma is the most common form, and it is the one that is least likely to ever spread or metastasize.
- [04:05]
Raj Panjabi
Oh, wow.
- [04:05]
Madison H.
Okay. So if caught early, it's very curable. Usually we just take it out with surgery. But basal cell carcinoma, for the most part, is caused by UV exposure. So we know it's a UV driven skin cancer. There are some genetic syndromes that predispose people to hundreds of basal cells. But that syndrome is, like, quite rare. But we do see it. But for the most part, most people are getting basal cells from the sun.
- [04:29]
Noah Michelson
And is this when it's like a mole that looks weird or is that something else?
- [04:34]
Madison H.
So it actually is not a mole. The mole predisposes some people to melanoma. So if you have hundreds of atypical nevi, or nevi is the medical term for mole. So that can be sort of a marker that you're at predisposed for melanoma. So melanoma can arise de novo, we say, or just from out of nowhere, or it can arise in a preexisting mole.
- [04:57]
Raj Panjabi
Okay. And we'll go into, like, in detail about what these things look like. So we can, you know, check ourselves and be really careful. But can you tell me a little bit about removing them? You said that a lot of these things, you can kind of just take them off of you and you're good to go. What's the process give me, like, the easy to the kind of, like, gnarly, for sure.
- [05:15]
Madison H.
So this is what I do day in and day out. I'm a Mohs surgeon, so Mohs doesn't stand for anything. It was actually the name of Frederick Mohs, who developed this technique of surgery to take out skin cancers. And it's actually basically real time removal of skin cancers while the patient is awake but anesthetized. And we actually look at the skin cancer under the microscope and track it and make sure all the margins are clear. So in real time, while the patient is there, we take that tissue that we just cut out or excised, look at it under the microscope, and then can look at the margins and the depth and make sure everything's gone. And then we can sew them up afterwards.
- [05:50]
Raj Panjabi
The actual basal cell carcinoma, or whatever it is that you're moving, it's not super thick or deep. It's like on top of your skin.
- [05:57]
Madison H.
It usually grows top down, I say. So I always draw this little diagram almost like an iceberg. And we have three layers of skin, mainly, you know, the epidermis, which is our top layer, the dermis, which is our middle layer, where our collagen is. And then below that is the subcutaneous fat. And depending on where you are on the body, those thicknesses can be quite different. Right. Your eyelid is super thin, but your back is very thick. Right. So it all depends on where it is on the body and then how long it's been growing for. So some of them, like you said, are really thin, but others that have been left and neglected can actually grow pretty large. And they can end up going deep or wrap around nerves. I've seen the whole gamut.
- [06:39]
Noah Michelson
Wow, that is terrifying.
- [06:42]
Madison H.
You're always welcome to spend a day in clinic.
- [06:44]
Raj Panjabi
I do want to.
- [06:45]
Madison H.
Yeah.
- [06:46]
Noah Michelson
Actually, we've had other doctors ask us if we want to do that. And Raj is always like, sure. I think we had, like.
- [06:51]
Raj Panjabi
Yeah.
- [06:51]
Noah Michelson
Who was it? Someone wanted to let you.
- [06:53]
Raj Panjabi
Dr. Yaniv.
- [06:54]
Noah Michelson
The urologist?
- [06:55]
Raj Panjabi
Yes. And he actually recently hit me up after like months and months being like, you can come in. So I have to contact him.
- [07:01]
Madison H.
Oh, that's great.
- [07:02]
Raj Panjabi
I have a health journalism background, so like anything I can just like be there and look at like, I feel like makes me smile and I don't.
- [07:09]
Noah Michelson
Even want to watch Grey's Anatomy, you know, I mean, I'm like, no, thank you.
- [07:12]
Madison H.
Through med school.
- [07:13]
Noah Michelson
Yeah, I'm sure. Yeah, I don't need to see it.
- [07:16]
Madison H.
I actually have a little bit of a hybrid with urology because I do a lot of like penile and vat. Vaginal cancer, like skin cancer. Believe it or not, you can actually get penile and vaginal and anal skin cancers, but they're differently derived. They're not really driven by the sun or UV exposure. They're more HPV induced, which is the human papillomavirus.
- [07:36]
Raj Panjabi
Yeah.
- [07:36]
Noah Michelson
Why don't we just set the baseline for that? I think most people think of skin cancer as being caused by exposure to the sun or not being preventative using tanning beds or not using sunscreen. But what are the different ways that you can get skin cancer? So you just said one of them is hpv.
- [07:51]
Madison H.
Totally. Most paradigms of cancer is that there's a two hit hypothesis. We say so there's your genetic baseline of how we inherit our genes from our parents and then the environmental exposure. And most cancers are caused by this two hit hypothesis. So you already have like the genetic predisposition for a certain cancer if, if they're inherited or if many family members have had a certain type of cancer. But then the environmental exposures give you that second hit. So I really do tell people, you know, their lifestyle makes a big difference.
- [08:24]
Raj Panjabi
Right.
- [08:24]
Madison H.
And in terms of skin cancer, we know the environmental exposure is UV or in the case of genital skin cancer is hpv. So which is a type of virus. And there are other types of viruses that we know can cause cancer. And people never thought that that could happen, like viruses can cause cancer or bacteria can cause cancer. But we know that happens in, in different organ systems. So for the skin, there are certain types of viruses like HPV that can cause skin cancer, like squamous cell carcinoma of the penis of the anus, of the vagina. So.
- [08:55]
Noah Michelson
Right. And hpv, for people who don't know, that's more commonly known as genital warts or anal warts. And that's usually a sexually transmitted infection.
- [09:03]
Madison H.
Or kids can get them. When you're a child, you can get them on your fingertips or Your feet. Those are common warts that people get and those are also HPV driven. But those are different types of hpv. So there's hundreds of different types of hpv. Some are high risk that can cause skin cancer and then others are low risk that can cause common warts. But fortunately, and a big plug is we have a vaccine for this, right? And we.
- [09:27]
Raj Panjabi
I'm vaccinated.
- [09:28]
Madison H.
Yes.
- [09:28]
Raj Panjabi
Before I turn 26. Yay.
- [09:30]
Madison H.
I got vaccinated later in life because it wasn't around when I was, you know, but hopefully we are catching kids earlier. But it is actually an underutilized vaccine.
- [09:39]
Raj Panjabi
That sucks. I don't understand why.
- [09:41]
Madison H.
I know because it's been shown countlessly to reduce the risk of cervical cancer in women and then even anal neoplasia in men. So it's really like well versed vaccine.
- [09:52]
Raj Panjabi
I'm such a vaccine pusher. Like that's the opposite of anti vaccine.
- [09:55]
Noah Michelson
I'm the same way. I'm like, if I could get, if I could get a COVID vaccine every week, I would get.
- [09:59]
Raj Panjabi
Oh my God, I would put it in my martinis. I say it all the time. Yeah, I love that.
- [10:03]
Noah Michelson
Give it to me. Other than the sun or uv, other than viruses like hpv, are there other ways that we can get skin cancer there?
- [10:11]
Madison H.
Those are the two main types. Melanoma is interesting because there's a genetic component of melanoma. If you are predisposed, like through family members. If you have a first degree family member who's had a melanoma, that's important to know because you could have a predisposition to developing a melanoma. And we know melanoma happens in young people as well. It's sort of bimodal, the young and then the older population. So it's really important to know your family history. If you can get it. It's always good to chat with, you know, your relatives. That is important. The UV exposure, of course is, is very important. You know, there are historic other types of exposures that we learn about like, you know, tar soot, you know, or these heavy chemicals that sometimes people use like in photograph development and such, you know, back in the day. So those are also carcinogenic and can cause, you know, skin cancer as well. But less common nowadays. But we still think about it.
- [11:06]
Raj Panjabi
My grandfather, my mom's father worked in a dye lab.
- [11:10]
Madison H.
Oh yeah.
- [11:10]
Raj Panjabi
And part of it was outside. So he had exposure on his head. It was before they knew. And he was mixing dyes all day. And he had skin cancer.
- [11:16]
Madison H.
Totally.
- [11:17]
Raj Panjabi
Yeah.
- [11:17]
Madison H.
I've seen people who, you know, unfortunately, were around Chernobyl. And I have patients who are around Chernobyl who've come down with many types of cancers, both skin and other organs. So I mean, radioactive exposure, of course, is, you know, is a big problem.
- [11:33]
Raj Panjabi
So let's talk about what we're looking for. Right. Because a lot of us. I was just saying that, like, you're supposed to go to the dermatologist every year for a little mole check. I go every other year and it's just. Cause I don't remember. But it's lovely and non invasive and I'm gonna start doing it every year. Like I'm supposed to. So aside from that mole check, which is, like, wonderful, they, like move your hair around and, you know, stroke you and just like. It's lovely.
- [11:54]
Noah Michelson
It's like a cuddle part.
- [11:55]
Raj Panjabi
Yeah, it's a cuddle part. Don't be scared. My audience and friends, like, go for it. But what are we looking for on ourselves when we're like, at the show?
- [12:02]
Madison H.
For sure. So we always say, like, check yourself. Look at yourself in the mirror. Have your partner look at you as well. Like, especially for places you can't see, take just a baseline inventory of what you have. I think it's a good idea.
- [12:14]
Raj Panjabi
And worst comes to worst, it just leads to sex.
- [12:16]
Madison H.
Exactly. So you can thank your dermatologist. So basically, you want to look for all your moles and you want to make sure they're regular. You remember them, you know that they've been around, they aren't changing or growing. You can go by the ABCDEs, which is like just a good mnemonic. A is for asymmetry, if they're asymmetrically shaped. B, if the border is irregular or jagged. C, if there's color change or there's multiple colors in the lesion. Like if it's, you know, brown turning black, black turning red, or if there's just speckled with multiple colors, that could be a warning sign.
- [12:54]
Raj Panjabi
Okay.
- [12:54]
Madison H.
D, we say, is the diameter bigger than a pencil eraser, which is about 6 millimeters. And then E, which is probably the biggest one, is evolving or changing over time. So if you see something evolving, then that's sort of your tip off that you should get it checked out.
- [13:08]
Raj Panjabi
So regular moles are not really supposed to change that much during your lifetime.
- [13:12]
Madison H.
Not really. That's a great question. It's. We usually will keep acquiring moles or nevi, you know, up to a certain age, but then by the time we sort of like, settle out, like, in our 30s, we're not really making new moles. So they're sort of genetically programmed almost, if you would say. And then if you are making new ones, you know, and this could happen even before 30 that are irregular that you should get checked out. And this is mainly for melanoma. For basal cell or squamous cell. These can present as, like, pink patches. They can be pearly papules, we call them. They're usually depending on what your baseline skin tone is, they can be pigmented as well, so they can also appear black, which is interesting. So depending on, you know, if it's new, changing, bleeding, growing painful, these are all symptoms that you should watch out for.
- [14:01]
Raj Panjabi
Okay.
- [14:02]
Noah Michelson
Will skin cancer ever look like something or not look like something? Could we have skin cancer and it's just not visible at all?
- [14:09]
Madison H.
Oh, wow. You've done some good research.
- [14:12]
Noah Michelson
I just know this is something I worry about in my bathroom. You know what I mean? I'm like, oh, God.
- [14:17]
Raj Panjabi
That keeps you up at night. Yeah, no problem. Problems?
- [14:19]
Madison H.
Unfortunately, you know, I do work at a cancer center, so we see, like, you know, everything. We do see patients that sometimes present with unknown primaries, meaning they present with metastatic disease, which is unfortunate because there probably was something on the skin, but it went away.
- [14:34]
Noah Michelson
Got it.
- [14:35]
Madison H.
And your immune system will attack atypical skin lesions. And we sometimes see this under the microscope. It's called regression. So your immune system really tries to attack it. And sometimes, you know, you may have never noticed the primary lesion on your skin. Fortunately, this is rare, but it does happen.
- [14:52]
Noah Michelson
Okay, that is terrifying.
- [14:54]
Madison H.
That's a little scary. And, you know, we're not, like, saying that's the common. But unfortunately, it has.
- [14:59]
Raj Panjabi
Okay, say you can take something off, and you're, like, skipping through the forest and you're happy. What are the odds it will come back?
- [15:06]
Madison H.
If you have a basal cell and you get it removed by Mohs surgery, the cure rate after Mohs surgery, if you get negative margins, it's super high. Like 98, 99% cured.
- [15:15]
Raj Panjabi
Okay.
- [15:16]
Noah Michelson
Wow.
- [15:16]
Madison H.
You won't have to worry about that one. The chance of you getting another basal cell is about 30 even. Some reports say 50%. Just because you've had enough of that second hit, that environmental exposure to cause the basal cell to begin with.
- [15:30]
Raj Panjabi
Got it.
- [15:30]
Madison H.
So we know that you've had the sun damage or you've accumulated enough UV exposure to induce those mutations in your skin and in the DNA. So the chance of you getting another one is high.
- [15:41]
Raj Panjabi
So now you just have to be super careful because you know that, you know you're more prone to something.
- [15:45]
Madison H.
Totally. My patients ask me all the time and I've actually had a basal cell carcinoma because like many people in America, I went tanning and tanning beds when I was a young pup.
- [15:54]
Noah Michelson
Right.
- [15:55]
Madison H.
And I'm pretty fair. Even though my parents are Italian, they're, they're dark skinned. I ended up with like a very light, you know, blond hair, light eyes, phenotype, we call it, which is like the physical representation of your genetics. So if you have light skin, red hair, light eyes, those are all like predisposures to having skin cancer. But I still went tanning and tried to darken myself, but. And I ended up with a skin cancer. But now I've. I've done a lot of like preventative and proactive approaches to like mitigate that risk.
- [16:30]
Raj Panjabi
Yeah.
- [16:30]
Madison H.
So there's a couple of things you can do, of course. Wear sunblock every day. It's like the best anti aging mechanism we have. Right. We know it prevents UV damage, it prevents skin cancer and it prevents wrinkles. So for all my people that don't love wearing sunblock, I just tell them it prevents wrinkles and they're all about it.
- [16:48]
Raj Panjabi
Totally.
- [16:49]
Madison H.
Yeah. And there's other techniques too. So my old fellow just put out a paper showing that this certain type of laser that we use that resurfaces skin, that actually is used a lot of times to reduce wrinkles, actually helps prevent further skin cancers. So they looked at two different cohorts of patients and they looked at the formation of new skin cancers on their face after they got the laser versus a matched population that did not get the laser. And they showed a reduction in skin cancer formation. And we sort of knew that, but it's nice to see it in statistical format.
- [17:26]
Noah Michelson
Yeah, yeah, that's great.
- [17:27]
Madison H.
There's nicotinamide, which in a large study in the New England Journal of Medicine, this is a form of vitamin B3. It's very specific form. It's not niacin, it's not niacinamide, it's nicotinamide. And taken 500 milligrams twice a day, it showed a reduction of basal cell carcinoma and squamous cell carcinoma and even pre cancers, actinic keratosis, but not melanoma. But this was only in immunocompetent patients, people with immunocompetent immune systems. Unfortunately, we didn't see that effect in the immunocompromised. So which is another risk factor for skin cancer.
- [18:02]
Raj Panjabi
Totally. Let's take a quick break and we'll be right back. This show is sponsored by Fabric Raj.
- [18:14]
Noah Michelson
On this show, we're concerned about if we're doing so many of the little things wrong, and one of the big things that we might be doing wrong is death.
- [18:23]
Raj Panjabi
Well, of course no one's gonna do literal death. Exactly right, Noah. But let's focus on the life insurance part of debt. If you have anyone relying on your income, then you should seriously consider having life insurance. And that's where Fabric comes in.
- [18:35]
Noah Michelson
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- [18:45]
Raj Panjabi
Fabric by Gerber Life is term life insurance. You can get done right here, right now. You could be covered right from your couch in under 10 minutes with no health exam required.
- [18:55]
Noah Michelson
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- [19:00]
Raj Panjabi
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Noah Michelson
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- [19:19]
Raj Panjabi
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Raj Panjabi
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Noah Michelson
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Raj Panjabi
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Noah Michelson
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Raj Panjabi
This podcast is brought to you by eHarmony, the dating app to find someone you can be yourself with.
- [20:17]
Noah Michelson
Okay, let's be honest and talk about doing dating wrong. So, Raj, have you ever pretended to be into something that you're not actually into when you're on a date just so you keep the person's attention?
- [20:28]
Raj Panjabi
Oh, absolutely. I once was on a date and I am a Knicks fan, but I was pretending to be this like hardcore sports girly cause that's what the dude was into. And I am not a sports girly.
- [20:41]
Noah Michelson
Right? So I bet even despite doing all of that, the date didn't go anywhere.
- [20:45]
Raj Panjabi
It certainly did not.
- [20:46]
Noah Michelson
That's because I'd imagine the best dates we've had were the ones where we were totally and completely ourselves. Not trying to jam square pegs into round holes, but enjoying a natural flow and chemistry with our date.
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Raj Panjabi
Well, eharmony knows this. And this is their whole deal now. Helping you find someone you can be yourself with.
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Noah Michelson
That's what true connection and compatibility are all about. Being seen and understood. And that's why folks are turning to eHarmony.
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Raj Panjabi
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Noah Michelson
So let's do dating. Right? We'd love for you to give eharmony a shot. Get started with their compatibility quiz for free so you can find someone you can be yourself with.
- [21:32]
Raj Panjabi
Eharmony. Get who gets you.
- [21:37]
Noah Michelson
It's a cold day here in Alaska, but there's one animal seemingly unaffected. Bright eyed and determined enters the husky. Observe as they go up the mountain. Guided by pure instinct. They are truly amazing masters of this wilderness. But even these amazing pets can't sign up for Lemonade Pet insurance. You can sign up now@lemonade.com Amazing.
- [22:09]
Raj Panjabi
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- [22:46]
Noah Michelson
We got a question from Lindsay. She said, what are some of the most unusual places you can get skin cancer that you wouldn't suspect? And what areas should we be checking more of and not ignoring? So you already talked about the genital area, the butt. But what are other areas that people maybe just don't think about?
- [23:03]
Madison H.
For sure. So other areas besides the genitals that you can get skin cancer are, you know, the soles of your feet. Oh, the palms of your hands and your scalp. I mean, a lot of People just don't check their scalp. And in fact, you know, my parents are hairdressers, so one of our organizations actually helped hairdressers just recognize and identify not really skin cancer, but just tell people that they're working on like, hey, you have something in like the 3 o'clock quadrant of your scalp, you know, that's amazing. Yeah. So it's, it's cool because your hairdresser probably sees your scalp more than anyone.
- [23:35]
Noah Michelson
Completely.
- [23:37]
Madison H.
So unfortunately we do see that a lot. You know, blonde hair doesn't really give a lot of protection density wise and color wise from the UV exposure. So if you have really light hair, it's easy to get scalp burns. And I'm sure many children remember like getting scalp burns as a kid, so we tell people to always check their scalp as well.
- [23:57]
Noah Michelson
Does dark hair protect your scalp a bit more?
- [24:00]
Madison H.
It's also the density of it too. Right. So, you know, for all my golfers that have, you know, shiny bald heads, they really should be wearing a hat, you know, you know, not even just sunscreen like a hat, like protect your scalp. It's unfortunate. I see so much skin cancer on the scalp.
- [24:16]
Noah Michelson
Yeah.
- [24:16]
Raj Panjabi
I mean, it makes sense.
- [24:18]
Madison H.
Yeah.
- [24:18]
Noah Michelson
When you see it on the soles of the feet, it's. That's not UV exposed skin cancer, right?
- [24:24]
Madison H.
Usually not. So that's, that's the other thing. Like melanoma, there is a genetic predisposition. And you know, this acril lentigenous type of melanoma can be hard to identify and sometimes it goes unnoticed for a while and you can get melanoma of the nail unit. So pigment under your nail.
- [24:42]
Noah Michelson
Wow.
- [24:42]
Madison H.
And so we see that. And sometimes in more pigmented skin or heavily melanized skin, we can, that can go unnoticed. And like, that's why certain Fitzpatrick phototypes or certain skin types can actually present with more aggressive skin cancers on their palms of their nails.
- [24:57]
Noah Michelson
We want to get into different populations. But first I just want to make it really clear. When we, if someone has melanoma, is that caused by UV or is that purely genetic, something different?
- [25:09]
Madison H.
It's usually that two hit hypothesis.
- [25:11]
Noah Michelson
Okay.
- [25:11]
Madison H.
So it's like the combo predisposition and the UV exposure. But however, like the palms of your feet are under a different regulatory control. So that's probably more genetically predisposed.
- [25:22]
Noah Michelson
Okay.
- [25:22]
Madison H.
So that's probably the dominating factor in there. You know, you can get melanoma in other places too that the sun doesn't shine and it's probably more genetically predisposition.
- [25:31]
Noah Michelson
Okay, got It. But it can be from uv.
- [25:33]
Madison H.
It can be.
- [25:34]
Raj Panjabi
Sure, we talked a little bit about this the last time you were on. But like a lot of darker skinned people like me believe that, like, we can like cavort around and worry less about skin cancer because we have more protection. But what I've read, and you can correct me on this, that like, oftentimes when we get melanomas or things like that, they go undetected for longer because they're, you know, sometimes on the bottom of their feet for black American populations, et cetera. And also we might not spot it and it can be more dangerous to us. Right. Is that somewhat correct?
- [26:03]
Madison H.
More so you're correct in the sense that it does go unnoticed a lot more. And you can get skin cancer even. Even with heavenly melanized skin. The melanin offers you natural protection. It's like a natural spf.
- [26:18]
Raj Panjabi
Okay.
- [26:18]
Madison H.
But unfortunately you can still get skin cancer and you can still get melanoma in these areas that are less UV induced, like, like the palms, like the soles and your fingernails. And because people consider them more aggressive is because they're usually diagnosed at a later stage.
- [26:34]
Raj Panjabi
Got it.
- [26:35]
Madison H.
So already they're set up to be a little bit more aggressive because they're diagnosed later, because they go on. Noticed.
- [26:41]
Raj Panjabi
Yeah.
- [26:41]
Madison H.
So it is important to check your skin. And even with a basal cell, which is very much so derived from the UV exposure, I've seen basal cells in all skin types. I've taken them out of all ethnicities, all races. It's a lot of cumulative UV exposure over our lifetime as well.
- [26:59]
Raj Panjabi
Yeah. Okay.
- [27:00]
Noah Michelson
Is there a certain amount of time between when the skin cancer starts developing and when it's really problematic? I mean, could you go for years and have an issue and still be okay, or what is the timeline and does it depend on the person? And it's a pretty local.
- [27:15]
Madison H.
It definitely is personal. So melanoma can develop quite rapidly and it can actually metastasize quite quickly, but it doesn't happen in every person. So some people, there are other forms of melanoma that can happen on sun damaged skin like the face, and actually take many years to develop, and it just slowly, insidiously grows larger and larger. So it's very personal, it's very dependent. Same with basal cells. Some of them grow very rapidly and others can take a long time to develop. Historically, you know, in the old medical textbooks, basal cells were called rodent ulcers because they just ate away at this tissue. And I've seen basal cells like eat through cartilage, eat through bone. You know, basically just keep just degrading the tissue that's there until they treat it. Yeah.
- [28:00]
Raj Panjabi
Terrifying.
- [28:00]
Noah Michelson
Yeah.
- [28:01]
Madison H.
Fortunately, we don't see it as much, but even in this like, modern population, we still see see is happening from neglect.
- [28:07]
Noah Michelson
But regardless this, the minute you see something, you really want to go get it checked out.
- [28:11]
Madison H.
Ideally, like, earlier detection is, you know, better in many. For many reasons. You know, it's easier to treat, it's easier to get rid of. We don't want to create like a paranoia, obviously.
- [28:22]
Raj Panjabi
Yeah.
- [28:22]
Madison H.
But I think just having a good sense of like, what's on your body, having a good intake, like you said, seeing your dermatologist, you know, your dermatologist should be your best friend.
- [28:31]
Raj Panjabi
I love my dermatologist. Everybody knows I should be dropping in there sometimes.
- [28:36]
Madison H.
Just hang out.
- [28:37]
Raj Panjabi
Yeah, I try to.
- [28:38]
Madison H.
Yeah. Dermatologists love, you know, detecting things. Like we're little detectives, like, that's what we do.
- [28:43]
Noah Michelson
Yeah.
- [28:44]
Raj Panjabi
And here's the thing. Like, I feel like in 2024, when we have telehealth, it's really easy to just like call, you know, like if. If again you're lucky enough to have the insurance to do that. Just like show them something and be like, what does this look like? And if they can tell right away and they don't need you to come in, like, easy peasy.
- [28:58]
Madison H.
Yeah.
- [28:58]
Noah Michelson
Amazing.
- [28:59]
Madison H.
Some things are slam dunk on telehealth and we learned a lot about that, like during COVID Other things are a bit more subtle. But yeah, like you said, like, the technology has really developed. I always caution people about some of these apps that, like, well, you can go on, oh, no, don't self die. Yeah, it's. It's unfortunately and the FDA has cracked down on some of the or FTC have.
- [29:19]
Noah Michelson
So this is an app that will tell you if a lesion or something is totally. And wow, I never heard of that.
- [29:25]
Madison H.
They say they're using AI, but it's probably not true.
- [29:28]
Noah Michelson
Even so, AI gets a lot wrong.
- [29:30]
Raj Panjabi
Yeah.
- [29:31]
Noah Michelson
Yeah.
- [29:31]
Madison H.
And you know, at our hospital, we're really working on like AI algorithms to diagnose skin cancer.
- [29:37]
Noah Michelson
Yeah.
- [29:37]
Madison H.
And it's come a long way for sure. And we actually have this machine where you stand in and you take a 3D photo of your whole body, almost like the matrix, like, so you have this 3D avatar. And that's how I basically track my patients and their moles. And if they're changing or developing new lesions. It's a really sophisticated way to look at your body and look at your skin.
- [29:59]
Raj Panjabi
Wow.
- [30:00]
Madison H.
And then the algorithm is like detecting lesions and, like, we'll give it scores and ratings, but that's all research that we're working on now. So I just caution people, like, not to just, like, download some random app and be like, oh, I'm diagnosing myself.
- [30:13]
Noah Michelson
You know, I went to the dentist a couple months ago, I told Raj this, and they use AI now.
- [30:18]
Madison H.
Totally.
- [30:18]
Noah Michelson
And the AI was like, oh, you probably have four cavities. And then my dentist looked, he's like, those aren't cavities.
- [30:23]
Madison H.
Yeah.
- [30:23]
Noah Michelson
But what he said was like, and I. You probably feel the same way, is that it alerted them to things that could be something they might want to take a second look at. So it's. It's not replacing healthcare, but it's helping to support it.
- [30:35]
Madison H.
Yeah.
- [30:35]
Noah Michelson
Which I think is great.
- [30:36]
Madison H.
Yeah. I call it augmented intelligence. It's not, you know, it's only as good as what we're feeding it, and then it's learning from that. So we have to feed it robust data sets. You know, there's been a big push to give it more skin types. Right. Because a lot of skin cancer is only in, like white, Caucasian, really light skin types. So if you only feed it that information, it's only going to know that. So we have to really improve the diversity of the AI as well.
- [31:02]
Raj Panjabi
Yeah, yeah, I've been reading a lot about that. And there's like a lot of times, like, people from marginalized communities have a healthy skepticism of the medical world. So you're not going to be like, hey, I want to be a part of your study. Other times they're like, purposefully left out. So, like, there's all this stuff that's happening, but all of. I think all studies need to be, like, more diverse.
- [31:22]
Madison H.
We have to be, like, aware of that from the jump. Like, you know that. But it's only as good as how we design it, you know, so, yeah, it's important.
- [31:30]
Raj Panjabi
Okay, so you mentioned like cumulative sun damage. So let's say like our seniors, our elders, like 60, 65 plus. Even if you don't suspect anything, you do want to go for regular checks. Right. Because that's like, when your risk is a little bit higher. Am I right?
- [31:45]
Madison H.
We do see that a lot from cumulative exposure. Right. At this point, you're going to start to see I treat a lot of, you know, they don't want to be called elderly. They're fully active. I actually just saw 100, like 4 year old, which is amazing. But, you know, because of the cumulative exposure. Yeah, unfortunately. And that population always tells me a lot, like, they were using baby oil and iodine as, like, tanning accelerators. And this story keeps coming up, like, all the time. Every time I'm doing surgery and they're awake, like, we're chatting, and they give me these tales of, like, baby oil iodine reflectors, you know, so that's not.
- [32:24]
Raj Panjabi
From that long ago. I love it. Like, I, as a teenager, definitely put, like, fucking whatever equates to Crisco on my body to, like, get a nice little glow. It's, you know, it's just recently I feel like people have become more informed about this.
- [32:39]
Madison H.
It's true, though. But what's old is new again, because I go on TikTok and, like, I start to cringe because, like, these things are coming back up on TikTok and, like, you know, influencers are talking about, like, using, you know, tanning accelerators and reflectors and, like, how sunscreen is poisonous. So there's a ton.
- [32:55]
Raj Panjabi
That's the worst rumor.
- [32:57]
Madison H.
There's a ton of misunderstood on the last episode, too.
- [32:59]
Raj Panjabi
It's the worst.
- [33:00]
Noah Michelson
Yeah. SPF is poisonous. And also that sun damage doesn't cause skin cancer.
- [33:06]
Madison H.
Exactly.
- [33:07]
Raj Panjabi
God.
- [33:07]
Noah Michelson
I also read. I had the stat here. Melanoma is the most common form of cancer in young adults aged 25 to 29 and the second most common form of cancer in people 15 to 29. So it's not just old people.
- [33:19]
Madison H.
Exactly.
- [33:20]
Raj Panjabi
For sure. Not getting it. Yeah.
- [33:21]
Noah Michelson
And when you have the misinformation or this, the delusion, that's a really awful recipe for disaster.
- [33:28]
Madison H.
For sure. And, you know, it's. We have so many new and great treatments now for melanoma, especially metastatic melanoma, which is a game changer because, you know, maybe 15 years ago we didn't have these, so new ones have been approved. But again, you don't even want to get to that point. You want to identify early, you know, and not give yourself the environmental exposure either. We're not saying to be a vampire. Like, I love sports, I love going outside. You just have to be sun smart and protect yourself.
- [33:58]
Raj Panjabi
Yeah. And I think there's a middle ground. For sure. Yeah, for sure. Let's take a quick break and we'll be right back. This episode is sponsored by hers.
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- [36:58]
Raj Panjabi
Welcome back to Am I Doing It Wrong? So what are our behaviors at any age that are putting us at Higher risk for skin cancer.
- [37:06]
Madison H.
So definitely tanning is the number one UV exposure. If you're doing artificial tanning, that's a huge. No, no. The bulbs are unregulated. Right. There's not really any regulation regarding what machines they're using.
- [37:20]
Raj Panjabi
Yikes.
- [37:20]
Madison H.
It's really high doses of UVA to give you an immediate pigment darkening and also to get you tan very quickly. Like it's like a 10 minute shake and bake, you know, so it's not, it's not a great practice. It's actually just even tanning once is like going to put you at risk and if you get a severe burn, that's even worse.
- [37:41]
Raj Panjabi
Yeah.
- [37:42]
Madison H.
So indoor tanning, huge. No, no. Outdoor tanning we don't believe in either. You know, again it's, you're getting, anytime you're getting red or peeling like that, you've already induced DNA break damage and mutations that your body's now trying to repair. And over time you're just accumulating more and more of these mutations. So eventually your body can't sort of repair that and you develop a skin cancer. Outdoor tanning, not great either.
- [38:07]
Raj Panjabi
Yeah.
- [38:08]
Noah Michelson
We have an entire episode dedicated to SPF that you did with us, which is great. But we should just do a little reminder, I think. What should people know about spf? How often, how much, what level? Give us the.
- [38:20]
Madison H.
Yeah, for sure. SPF year round. Right. So sunscreen is super important. You can have your physical sunscreens like titanium and zinc dioxide versus your chemical sunscreens which is like avobenzone, oxybenzone. I think a lot of the misinformation is surrounding the chemical sunscreens because there is some evidence in the literature that in lab, in rats, they may be endocrine disruptors. So that's where people are extrapolating that onto the human body. But if you're not, if you're not really into that, then you can use the physical sunscreens which are very safe. They sit on the skin. So SPF 30 or above is going to be where your benchmark is. And then ideally you would apply in the morning and then reapply every two hours. If you're in like a heavily sun exposed area, like beach, playing sports, etc.
- [39:07]
Noah Michelson
Right. Long walks.
- [39:08]
Raj Panjabi
I promise this is a really organic plug. I want to know your brand of sunscreen is. I really like it. And you, you only need very little. Is it the mineral one or is it.
- [39:18]
Madison H.
It's the mineral one. Yeah. So I love mineral sunscreens because I think they Do a great job of blocking, physically blocking the UV exposure. I also. They're less irritating than chemical sunscreens. And that's another reason why people don't love chemical sunscreens.
- [39:31]
Raj Panjabi
Yeah.
- [39:32]
Madison H.
So some people have sensitive skin and they do get irritated and then they'll never use it because they just won't be complicated.
- [39:37]
Raj Panjabi
It's going to give you like, pimples or whatever. Exactly.
- [39:39]
Madison H.
Yeah. And. Or it can even make them itchy. You know, they got it. So they sort of shy away from it. So I say the best sunscreen is the one you're going to use every day.
- [39:47]
Raj Panjabi
Yeah.
- [39:47]
Madison H.
Whichever one you're going to be compliant with, go for it.
- [39:50]
Raj Panjabi
Totally.
- [39:50]
Madison H.
But thank you for loving mine.
- [39:52]
Noah Michelson
Yeah, it is really good. I also like Supergoop. I think that they make a great one. Is pretty sensitive. It goes on really smoothly.
- [39:59]
Raj Panjabi
Yeah.
- [40:00]
Noah Michelson
I mean, the thing we should say too, about the studies about the rats with the chemicals on screen is that again, we say this on the show a lot, but you have choices to make.
- [40:07]
Madison H.
Definitely.
- [40:07]
Noah Michelson
And, you know, we don't know if actually we're going to see that same reaction in humans. And maybe your chances of getting skin cancer are higher if you don't use it. So maybe you do want to use it because you're not going to worry about that, you know, so these rats.
- [40:22]
Madison H.
Were given high concentrations, you know, so it's important, you know, to know the studies.
- [40:27]
Noah Michelson
Yeah.
- [40:27]
Madison H.
But you can't like extrapolate them in every sense to human beings.
- [40:31]
Noah Michelson
Right.
- [40:31]
Madison H.
And again, we have choices. So if you don't want to use that. We have the physical screens.
- [40:36]
Noah Michelson
Exactly.
- [40:37]
Madison H.
Which are great.
- [40:38]
Noah Michelson
Yeah.
- [40:38]
Madison H.
So I do think it's less about the noise and more about just getting to the point is like, we should be using sunscreen. Like it's a modern technology to help us combat the environment that we're living in, you know?
- [40:50]
Noah Michelson
Yeah. I think it becomes to just making it part of your routine. You know, you get up, you brush your teeth, put on deodorant and you do your sunscreen.
- [40:57]
Raj Panjabi
Okay. So we talked a little bit about looking on your body and, you know, all of that stuff. But like, what does a routine self check look like? Do you need a little flashlight? You know what, what should we be doing?
- [41:07]
Madison H.
Magnifying glass.
- [41:08]
Raj Panjabi
Yeah.
- [41:09]
Madison H.
So it's good to routinely check your body.
- [41:13]
Noah Michelson
What does routinely mean? How often?
- [41:15]
Madison H.
I would say at least once a month. And then we always say, get in your birthday suit on your birthday. So if that's like how you remember to get naked and go to see a dermatologist for a skin check, then do it. But every time you're coming out of the shower or bath, you have the opportunity to check your skin. And, you know, or let your partner check your skin, too, like, behind or use, like, a mirror situation to, like, look at your back. But you really do want to look at, like, the bottom of your feet, your palms. If you can part your hair and look at it too, or have your partner look at it, or your best friend, whomever you feel comfortable with, they should do that as well. But even just going to the dermatologist and, you know, getting in your birthday suit is also good. But a thorough inventory of what you have is really important. I think that e that evolving or changing over time, that's super important. And we know there was a study that showed, like, people who've already had a skin cancer are really good at knowing when they have another one because they've now gotten to the routine of just looking and checking, and they know when things have changed. So if my patient comes to me and says, I know this changed, I really believe them.
- [42:24]
Raj Panjabi
Yeah. Yeah. Okay. That makes sense.
- [42:26]
Noah Michelson
I also like the idea, too. I mean, great, if you can do it once a month, you should. But we're always on the show talking about harm reduction, and we know that people maybe aren't going to do these things all the time. We're busy. So I love the idea of, like, get in your birthday suit on your birthday.
- [42:39]
Raj Panjabi
Yeah.
- [42:40]
Noah Michelson
When we did the Treat yourself. Yeah, no, clearly. We did an episode about food safety, too. And we had this thing where this woman, every year on New Year's Eve or New Year's Day, checks her spices and, like, throws all of her spices out once a year, too, you know, which is not the same thing, but it's these little ways to remind yourself, like. Like, we have to do human things.
- [42:58]
Raj Panjabi
Yeah.
- [42:58]
Noah Michelson
And they're annoying, and they take up time, but, like, you can find ways to do them. Find ways to remember to do them, which I love.
- [43:05]
Raj Panjabi
Yeah.
- [43:05]
Madison H.
And I change your makeup palettes, too. Like, oh, my God, I see so many. Like, they just have makeup that's, like.
- [43:11]
Raj Panjabi
Probably collecting and brushes and all of that stuff. Yeah.
- [43:14]
Noah Michelson
Not good for you.
- [43:15]
Madison H.
Yeah.
- [43:16]
Raj Panjabi
Yeah. It's just little phone reminders or something, you know, that's my favorite thing.
- [43:19]
Noah Michelson
Put it in your calendar.
- [43:20]
Raj Panjabi
Yeah.
- [43:21]
Noah Michelson
Because I don't remember anything. Someone doesn't tell me.
- [43:23]
Madison H.
So even when I'm doing skin checks on my patients, I always ask them, you know, have you gotten your mammogram have you gotten your Pap smear? Did you get your colonoscopy?
- [43:30]
Raj Panjabi
If it's the right agenda.
- [43:32]
Madison H.
Yeah. I mean, it's just a reminder to, like, we need to take care of ourselves. Like, these age appropriate screenings are really important. Yeah. Screening is a. Is a powerful tool. You know, obviously it's extended on a population base, but it's really important, you know, especially if you have a family history.
- [43:48]
Raj Panjabi
Yeah, for sure.
- [43:49]
Madison H.
I know it's time out of people's busy schedules, and I hear this story a lot. Like, you know, I know I had to come in, but I just couldn't find time in my schedule, you know.
- [43:56]
Raj Panjabi
And people have kids and stuff.
- [43:58]
Madison H.
Exactly.
- [43:59]
Noah Michelson
And it can be hard to get into a dermatologist. Yeah. You know, mine is like booking out two months in advance, so.
- [44:05]
Madison H.
But if you usually tell them, like, hey, I have a changing lesion, I'm really worried about, many times the dermatologist.
- [44:12]
Raj Panjabi
Yeah.
- [44:13]
Madison H.
Or do like, you know, a, A quick check, like.
- [44:15]
Raj Panjabi
Yeah.
- [44:16]
Madison H.
So if you, if you're really concerned, like, you know, definitely use your voice.
- [44:20]
Raj Panjabi
That's good. That's really good advice. I think a lot of people are shy to be like, no, I think there's a problem.
- [44:23]
Noah Michelson
Yeah.
- [44:24]
Raj Panjabi
Yeah.
- [44:25]
Madison H.
Actually, someone came into me, you know, they thought they had a skin cancer on their scrotum. Actually, it wasn't. It wasn't a skin cancer. It was a tick. They just, they just, you know, they can't see that.
- [44:37]
Raj Panjabi
Unfortunate.
- [44:38]
Noah Michelson
So relieved. And also just horrifying.
- [44:41]
Madison H.
Yeah. Yeah.
- [44:42]
Raj Panjabi
What are some behaviors that you have that you've adopted since you've gone into this field? Like things that you would tell other people to do to have lower your risk of skin cancer?
- [44:52]
Madison H.
For sure. So I personally use sunblock every day. Right. I put it on even when it's cloudy. Right. Because UVA goes through clouds. And so it's also about the habit, the ritual of just remembering to put it on. So I always do that. I do take nicotinamide. It's not necessarily, you know, for everyone. And it can interact with other medications that you're on.
- [45:13]
Noah Michelson
It's a B3.
- [45:14]
Madison H.
Yeah, exactly. But I, you know, considering I had a skin cancer myself, sure. I wanted to do all, you know, risk reduction. So I do take that. I think the study that was done in the New England Journal was great. But there's more studies too, so I do do that. I go get skin checks. I ask my friends who are dermatologists to check me out. I have done some other preventative strategies, like not only the laser that we talked about. But there's other things called photodynamic therapy, which is a form of red light, but it's mixed with a photosensitizer, so.
- [45:48]
Raj Panjabi
So cool.
- [45:48]
Madison H.
Yeah. The dermatologist puts this medication that we actually make in our blood, but it's highly concentrated. The ones that we put on, we put it on the skin, we let it get absorbed, and it gets preferentially absorbed into the precancerous cells. And then when we shine red light on it, the red light photoactivates the sensitizer, and it causes a photochemical reaction that kills or destroys the skin cancer. Or the skin pre cancers. It's a really sophisticated mechanism. The way it was sort of evolved is because there are some people who have a genetic predisposition to make too much of this compound in their blood, and when they go outside, they get blisters. And so that's where they think the werewolves and vampires came from.
- [46:32]
Raj Panjabi
Oh.
- [46:33]
Madison H.
So, yeah, it's. It's a condition called porphyria. And they make just too much of this compound called amino levionic or portoporin 9 in their blood. And when they go out in the. In the sunlight, they blister. So probably historically they just avoided the sun.
- [46:51]
Raj Panjabi
Right.
- [46:52]
Madison H.
Which would make sense. So they think maybe this myth of, like, vampires and werewolves came from.
- [46:57]
Raj Panjabi
That's really cool.
- [46:58]
Madison H.
But we use it to our advantage to kill cancer. Like skin cancer.
- [47:01]
Raj Panjabi
Yeah.
- [47:01]
Madison H.
And it's even used in other organ systems, like esophageal, like with a fiber, you know, down to illuminate it. So it's a really cool procedure.
- [47:12]
Raj Panjabi
Just another example of outsiders being heroes.
- [47:15]
Noah Michelson
Thank you, vampire.
- [47:17]
Madison H.
Yeah. Exactly.
- [47:18]
Noah Michelson
How new is that technology? I've never heard of that.
- [47:20]
Madison H.
It's been around for quite some time. Yeah, it's just. It's time consuming. You do it in the office. But I use it a lot, especially in our immunosuppressed patients, because unfortunately, they develop skin cancers very rapidly, like organ transplant patients, because we know the immune system will kill cancer. Right. We use it now in immunotherapy. That's how we harness the immune system to try to, like, attack cancer. So in immunosuppressed people, because they develop a lot of skin cancers. I try to do this pretty regularly.
- [47:49]
Raj Panjabi
Okay.
- [47:50]
Madison H.
Yeah. It's a cool procedure. But you look really like you have a bad sunburn afterwards and your face peels.
- [47:56]
Raj Panjabi
I mean, people do chemical peels anyway.
- [47:58]
Madison H.
Totally. And that's another way to do it too. Yeah.
- [48:01]
Raj Panjabi
Okay. You. When you start marketing this, you got to call it the red light special, like tlc. If anyone who's listening gets that joke, you're approaching menopause.
- [48:10]
Madison H.
I love tlc.
- [48:11]
Raj Panjabi
We're all approaching menopause.
- [48:12]
Madison H.
I should tell my patients.
- [48:14]
Raj Panjabi
So say you see something scary and you go to the doctor and they tell you that you have one of these things and you're nervous and scared. What's the first thing you want to ask them? Just to like help yourself understand this better.
- [48:25]
Madison H.
Always ask for the stage of the. You know, that's a good place to start and ask. You know, you can be frank with your doctor. You know, be like, how serious is this? Like, what do I have to do to take care of it? There's a lot of like follow up questions, of course. But just knowing the stage and where you're at is really important because then that sort of dictates the treatment and how you're going to get rid of it and how you're going to treat it.
- [48:46]
Raj Panjabi
Okay, that's helpful. Yeah.
- [48:48]
Noah Michelson
When you're treating skin cancer, is it just surgery removal or are people ever getting chemotherapy or radiation for skin cancer?
- [48:55]
Madison H.
For certain types of skin cancer and depending on the stage, you might have to have adjuvant treatment. So surgery is the mainstay for many skin cancers. But if it's deeper or if it's spread or if it's a more aggressive type of skin cancer, then sometimes we add adjuvant treatment on. So add ons. So like radiation or in some respects chemotherapy or even in more respects immunotherapy now, which is like a newer form of targeted therapy or this systemic therapy that can attack cancer. So hopefully you don't get to that stage. Right. If you catch it early, then usually surgery is just the mainstay. But there's even good reports if it's very superficial or very early. You can use topical chemotherapies or topical therapies to get rid of skin cancer. A lot of those are not approved for that indication. So FDA not approved, but we use them off label in some respects.
- [49:46]
Raj Panjabi
Yeah.
- [49:46]
Madison H.
So, you know, we have a lot of tools in our toolbox to like combat skin cancer.
- [49:52]
Raj Panjabi
I definitely, I get your whole thing about like, you know, connect with your dermatologist, find one you like because there are so many things you can do. It doesn't need to be this like awful, horrible, scary diagnosis.
- [50:03]
Noah Michelson
This was actually kind of a, I don't want to say a fun episode, but a hopeful one.
- [50:07]
Raj Panjabi
No, really hopeful.
- [50:08]
Noah Michelson
And we got a lot in and I think I learned a Lot.
- [50:11]
Madison H.
We've definitely made strides towards, you know, like, making it more, you know, palatable. You know, just detecting, getting in there and then getting things done and treating it. Yeah. And we're even developing new non invasive imaging tools. So, you know, historically we'd take a biopsy, send it to the lab, look at it under the microscope. We now have these new non invasive imaging tools that use a form of laser light that we can actually see below the skin in real time and you can actually see the cells. My patients love looking at this.
- [50:42]
Raj Panjabi
So cool.
- [50:43]
Madison H.
It's not widespread, but it's in, you know, the technology's there, it's coming.
- [50:48]
Raj Panjabi
That makes me so happy. Because biopsies are so scary.
- [50:51]
Madison H.
Exactly. Yeah.
- [50:52]
Noah Michelson
I just think about 20 years from now, what we're going to be able to do. We won't even have to.
- [50:56]
Raj Panjabi
It's so encouraging. I love that. But a.
- [50:58]
Noah Michelson
Also, I'm also terrified.
- [50:59]
Raj Panjabi
Don't, don't go the black mirror direction. Go the, like, live hot till 120.
- [51:05]
Madison H.
Totally.
- [51:07]
Noah Michelson
Dr. Anthony, thank you so much for being here.
- [51:09]
Madison H.
Thank you so much. I love this.
- [51:10]
Raj Panjabi
Thank you.
- [51:16]
Noah Michelson
It's time for Better in five. These are your top five takeaways from this episode.
- [51:20]
Raj Panjabi
Number one, there are four different kinds of skin cancer. Some are typically less concerning than others, but you want to see a dermatologist if anything looks off.
- [51:29]
Noah Michelson
Number two, speaking of which, Dr. Anthony said to follow the ABCDEs to tell if a spot looks sketchy.
- [51:37]
Raj Panjabi
Number three, sun exposure is a big cause of skin cancer, but it can develop because of genetics and viruses too.
- [51:44]
Noah Michelson
Number four, years of sun exposure is problematic, but skin cancer is the most common form of cancer in young adults too. So everyone needs protection.
- [51:54]
Raj Panjabi
And number five, maintaining an SPF routine is crucial, even in the wintertime and on cloudy days. Okay, Noah, have you been doing skin cancer prevention wrong?
- [52:05]
Noah Michelson
I don't think I've been doing it wrong, but I think I could always do it better. I loved what he said about getting in your birthday suit on your birthday. Yeah, I don't do it on my birthday, but I do see a dermatologist every year.
- [52:16]
Raj Panjabi
Yeah.
- [52:16]
Noah Michelson
And I do this skin cancer check. I sit there in my underwear and he goes over everything and it makes me feel better, honestly. I do use SPF every day, but I don't know, I just feel like we have so much exposure to the sun now. And it really does worry me. So having an episode like this where I can think about some things that I could do more of or just even be more sort of vigilant about my routine. Yeah, that's a good thing.
- [52:39]
Raj Panjabi
Yeah, it's the vigilance for me actually, because I've been doing a little bit of what I need to do. But Dr. Anthony talked about a lot of tools and a lot of behaviors that I think I definitely should pick up right now. And I plan on doing that.
- [52:52]
Noah Michelson
Yeah. And not to again, not to freak yourself out, not to worry about every single freckle or every single mole, but just know what to look for.
- [52:59]
Raj Panjabi
Anxiety is just a part of my life. She's here.
- [53:02]
Noah Michelson
She's not going anywhere.
- [53:03]
Raj Panjabi
She's not going anywhere. So this is just adding to it.
- [53:05]
Noah Michelson
And we're not going anywhere either.
- [53:06]
Raj Panjabi
No.
- [53:07]
Noah Michelson
So until next time. As long as there are things to get wrong, we're going to be right here to help you do them better.
- [53:12]
Raj Panjabi
Love you guys.
- [53:14]
Noah Michelson
Do you have something you think you you're doing wrong? Email us@amidoingitwrongoughpost.com and let us know.
- [53:28]
Madison H.
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Raj Panjabi
Stagnant water Tug of wars with tangled.
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Madison H.
Hairs Plumber on speed dial it's time to tell your plumber to lose your.
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Raj Panjabi
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Madison H.
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Raj Panjabi
Make home life easier.
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Madison H.
Join them visit tubshroom.com that's tub s h r o o m dot com.
- [53:58]
Raj Panjabi
My dad works in B2B marketing. He came by my school for career day and said he was a big roas man. Then he told everyone how much he loved calculating his return on ads spend. My friends still laugh at me to this day.
- [54:12]
Noah Michelson
Not everyone gets B2B, but with LinkedIn.
- [54:15]
Raj Panjabi
You'Ll be able to reach people who.
- [54:16]
Madison H.
Do get a hundred dollar credit on.
- [54:18]
Noah Michelson
Your next ad campaign. Go to LinkedIn.com results to claim your credit. That's LinkedIn.com results. Terms and conditions apply. LinkedIn the place to Be To Be.
- [54:28]
Raj Panjabi
What makes a great pair of glasses? At Warby Parker, it's all the invisible extras without the extra cost. Their designer quality frames start at $95 including prescription lenses plus scratch resistant, smudge resistant and anti reflective coatings and UV protection and free adjustments for life. To find your next pair of glasses, sunglasses or contact lenses or to find the Warby Parker store nearest you, head over to warbyparker.com that's warbyparker.com hey marketers.
- [54:59]
Madison H.
Are you ready to discover the latest.
- [55:01]
Raj Panjabi
Trends in podcast advertising.
- [55:03]
Madison H.
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Raj Panjabi
Learn how podcast audiences are more engaged.
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Madison H.
Than ever, why hosts are trusted voices.
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Noah Michelson
For brands, and how niche shows are delivering massive impact. Download the report today at podcastpulse2024acast.com.