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  • Northeast Wisconsin
  • May 2018
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Stories from discovery to survival with Forefront Dermatology

5.4 million.

According to skincancer.org, it’s the number of skin cancer cases treated in the U.S. in 2012. And it’s estimated that 178,560 cases of melanoma specifically will be diagnosed in 2018.

Of the three most common types of skin cancer — melanoma, basal cell carcinoma and squamous cell carcinoma — melanoma is a dangerous form that, if not detected and treated immediately, can spread to other areas in the body. According to American Cancer Society research, if melanoma is caught in stage one, the five-year survival rate is 97 percent. Late detection survival rates can be as low as 15 percent.

They’re astounding numbers, and May, Skin Cancer Awareness Month, provides a public reminder that skin screenings can save your life.

“A lot of different diseases get a lot of attention, and rightfully so,” Dr. Betsy Wernli, board-certified dermatologist at Forefront Dermatology, says. “For some reason, skin cancer gets a little lost in the shadows. I think people in general underestimate the impact and severity of melanoma.”

“Creating awareness is key,” Dr. Victoria Negrete, board-certified dermatologist at Forefront Dermatology, adds. “Skin cancer is the most common type of cancer, but it’s also one of the most preventable.”

Dermatologists recommend sun avoidance during peak hours from 10 a.m. and 2 p.m., wearing wide brimmed hats and using an SPF of at least 30 (if not 45). Reapply sunscreen every few hours and when you get out of the water, and be diligent — even when it seems unnecessary.

“You have to wear sunscreen even on a cloudy day because the ultraviolet (UV) rays penetrate 80 percent through the clouds,” Dr. Negrete says. “One of the common themes I hear is that someone doesn’t like sunscreen. Now there are mineral sunscreens you can brush on like a powder, you can wear hats, UV protective clothing.”

Creating healthy skin habits at an early age are also vital.

“Parents using sunscreen on their kids and teaching them to wear hats and rash guards are getting them in the habit of using protective measures against the sun,” Dr. Wernli explains. “I think it’s the best thing you can do.”

And the worst?

“People always try to come up with the rationalization that they need to get their base tan before they go on vacation,” Dr. Negrete says. “And that couldn’t be any further from the truth. There is no such thing as a safe base tan. Every single time you go into a tanning bed it raises your chance of skin cancer by 2 percent.”

Studies also show that those “coupled up” have a much higher chance of detecting skin cancer. Partners should be looking at not only their own skin but their partner’s, and if they notice something new that’s changing or growing, visit a board-certified dermatologist.

“We see melanoma showing up even where the sun doesn’t shine,” Dr. Negrete says. “It’s painless to get checked, and an ounce of prevention is worth a pound of cure.”

And while there are statistics and signs that point to probable cases, there are always exceptions and distinctive circumstances to be aware of. Forefront Dermatology was founded on the belief that dermatologists’ ability to treat not only medical conditions but the emotional response that accompany them is crucial, and it’s clear: it’s the patients who matter most.

Here are three of their unique stories:

Laura

“It only takes one sunburn and I’ve had many.”

Laura, a wife and mother of two, has grown up loving the outdoors — hiking, boating and spending time on the beach — and has always made it a priority to spend time outside while the four seasons of Wisconsin allow.

I grew up loving the sun. I loved the way it made me look and feel. I thought, ‘I don’t need sunscreen because I want an awesome tan and to look really pretty.’ I used baby oil! I had an opportunity to work at a tanning salon… so I got it for free. You see a lot of superstars, Hollywood actresses, and they were always so tan and gorgeous. I thought ‘I want that.’

I was down in Florida when I recognized a spot on my inner arm and I thought, ‘Oh that’s weird, I never noticed that,’ but I have freckles so I thought I’d just watch it and see. Some time passed and I noticed it started growing a little bit. I started comparing it to other freckles and spots I had and thought, ‘This one’s a little weird, it has weird edges,’ and I noticed it had changed shape. I wasn’t too concerned yet but I decided to go to the dermatologist to check on some other things, and to get an annual look over.

“It was on the inside of her left upper arm, not an area that gets a ton of sun exposure,” Dr. Negrete explains. “It wasn’t your typical melanoma, like one that you would see on Google. This was nonspecific, a pink little area that some people wouldn’t think twice about it.”

It was pretty shocking. You never think it’s going to be you. I was 34. My friends are focusing on having babies and building careers and here I am getting this news that I have skin cancer. All of those years in the sun finally caught up with me.

“Fortunately for (Laura), it was caught extremely early,” Dr. Negrete says. “She had a melanoma in situ, which means it hadn’t even penetrated past the top layer of the skin. We were able to excise it and her overall outlook is exceptionally good.”

I try and use my situation as a lesson to people that you’re never too young or old to get your skin checked out… I tell my daughters, ‘Mom spent too many careless hours in the sun, you don’t want to have an owie like mommy, you want to protect your beautiful skin.’

I always recommend Dr. Negrete and Forefront. If there was one thing I’d want you to know it’s that they’re there for you, they’re there to listen to you, even to help you through the financial aspect after.

Marvin

“I didn’t think melanoma was that severe… I’m very lucky to be alive.”

Marvin, an active father and grandfather in his 70s, is a prostate cancer survivor who, like many, wasn’t aware of the severity of skin cancer.

I was diagnosed with prostate cancer in 2001… the conversation about cancer was so routine for me that I wasn’t alarmed. I was not a sun worshipper. I never had any inkling of having a problem with skin cancer.

My melanoma was on my back so I couldn’t see it. I had a mole that was there for my entire life. I never had a concern about it; however, around Labor Day of 2013, my wife said, ‘You better have it looked at.’ My wife was insistent. I went to see Dr. Negrete… she sent in the biopsy and it came back positive.

I was scheduled for an operation the day after Thanksgiving… and when you have an operation the day after Thanksgiving, you know it’s urgent. I didn’t think melanoma was that severe. I had the mole removed, then I was scheduled for another surgery in January.

“He came in with a very quickly growing nodule on his back. He had a 3 cm growth that was really pink and at the base looked black,” Dr. Negrete explains. “It had grown very rapidly in a few months’ time. It came back as a rather aggressive melanoma: 8 mm deep. 4 mm is considered aggressive. (But) fortunately in Marvin’s case, it hadn’t spread.”

I like to think people are more aware of melanoma now than they were 5 years ago. It isn’t something that happened just last week. In my case, I was exposed to the sun as a teenager. My mountain to climb was huge… If you have melanoma to the degree I did, death is within one year. That was absolutely frightening. It changed my way of life. It’s my personality to keep going.

Now, I never go out in the sun without a long sleeve shirt, I do put on sunscreen. I take extra precaution. I owe it to myself to do everything possible so I don’t have a continuation of melanoma.

I chose Dr. Negrete because my wife had some skin problems and she liked Dr. Negrete. The longer I have been on this road, and the more I know about it, I feel very, very privileged to be alive. And I totally respect her… I feel very comfortable and I enjoy having her as my doctor.

“He is my melanoma miracle,” Dr. Negrete says.

Kimberly

“I had ‘just a freckle,’ and it was something.”

Kim, now an advocate of skin cancer screenings and taking responsibility and action for your health, knew of melanoma but never thought about it personally or that a small blemish could be as serious as it was.

I’ve been to the dermatologist before, and I’ve had little checkups… I had something that was irritating my neck, so I thought, ‘You know, I should go in to check it out.’ Before that I had found three freckles on my backside. I didn’t think anything of them because they were just freckles. It was my neck that made me make the appointment.

I went to the (Forefront Dermatology) website. I wanted to find a female and wanted to check these people out! I was looking at Dr. Wernli’s picture on the internet as I made the phone call. I said I wanted an all-over check, we made the appointment and I went in.

(Dr. Wernli) started with my feet and worked her way up and then she asked if anything was new. At first I was thinking, “No,” but then I remembered the three freckles. She said she’d like to take a biopsy of one of them but didn’t make a big deal about it.

I came back and she rolled her chair up to my knees… I can feel the anxiety increasing. She has a piece of paper and I see in capital letters: “Malignant Melanoma.” I said, “From that freckle you took off?”

“In (Kim’s) example, hers was in a very unique location… anywhere you have skin is at risk for skin cancer,” Dr. Wernli explains. “Because we caught it early enough and she was diligent about coming in for a skin check, she didn’t require any chemotherapy or lymph node surgery or anything like that.”

I thank God that I was lucky enough that the results came back and everything was clear. The margins were clear. How lucky I am to have made that appointment, have a doctor who saw it right away and removed it, and who kept me calm.

For me, it wasn’t just being in a tanning bed and having that freckle appear the next day. It had been at least ten years since I had been in a tanning bed and the freckle popped up that long later. You have to think about it long term.

“I’ve had other patients who have been diagnosed with melanoma who didn’t quite understand or grasp the gravity of the diagnosis. Kim got it,” Dr. Wernli says. “She understood from day one that it’s a big deal, and she became the biggest advocate for melanoma awareness and prevention in our town.”

One check isn’t enough. You need to make it a part of your regular routine. If you go see Dr. Wernli, she’s amazing so that makes it a lot better too. Once you meet her, you want to know her. It was a no brainer for me.

“Just skin cancer” is cancer. What would I have missed? My grandson. My daughter’s wedding. I can’t even fathom not being here for those things. I would have missed so much.

Do it for yourself. Do it for your family. Just do it.

Hear more from Laura, Marvin and Kim by visiting www.forefrontdermatology.com or www.facebook.com/forefrontderm

Forefront Dermatology is the health care expert on treating melanoma, basal cell carcinoma, squamous cell carcinoma and less common skin cancers. The level of medical care and technique is unmatched, and it’s also complemented by their dedication to providing patients with compassionate care, education and personalized treatments throughout a patient’s journey.

Currently in 36 locations throughout Wisconsin, they also expertly address a wide spectrum of other conditions and concerns, including acne, eczema, rashes, warts, psoriasis and rosacea, along with cosmetic treatments.

For more information about Forefront Dermatology and to find a location nearest you, visit www.forefrontdermatology.com or call 855-535-7175.

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