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Summer, sun, and skin cancer - what you should know

It is easy to get carried away enjoying the string of lovely sunny summer days we have had in Seattle. Our sun is strong, and our unprotected skin vulnerable to UV damage that can lead to sun damage and perhaps skin cancers. Skin cancers fall into the broad categories of squamous cell cancer, basal cell cancer and melanoma. Each of these cancers are usually surgically excised or destroyed by either a dermatologist or general surgeon.

How to tell if a skin lesion is concerning

Warning signs include moles larger than a pencil eraser head, change in size, change in color, itching, bleeding or scab forming over the mole. Areas of particular concern include face, neck, back and extremities. However, skin cancers can also develop in areas where the sun does not shine.

What to do if I have a skin cancer?

If you have a mole or skin lesion that is concerning, bring it up with your family physician who may biopsy it or refer you ..

Facts and myths about antioxidants and cancer

Some of the most popular misconceptions surrounding cancer, cancer prevention and cancer treatment are about the role of antioxidants. Like many of the popular myths about cancer, there are facts, half-facts and outright falsehoods.
 
Fact: Damage to genes, particularly those involved in the regulation of cell division and cell death, is the key event in the development of cancer. 
Fact: Oxidants are substances, most often generated by our own body, that cause damage to chemicals, including the DNA that makes up our genes, by oxidizing them. The oxidation reaction most familiar to us is when metal rusts. 
Fact: Our bodies’ oxidants can contribute to cancer.
 
Half-fact: Antioxidants are chemicals we ingest that then run around neutralizing oxidants, rendering them powerless to promote cancer. The so-called antioxidant vitamins, of which vitamin C, E, and beta-carotene are the most well known are more properly called redox agents. In a particular environment, they prevent or reverse oxidation, called reduction. But they may change the acidity or even just the concentrations of the components of the reaction, and they may facilitate just the opposite. For example ....

When stress takes a toll on your heart

When you face danger, your body’s built-in alarm system triggers the production of adrenalin and cortisol. Adrenalin makes your heart beat faster and cortisol produces sugar to help you physically and mentally react. Your body returns to normal when the danger is over.

Unlike cavemen, barbarians and knights, we don’t face extreme danger very often. Unfortunately, every-day stress also triggers your alarm system.

Work. Commute. Kids. Relatives. Friends. Death of a loved one. Money. Everything in life can cause stress.

Stress takes a toll on your body — including your heart. Because stress can linger, your body continues to produce extra adrenalin and cortisol.

When your body’s alarm system doesn’t turn off, you may eat more, exercise less, lose sleep, argue more, forget things, get depressed, or smoke or drink more than usual. These things put an added burden on your heart and increase your risk of heart disease. Recent studies have shown that laughter and positive thinking promote heart health, while anger and job stress can increase the risk of heart attacks.

Here are some tips to protect your heart from stress:

Parent's guide to newborn testing, screening, and prevention measures

When picturing the first days of an infant’s life, what we look forward to the most is love. We express our love in so many ways: skin-to-skin, breastfeeding, swaddling and snuggling. 
 
Love also means keeping them safe. 
 
Advances in maternal-infant health are one of the greatest success stories of the 20th century, with a drop in the death rate of 99%. But some of those dangers only stay in the past through constant vigilance. Behind every screening test and preventive measure is a careful, research-driven rationale. Here are seven newborn tests, screenings, and prevention measures you should know about:
 
Vitamin K injection 
Vitamin K is vital for blood to clot properly. Newborns cannot make Vitamin K and it is poorly transferred in breast milk. Without this injection, babies are at risk for spontaneous bleeding from the umbilical cord, mucus membranes, even in the brain. Giving Vitamin K has greatly reduced this "hemorrhagic disease of the newborn," but rates are increasing as more parents refuse it. Oral Vitamin K has not been shown to prevent this potentially devastating disease. 
 
Hepatitis B vaccine
This is an anti-cancer vaccine. Before this vaccine existed, approximately 10,000 kids under age 10 contracted hepatitis B each year. Most had no known exposure to it. Kids are more likely than adults to get very sick and to have complications. Vaccination at birth has greatly reduced rates of pediatric liver cancer due to hepatitis B. 
 
Antibiotic eye ointment
This prevents bacterial eye infections. Some of these infections are associated with sexually transmitted bacteria, but not all of them are. Negative testing or a monogamous relationship does not ...

When a mole is more than a mole

As a general surgeon, I am often asked to evaluate a patient with an abnormal mole (pigmented nevus) or one that has been biopsied, revealing a premalignant or malignant growth.  It is not uncommon for the patient to tell me they either were totally unaware of the lesion or dismissed changes in the lesion over time. 

All skin cancers are not alike, and melanoma, a malignant cancer of pigmented skin cells (melanocytes), is by far the most dangerous of the group, accounting for over 75% of skin cancer deaths in the United States.  This amounts to about 48,000 melanoma related deaths world wide per year. 

Found early, when the lesion is superficial and small, cure rates are high, but as the cancer progresses, it invades deeper into the skin, and becomes far more likely to spread far from where it started.  It is for this reason that  ...

Treating and preventing common sports injuries

Looking to be more active in 2014? Have you been waiting all year to enjoy winter sports such as skiing or snowboarding?

There are a few common injuries that often get my patients down when they are on the go. Below are a few tips and tricks to help you prevent these common injuries and determine the best treatment options should you need it.

Sprains/Fractures
The most common injuries in the wrist and ankle are sprains and fractures. Throwing, twisting, weight-bearing, and impact can put you at risk for a wrist injury. Ankle sprains and fractures are typically caused by making a fast, shifting movement with your foot planted on the ground.

In most cases, I recommend the RICE approach: rest for around 48 hours; ice the injured area to reduce swelling (use a pack wrapped in a towel); compress with an elastic ACE wrap; and elevate the injury above heart level.

However, if you experience these symptoms, contact your provider for further evaluation.   
  • Pain at the time of injury
  • Swelling
  • Bruising or discoloration
  • Difficulty moving the wrist or ankle
  • A “popping” or tearing sensation during the trauma
  • Warmth and tenderness of the skin
More serious injuries will likely be treated with a splint, boot or cast. The healing process can take up to six weeks. Surgery may also be required.

ACL Tears
The ACL, or anterior cruciate ligament, is one of the major ligaments in your knee that helps with stabilization when turning or planting. ACL injuries take place during cutting or pivoting movements. The hallmark of a torn ACL is a distinct popping noise and your knee may give out. The  ...

Why you should care about fatty liver disease

The liver is a vital organ necessary for survival.  It performs crucial functions including protein synthesis and detoxification.  When excessive amounts of fat and lipids accumulate in the liver cells, this can lead to liver injury and cause a disease called fatty liver disease.  Fatty liver disease is a serious diagnosis that has become one of the most common causes of abnormal liver function tests in the United States.   Fatty liver disease is also referred to as Non Alcoholic Fatty Liver Disease or NAFLD.  NAFLD is associated with other diseases which influence fat metabolism, such as type 2 diabetes.

Why is fatty liver disease important?

NAFLD is a single disease seen in both alcoholics and non-alcoholics, especially in those who are overweight.  When a biopsy is taken of a fatty liver, features of liver injury and fat deposit in the liver may be seen.  These findings are of crucial importance as fat accumulation may cause progressive inflammation of the liver over time.  This is called steatohepatitis.  Unfortunately, NAFLD may progress to cirrhosis. Cirrhosis is scarring of the liver, which may mean someone would later need ....

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