Dermatology Adds New Treatments

April 26, 2012 | Wayne Wood

Michel McDonald, M.D.

Vanderbilt Dermatology has increased its ability to treat various forms of skin cancer, with the recent addition of a fifth Mohs surgeon and the approval of a new oral drug to treat the most severe cases of basal cell skin cancer. Preventing skin cancer, however, will always remain a focus.

The Vanderbilt Mohs program became active in the early 1990s under the leadership of Thomas Stasko, M.D., professor of Medicine, and has now grown to five surgeons, including Michel McDonald, M.D., assistant professor of Medicine.

“We want to cover all aspects of cutaneous oncology,” she said. “Prevention and treatment, which may be surgical, topical or oral, and maintenance and follow-up with patients.”

For melanoma patients, McDonald said that Dermatology works seamlessly with surgical and medical oncology to bring patients the level of care they need.

For patients with severe basal cell carcinoma, the FDA has recently approved Vismodegib, the first oral medication for such cancer.

“It’s certainly not for every patient,” McDonald said. “This is for patients who have aggressive, difficult-to-treat tumors. It’s a new way of thinking about treating basal cell cancer, which can usually be treated with surgery or topical creams.”

Keeping pre-cancers from becoming cancerous is also an emphasis, with treatments such as light therapy and wrap therapy allowing many patients who have serious skin disease to avoid the need for multiple surgeries.

Of course, the need to treat cancer or pre-cancer would be reduced if more people opted for simple prevention.

The early spring in Nashville has allowed people to get an early start on warm weather activities, and dermatologists have begun to offer their skin care tips early, too.

Since most people get a large amount of their lifetime sun exposure before the age of 18, she says that parents should think about preserving their children’s skin automatically, much the same way they reflexively teach children to use seat belts. And she has an idea for how parents can set a good example.

“I tell people to put sunscreen next to their toothpaste,” McDonald said. “We don’t want people to change their lifestyle. We tell them to just be sensible.”

Being sensible involves staying out of the sun when it is most intense, between 10 a.m. and 2 p.m., using broad coverage sunscreen that filters both UVA and UVB light, and has a sun protection factor (SPF) of at least 15. The sunscreen should be reapplied every two hours.

For those who have a negative skin reaction to sunscreen, McDonald says, “There is great sun protective clothing and it has gotten less expensive.”

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