DR. HOOK-- Shar-pei skin?: Use sunscreen to prevent BCC

Cooking is an art form. When I was a medical student, I didn't know how to cook. Everything I made was either a salad or a sandwich. One time I invited my now partner-in-life to dinner. I served a baked potato, but I didn't have any butter– so I did what Martha Stewart would do– I sprayed on butter-flavored Pam cooking spray.

That ended that dinner! "Pizza!" (Hey, the cooking spray was practically fat-free!)

When I moved to LA for my internal medicine residency, I finally decided I had to learn to cook. All my coworkers and friends thrived on California's fresh fruits, vegetables, and herbs. I remember sitting in the residency lounge and hearing between medical cases, "I made the most amazing dinner last night: fresh penne with extra virgin olive oil, thyme, oregano, crushed black pepper, and basil." Words like hepatosplenomegaly, aplastic anemia, and glomerulonephritis all made sense to me, but what the heck were thyme and basil?  

So I bought a cookbook and went to Pavilions, the grocery store to the stars in Beverly Hills. It was a nightmare for me to find all the ingredients. I asked a grocery worker at the fresh herb counter which was thyme and which was basil. He knew basil, but he wasn't sure about thyme. 

Then this large African-American woman grabbed something out of the water pot and said, "Here, this is thyme." I said to her, "You got the thyme, lady? Hardy har-har." She replied, "Don't quit your day job." I then realized she was Nell Carter from Gimme a Break (among other things).

I had always thought basil was a type of skin cancer, not an herb. Basal Cell Carinoma (BCC) is the most common skin cancer in Americans– mostly in white people. Probably 750,000 to 1 million new cases are diagnosed every year. The closer people live to the equator, the more likely they are to have BCC. Twice as many people in Hawaii and California have BCC as in the Midwest. Australia, which is under a big hole in the ozone layer, has 40 times more BCC than Finland– yikes!

What's frightening is that the incidence of BCC in white Americans has been increasing 10 percent every year, and the lifetime risk of BCC in white Americans is 30 percent right now. (That means you have a better chance of having a BCC than I have of ever seeing any social security checks when I retire.) 

And though older people (55-75 years old) tend to have a greater risk of BCC, more and more younger women are being diagnosed. Guess which women are getting BCC the most? Those who use tanning beds– call the National Guard! 

I have quite a few female patients who use tanning beds, and I always say, "Young lady, not only are you going to look like Joan Rivers without her 20 facelifts, but you're going to get skin cancer." Who wants to look like a Shar-pei in 30 years?

Unfortunately for older Americans, preventing BCC is not easy. The damage probably has already been done in the past. Still, it's important to wear sunscreen when out in the sun to prevent other skin cancers. 

There are three main types of BCC. Nodular BCC tends to occur on the face and looks like a pearly, translucent bump with small red vessels inside. Superficial BCC usually occurs on the trunk of the body, and those lesions look more like a reddish plaque or are bumpy. Morpheaform BCC is smooth and flesh colored.

Prognosis is excellent because BCC grows so slowly it tends to be excised before it metastasizes (spreads). But if it does metastasize, it's very deadly. Also if BCC grows too big, a person's face can be disfigured when it's removed.

Yes, it's nice to have a sunny disposition, like Nell Carter, but protect yourself from the sun and UV light.