Melanoma/Skin Cancer Awareness Month

Name: Melanoma/Skin Cancer Awareness Month
Uploaded: 2023-05-15T13:55:26.3966667Z
Duration: 29 min
Description: Yale Cancer Center visit: http://www.yalecancercenter.or... email: canceranswers@yale.edu call: 203-785-4095

May 15, 2023

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Yale Cancer Center

visit: http://www.yalecancercenter.or...

email: canceranswers@yale.edu

call: 203-785-4095

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00:00Funding for Yale Cancer Answers is
00:02provided by Smilow Cancer Hospital.
00:07Welcome to Yale Cancer Answers
00:09with Doctor Anees Chagpar.
00:10Yale Cancer Answers features the
00:12latest information on cancer care
00:14by welcoming oncologists and
00:16specialists who are on the forefront
00:18of the battle to fight cancer.
00:20This week it's a conversation
00:21about Melanoma and other skin
00:23cancers with doctor Christine Ko.
00:25Doctor Ko is a professor of
00:27dermatology and pathology at the
00:29Yale School of Medicine.
00:30Where Doctor Chagpar is a
00:32professor of surgical oncology.
00:34So Christine, maybe we can start off
00:36by you telling us a little bit more
00:38about yourself and what it is you do.
00:41Yes, I'm a dermatologist and
00:44dermatopathologist, so a lot of people
00:46might understand what a dermatologist is.
00:47But just in case, a dermatologist
00:50is a physician who studies and
00:52examines patients skin, hair, and nails.
00:55Sort of the outer part of your
00:58body and your scalp and your nails.
01:01And a dermatopathologist is
01:02someone who looks at tissue,
01:05so the tissue from your
01:07scalp, hair, nails,
01:08under the microscope.
01:11So if you've ever gone to a doctor and
01:13had a piece of your skin taken off,
01:15which is called a biopsy,
01:16and had that sent to a laboratory,
01:18and then you get a report back,
01:19that report was created by a
01:21dermatopathologist or sometimes
01:22a pathologist without specialized
01:24expertise in the skin.
01:25But those are the two main things that I do.
01:28So you do both.
01:30You're a dermatologist and a
01:32dermatopathologist, is that right?
01:33That's fantastic.
01:36So tell us a bit more about skin cancers.
01:40I mean, it seems like you do skin
01:44cancer all the time and we're now
01:47celebrating Skin Cancer Awareness Month.
01:49Talk a little bit about what that
01:51landscape kind of looks like in terms
01:54of how common are skin cancers.
01:56What's the most common type
01:58of skin cancer we see and how
02:01is that diagnosed and treated?
02:04Yes. So skin cancer is really important
02:07because one in five Americans will have
02:10a skin cancer by the time they're 70.
02:13So that's 20%. And so in a nuclear family
02:17that may typically be that one of those
02:22people will have a skin cancer.
02:24The most common type of skin
02:26cancer is basal cell carcinoma.
02:28And I know that's a lot of words.
02:30It's 3 words.
02:31But I abbreviate it to my patients and
02:33we abbreviate it among doctors too.
02:35We just call it B like boy, and 2 C's, BCC.
02:39And so you can call it that
02:41even as a patient, BCC.
02:43And so that's BCC is the most
02:45common skin cancer for Americans,
02:48especially lighter or
02:50fairer skinned Americans.
02:52And that usually presents,
02:54as we call it, pearly.
02:57It might look a little shiny or
03:00that kind of oyster like Translucence,
03:02if you think of shellfish with
03:05sort of blood vessels like red
03:07little lines going through it.
03:09And one thing that I often tell my patients
03:12is that it can bleed relatively easily.
03:14Like you're just sort of
03:15washing your face or
03:17it gets brushed with your clothing
03:19or something and it
03:21bleeds a tiny bit or sometimes a lot.
03:23So that's the most common skin cancer.
03:25The one cancer that of the
03:27skin that a lot of people are
03:30more familiar with is Melanoma.
03:32And I think that's because of
03:34really good skin cancer campaigns.
03:36And people know that it's often a dark
03:38spot and it might be changing or it
03:40might be a little irregular in shape.
03:42And that also I think people are aware
03:45of because it can really affect
03:47even younger individuals,
03:49in their 20s and above.
03:51So it can affect all ages and
03:53it can be deadly.
03:55So I think for good reason
03:57there have been awareness campaigns
03:58and people are becoming more and
04:00more familiar with Melanoma.
04:02And so let's talk a little bit
04:05about each of those in turn,
04:07maybe starting with Melanoma
04:09since that's the most deadly.
04:12Tell us a bit more about
04:14what are the risk factors
04:16for developing Melanoma,
04:17is there a screening protocol
04:20that people should follow,
04:23who should follow it and so on?
04:26Yes. So Melanoma is one of
04:28the most deadly skin cancers.
04:31There are others that are much more
04:33rare like Merkel cell carcinoma,
04:34so I won't talk about those.
04:36But Melanoma skin cancer screening programs,
04:40the general recommendation is for
04:43each individual person to look at
04:46your skin to do a self skin exam,
04:48just like women and men are told
04:51to do breast exams on themselves.
04:54And so a skin exam actually I tell my patients,
04:56is relatively easy once you get used to it.
05:00And all you really have to do is
05:02ideally have a full length mirror
05:03but a waist up one
05:05will do if that's all you have.
05:07And when you come out of the shower or bath,
05:10maybe choose the 1st of the month or
05:12the last of the month or
05:13the 15th or whatever day works for you.
05:16And ideally, once a month,
05:18just look at your skin, all of it,
05:21including the genital area.
05:22It's a little harder for women,
05:23but we can take a mirror and look
05:26at the genital area as well and
05:28get used to what spots you really have.
05:31Some people have very few,
05:32Some people have a lot and just
05:34get used to it and anything that
05:36looks a little weird to you,
05:37ask your doctor about it.
05:39So that's a big component.
05:40I think I advocate that
05:42people do self skin exams.
05:44The other thing you can do is you can
05:46go to your doctor or your dermatologist
05:49and have the physician do a skin
05:52exam in which ideally they would look
05:54at every single part of your body.
05:57So I will examine under the hair,
06:00you know, between the hairs.
06:01If I can do it,
06:02I will tell people to
06:04enlist the hairdresser's help if
06:05they go to a hairdresser or Barber.
06:08For people that have a good
06:09healthy amount of hair,
06:10it can be hard to look in
06:12between all of that hair,
06:13and it's easier when it's wet.
06:15So I'll ask people if they do go to
06:17a Barber or hairdresser
06:19if they ever notice anything,
06:20ask them to take a photo,
06:22kind of have a general sense of where it is,
06:24and they can even upload that photo to me
06:27in an electronic medical record.
06:30And so then ideally the physician
06:32will look under the hair,
06:35in between the hair, the rest of the body,
06:37the general nails,
06:38bottoms of the feet,
06:40so the socks and shoes come off as well.
06:46Thank you for that really
06:49thorough description because I think
06:52that well many of us may have heard,
06:54yeah, we should look at our skin.
06:57We don't really think about
06:59some of those other areas.
07:00Taking a mirror and looking
07:03at the genital area is something that
07:05a lot of people may not think about,
07:08especially because so much of us
07:11think about skin cancers and Melanoma
07:13as being related to sun exposure.
07:16So in that area, if you haven't
07:19gone skinny dipping for a while,
07:22it generally isn't exposed to sunlight,
07:24but is it still at risk for Melanoma?
07:27Yes, absolutely.
07:28I'm glad that you made that comment
07:31because often my patients and
07:34friends, family who talk to me
07:36about skin and skin cancer and
07:37how and when they should
07:40be looking at their own skin,
07:41they often say,
07:43but I don't go to nude beaches
07:45or I don't go skinny dipping.
07:47And absolutely it's a myth and
07:51that misconception comes from partial truth,
07:54which is often the case.
07:56Ultraviolet light,
07:57sunlight, is a major contributor to
08:00skin cancer and that's a major reason
08:03why fairer skin or lighter skin,
08:05especially skin types that
08:07burn and virtually don't tan,
08:10they burn and then they go
08:12back to the fair skin that they
08:14had before the burn and they
08:16don't really become significantly
08:17darker or tan in any way.
08:19That's the highest risk skin type
08:21for skin cancer because there's
08:23essentially no melanin pigment.
08:25Melanin is the
08:26Pigment in the skin that
08:28creates color that can create a tan and
08:31with virtually no protection from melanin
08:33you are at highest risk for skin
08:36cancer compared to skin that's has
08:38more melanin in it, but ultraviolet
08:41light is not the
08:44only risk factor and another risk
08:47factor is for example human papilloma
08:50virus and
08:54I think that can make sense.
08:56The way I often translate it to patients is
08:58you know that cervical cancer or a
09:00lot of people understand that and
09:02they know about vaccination of
09:04younger kids and even up to age 45
09:07against HPV virus to prevent
09:09cervical cancer as well as other
09:11especially genital cancers and oral
09:13cancers that are related to HPV virus.
09:15But it's same for the skin.
09:17And so that genital area or the
09:19sort of near genital area,
09:20a risk factor is human papilloma
09:23virus.
09:25And so that can be a reason why you
09:27may have never gone to a nude beach,
09:29but you can have skin cancer
09:30in that area as well.
09:34So does HPV vaccine protect you
09:36against skin cancers in that area?
09:40Yes, I think it can.
09:41And so one thing for example is that
09:45transplant patients who are
09:47immunosuppressed because,
09:48you know, to help them not
09:51reject the transplanted organ,
09:52they are at higher risk of skin cancer
09:54as well as other cancers due to that
09:57suppression of the immune system that's
09:59appropriate to keep the
10:01transplanted organ doing well.
10:03But especially patients with sort of darker,
10:07higher skin types,
10:08they have higher risk of skin cancer
10:11in those sort of more sun protected
10:13areas and it is thought to be
10:15because of human papilloma virus.
10:17And there are efforts to see if
10:20vaccination against HPV can reduce
10:22skin cancers in that population.
10:24So yes, you're absolutely right that
10:27HPV induced skin cancers should be
10:29prevented as well from the HPV vaccine.
10:33Interesting. So you mentioned
10:36that people with darker skin with
10:40more melanin are more likely to
10:44get these HPV type skin cancers.
10:49Do we see other differences based
10:52on race or or skin color in terms
10:56of how skin cancers present?
11:00Yes, that's a great question.
11:02I'm not sure that they're more susceptible
11:05to HPV induced cancers if they have
11:07darker skin or you know higher type skin.
11:10But just that since they have fewer
11:14skin cancers in sun exposed areas,
11:17that is an important
11:19place to check for higher and
11:21darker skin types including mine.
11:23So but what I would say is,
11:27that there are major differences
11:30and so another major difference is
11:34that higher or darker skin types and
11:36I say higher because we kind of have a
11:39Fitzpatrick skin color scale which kind
11:42of gives you a number for the skin color,
11:46the skin type that you have and
11:49lightest or fairest is close to 0
11:52Melanin and pigment.
11:53That color that makes brown in the
11:55skin or tan in the skin is A1.
11:57And then the higher skin type is
11:596 it goes up to six is darker skin,
12:02the darkest that has the most melanin in it.
12:05And it's also based on how your
12:07skin reacts to sunlight.
12:08So if you basically burn and hardly
12:11really tan at all don't get darker,
12:13you're a one.
12:14And if you essentially never,
12:16never ever burn,
12:17but you do get a little darker from the
12:19sun that's a six and in the middle 3-4,
12:21it's like you generally tan
12:22but you can burn.
12:24And so that's the scale
12:25that I'm talking about and why
12:27I'll say higher skin types.
12:28And so if you have higher skin types
12:31we'll think like 4-5 and six,
12:35you tend to get Melanoma for example
12:39under your nails more so than if
12:41you have lower skin types or on the
12:43bottoms of the feet or on the palms
12:46or you know for example in that
12:48genital area as we talked about.
12:50So I really emphasize to my patients
12:52with higher skin types to definitely
12:55definitely look in those areas as well.
12:57And so I think that sort of myth
13:01or misconception that it's sun
13:03exposed areas may also contribute
13:06to the statistics that we know
13:07that are true that patients with
13:09higher skin types often have their
13:12skin cancers not often,
13:13but maybe can have for sure their skin
13:16cancers detected later than fair skin types.
13:20And I think it might be because
13:21of that myth or misconception that
13:23people don't think you can have
13:25a skin cancer under your nail or
13:27on the bottom of your feet,
13:28which generally isn't being
13:29exposed to the sun either,
13:31or the genital perigenital area.
13:34Yeah, I was going to ask you that
13:35question in terms of
13:37the fact that we simply don't
13:38think to check in those areas.
13:40So that may contribute to
13:42these being picked up later.
13:44We are going to continue this very
13:46interesting conversation right after we
13:48take a short break for a medical minute.
13:51Please stay tuned to learn more about
13:53the care of patients with Melanoma
13:54and other skin cancers in honor of
13:57Melanoma and skin cancer awareness Month
13:59with my guest Doctor Christine Ko.
14:02Funding for Yale Cancer Answers
14:04comes from Smilow Cancer Hospital,
14:06where their Melanoma program
14:07brings together an extensive
14:09multidisciplinary team to diagnose,
14:11treat, and care for patients with
14:13Melanoma and other skin cancers.
14:15Smilowcancerhospital.org.
14:19It's estimated that over 240,000
14:21men in the US will be diagnosed
14:24with prostate cancer this year,
14:26with over 3000 new cases being
14:29identified here in Connecticut.
14:30One in eight American men will
14:32develop prostate cancer in
14:34the course of his lifetime.
14:35Major advances in the detection and
14:37treatment of prostate cancer have
14:39dramatically decreased the number
14:40of men who die from the disease.
14:43Screening can be performed quickly
14:44and easily in a physician's
14:46office using two simple tests,
14:48a physical exam and a blood test.
14:51Clinical trials are currently underway
14:53at federally designated Comprehensive
14:55Cancer centers such as Yale Cancer
14:57Center and Smilow Cancer Hospital
14:59where doctors are also using
15:01the Artemis machine,
15:02which enables targeted biopsies
15:04to be performed.
15:06More information is available
15:08at yalecancercenter.org.
15:09You're listening to Connecticut Public Radio.
15:13Welcome
15:14back to Yale Cancer Answers.
15:15This is Doctor Anees Chagpar,
15:17and I'm joined tonight by my guest,
15:19Doctor Christine Ko.
15:20We're talking about the care of patients with
15:24Melanoma and other skin cancers in honor of
15:27Melanoma and Skin Cancer Awareness Month.
15:29Now, right before the break, Christine,
15:31you were mentioning that some people,
15:34particularly those who
15:36have higher skin types,
15:38that is to say darker skin with more melanin,
15:43tend to get fewer skin cancers,
15:45but may have proportionately more in
15:48places that people often don't look.
15:51So under the nails,
15:53the bottom of the feet,
15:54the genital areas.
15:56Non skin exposed areas that
15:58still can get skin cancers.
16:01And so really important for people to
16:03look because one of the very important
16:06points that I think you made right
16:09as we were going to break was that
16:11these can be found at a later stage.
16:16And so the question that
16:18then leads into is
16:20can you talk a little bit more
16:22about the treatment algorithms
16:24for treating Melanoma?
16:26Stage is something that we'll use to
16:28refer to how advanced a cancer is.
16:31And really the goal of I think
16:35physicians, dermatologists,
16:36anyone who deals with cancer is to
16:40detect it as early as possible and
16:42so that you have early stage cancer,
16:45people might be more
16:47familiar with breast cancer.
16:48But same thing applies to
16:50Melanoma or other cancers.
16:51And stage one cancer or even
16:54to stage zero
16:57is the best to have rather than
16:59stage 4 which means that you have
17:02cancer that has spread and so Melanoma
17:04can definitely be stage 4, stage 3,
17:07these higher stages that suggest that
17:10you're going to have a worse prognosis
17:13meaning that cancer really
17:15might affect the course of your life.
17:17And so ideally when we catch skin cancer
17:20including Melanoma at stage zero,
17:22stage 1 or even stage two,
17:24we can cure the patient.
17:27Usually the best way is just to cut it out.
17:31And so it sort of
17:34comes down to math, right?
17:36If you imagine something smaller,
17:39it's much easier to cut it
17:40out no matter where it is,
17:42even if it's in a sensitive area.
17:44Like the genital area and the bigger it is,
17:48the harder it is to cut
17:49that larger thing out.
17:51So excision or cutting something out
17:53is the main way we treat things and
17:56it works often very well and many,
17:58many people have a cure.
17:59And so I'll often tell people that,
18:01for example BCC,
18:02the basal cell carcinoma that
18:04we mentioned in the first part,
18:06that often is cured very easily,
18:08relatively easily compared to other
18:11skin cancers with a simple excision.
18:13And people do very well.
18:14And so it's the best cancer to
18:16have is what I'll tell patients
18:18if you have to have one.
18:20Melanoma often can also be
18:22cured with excision.
18:23Other ways especially for
18:25higher stages is
18:28newer modalities,
18:29there's been an explosion,
18:31a really wonderful explosion in
18:33cancer treatment for all cancers,
18:35but also including Melanoma.
18:36And we used to not have great
18:39treatments for advanced stage Melanoma,
18:41stage 3 or stage 4.
18:43But increasingly we have new
18:46treatments including something
18:47called BRAF inhibitor treatment,
18:50also MECH inhibitor treatment.
18:52And they all have fancy names
18:55but the important thing to remember
18:58is that increasingly with help of
19:01researchers and scientists and
19:03physicians who dedicate their time
19:05to research as well in laboratories
19:08that there are molecular alterations,
19:11there's alterations on that inside
19:14cell level that are detected.
19:16And so for Melanoma,
19:17an example is a BRAF mutation,
19:20BRAF is a particular gene
19:22in our genetic code that can
19:24be changed in skin cancer,
19:26in Melanoma and a drug
19:28targets that
19:30particular BRAF mutation.
19:32And so we have these advances
19:34that can do wonders even with
19:37stage 4 with metastatic Melanoma.
19:39And so I would just say work
19:42carefully and closely
19:43with your oncologist and
19:45you'll see that oftentimes there
19:47can be really great treatments.
19:48So you know, when you talk about these
19:51fancy drugs that are
19:54inhibitors of various mutations,
19:56it certainly sounds a lot like
19:59the precision medicine that
20:01we've talked about on this show
20:03previously for other cancers.
20:05Can you tell us a little bit more
20:08about how common these mutations are
20:10in Melanoma because it's still the
20:13perception of many that Melanoma is
20:15the most deadly skin cancer.
20:18But if the majority of these have
20:22a targetable mutation and if those
20:26drugs that are inhibitors of those
20:29targetable mutations are very effective,
20:31one can imagine that it might not
20:33actually be as deadly as some think.
20:36Absolutely. And that's why I said
20:39there's this wonderful explosion of new
20:41treatments because we are seeing that.
20:44When I started out,
20:46and even probably for a good half
20:48of my career as a dermatologist,
20:50if someone was diagnosed
20:53with advanced Melanoma,
20:55Stage 4 Melanoma that had spread,
20:58that was pretty much a fatal diagnosis.
21:01A really difficult conversation to have
21:04with that patient about what was sort
21:07of in store in terms of that cancer.
21:10There were treatments,
21:11say like interferon alpha.
21:13But they didn't work that well and in
21:17the vast majority of patients.
21:19So now what we're seeing is
21:21with that personalized medicine,
21:23absolutely your cancer,
21:25your Melanoma can be sequenced
21:27and even just stained.
21:29So now for that BRAF gene for example,
21:32we have an immunohistochemical
21:34stain which just means that your
21:38pathologist or dramatopathologist can
21:41stain the tissue with a particular
21:43antibody and just see if the tissue
21:45lights up a different color showing that
21:48the antibody, that protein, is stained.
21:50And so then that would suggest that
21:53that personalized treatment with a
21:55BRAF inhibitor would work versus if your
21:57tissue doesn't stain,
21:59it wouldn't work.
22:00So we can get more and more precise and
22:03personalized for the best treatment
22:05to use on patients and so there are these
22:08really stunning curves in science
22:10journals that will show survival curves
22:13and they're called waterfall plots.
22:15It's kind of a pretty fancy
22:17kind of picturesque term,
22:19but it really shows that survival has really
22:22changed with newer medicines like that.
22:24And I just want to again emphasize though
22:27that early detection is still better because
22:29what happens with some of these medicines,
22:32for example,
22:33that BRAF inhibitor medicine
22:37it's tricky and it's growing fast
22:39because it's out of control, right?
22:41That's what cancer is,
22:42uncontrolled growth and it can bypass,
22:45it can start to bypass around that treatment.
22:48So the earlier we can detect it,
22:50the fewer cells of cancer that there are,
22:53there's less chance of that kind of
22:55resistance to treatment developing.
23:03Most melanomas have these mutations
23:06such that they are targetable or
23:09are many of them without a target
23:12such that they need to be treated
23:16with more generalized therapies like
23:19chemotherapy or immunotherapy, yes.
23:21So I would say the majority,
23:23maybe 60% plus of melanomas can
23:27have a targetable BRAF mutation.
23:33Studies showed
23:35relatively early on that treatment with
23:37a BRAF inhibitor alone resistance
23:40would often develop within sort of
23:43less than a year's time in patients.
23:45So now immunotherapy and
23:48adding on other medicines on top of a
23:52BRAF inhibitor is commonly used and
23:55is very effective and can prevent
23:58that kind of resistance from
24:00forming, absolutely.
24:01And so how many of these patients
24:04who have a BRAF mutation who are
24:08treated with targeted therapies then
24:13relapse and I mean do we see
24:16you mentioned that if they relapse,
24:18they generally relapse within a year
24:21but do many of them never relapse,
24:24I mean is this truly curative treatment?
24:27Yeah, there are definitely success
24:30stories where there's a cure.
24:33Some patients do need to stay
24:35on that immunotherapy that inhibitor,
24:38but it can keep
24:40the cancer in check basically.
24:43So yes, there are cures,
24:46close to being cures or sort
24:48of control of the disease,
24:50yes and they're stunning.
24:52Other patients may not have
24:53as good a response rate and
24:56I would say it is still to me
24:59also part of personalized medicine
25:01entails that your response
25:03becomes what it is for you.
25:06So there are statistics,
25:07but good careful follow up and
25:10follow up of any scans if you have them.
25:12That kind of periodic monitoring
25:15is probably at least right
25:17now still always important.
25:20And when you mention that some
25:22patients need to take immunotherapy
25:25to kind of keep this cancer under control
25:27is that given orally and how long do
25:30patients need to be on those therapies?
25:34Yes, immunotherapy.
25:35There are things like PD1 inhibitors
25:38which are used for other cancers as well.
25:41So people may be familiar with them
25:44in other in the context of other
25:46cancers like colon cancer or lung
25:49cancer or other organ systems.
25:51And they're generally infusions, yes.
25:53So you would still go
25:59get an IV put in and it would be
26:02infused through your vein.
26:05Getting back to where we started
26:08this conversation, you know,
26:10we talked to at the top of the show
26:13about the spectrum of cancers and you
26:16mentioned that the majority of cancers
26:18are actually basal cell cancers.
26:21And many of us may not talk a lot
26:23about basal cell cancers because they
26:26generally have a really good prognosis.
26:29Is that right?
26:31Yes. Basal cell cancer especially
26:33when detected early, it's less
26:36than you know say a centimeter,
26:38it's highly curable with excision.
26:41Then they don't require
26:44any further treatment?
26:45Generally not.
26:48And so how can yoy
26:51kind of guide our audience
26:53when we're doing those very thorough
26:55skin exams once a month that you had
26:58mentioned in the first half of the show,
27:00what should we be looking for in
27:03terms of a basal cell versus a
27:07squamous cell versus a Melanoma?
27:09And when should we really be
27:11going to our doctor and saying,
27:13hey, look at this because,
27:15many of us will have little spots,
27:17moles, you know,
27:18maybe a freckle or two.
27:20And we really don't want to bother
27:22our doctor if we don't think it's
27:24anything to be concerned about.
27:26But at the same time,
27:28we want to be sure that we're detecting
27:31anything that might be a cancer early.
27:33So can you kind of give us some tips?
27:36It's interesting because Melanoma,
27:38which people are more aware, most aware of,
27:42it seems like when I talk to my patients
27:44it's great that they're aware of that,
27:45but in the sense that Melanoma often
27:49looks very different than other skin cancers,
27:52especially BCC, basal cell carcinoma,
27:54which is the most common as
27:55we've been talking about.
27:57And so basal cell carcinoma,
27:58what you want to look for that
28:02pink to sort of translucent
28:05to sometimes dark,
28:06it can sometimes be Gray or black,
28:08especially in patients
28:10with higher skin types.
28:11That 4-5 or six Fitzpatrick scale,
28:15it can be Gray.
28:16So not everything that's dark
28:17and irregular is Melanoma.
28:19Sometimes it is BCC basal cell carcinoma.
28:22So a general rule of thumb
28:24that I'll tell patients is
28:26let me know about, let your dermatologist
28:29know your physician know about
28:31anything that looks weird to you.
28:33Doctor Christine Ko is a professor
28:36of dermatology and pathology at
28:38the Yale School of Medicine.
28:39If you have questions, the address
28:41is Cancer Answers at Yale dot Edu,
28:44and past editions of the program
28:46are available in audio and written
28:48form at yalecancercenter.org.
28:49We hope you'll join us next week to
28:52learn more about the fight against
28:54cancer here on Connecticut Public Radio.
28:55Funding for Yale Cancer Answers is
28:58provided by Smilow Cancer Hospital.