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Advancing Care - July 2022

advancing care

 

 

Spot the warning signs of skin cancer  

Summertime is sun time. We may spend our days soaking up the rays, but it’s important to learn to spot any potential problems on our skin. Skin cancer is the most common cancer in the United States, and early detection can offer more treatment options.

There are three main types of skin cancer and each can look different. We turned to Jonathan Leventhal, MD, director of the Oncodermatology Clinic in the Melanoma Program at Smilow Cancer Hospital, and Mary Ann Bentz, MD, chief of dermatology at Lawrence + Memorial Hospital, to learn more. 

Basal and squamous cell skin cancers are the most common types, according to Dr. Bentz. “These cancers are most often found in areas exposed to the sun, such as the head, lips, ear, neck, and arms, but they also can occur elsewhere,” she said. Added Dr. Leventhal, “Patients with sunburns are at increased risk for developing skin cancer.” 

Warning signs of basal cell skin cancer can include a pink pimple-like growth on the skin, or a sore that doesn’t heal or bleeds. Squamous cells can be fast growing, painful to touch and look like a scaly, crusty or warty-looking lesion. Dr. Bentz cautions that these types of skin cancers can cause serious problems if they are not treated promptly. “Squamous cell cancers — particularly on the lips and ears — can spread to the lymph nodes,” she said. 

Melanoma, the third type of skin cancer, is less common. It accounts for approximately one percent of skin cancers (although studies indicate that the risk of melanoma seems to be increasing in people under 40, especially women). It can be more serious because it is more likely to spread to other parts of the body if not caught in the early stage, according to Dr. Leventhal. 

Melanomas most often appear on areas that have been exposed to the sun, “especially your back, legs, arms and face,” said Dr. Leventhal. However, melanomas can also occur in areas that don't receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds. Signs of melanomas include a dark spot that changes in size, shape or color or starts to bleed or itch. Risk factors include having many moles or a family history of skin cancer or certain genetic syndromes. Exposure to tanning beds also increases the risk of melanoma.

Dr. Leventhal and Dr. Bentz recommend regular skin self-exams to check for signs of skin cancer. “Look with intention,” said Dr. Bentz. “Get a hand mirror and use it to look at the places you can’t readily see – like your back and the backs of your legs and neck.” If you have risk factors, schedule an annual skin check with your dermatologist.  

Dr. Leventhal and Dr. Bentz recommend these tips for protecting your skin while outdoors:

  • Seek shade.
  • Wear protective clothing — including a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses with UV (ultraviolet) protection.
  • Apply a broad-spectrum, water-resistant sunscreen with SPF 50 or higher to all skin not covered by clothing. Reapply sunscreen every three hours. 

Being vigilant is the most important thing for your skin, said Dr. Bentz. “If you think you have reason to be worried – if you see something that isn’t healing or that looks unusual to you – call your doctor,” she said. “Is it new? Is it growing? Is it refusing to heal? Don’t wait too long. It can make a difference.” 

Summer safety: Avoid a visit to the ED 

Sprains, fractures, allergic reactions and heat-related illnesses all bring patients to the Emergency Department during the summer months. Proper prevention can help keep you out of the hospital.

Andrew Ulrich, MD, vice-chair of clinical operations at Yale New Haven Hospital and interim chair of Emergency Medicine at Yale Medicine offers tips for staying safe during the summer. 

Symptoms of heat stroke

According to Dr. Ulrich, it’s important to pay attention to early warning signs of heat-related illnesses such as heat stroke. If you are thirsty, drink plenty of fluids and get out of the heat, he advises. Heat stroke happens when a person’s body temperature rises above a safe level and stays there. This is a very serious illness that can become deadly.

Signs of heat stroke can include:

  • Nausea
  • Vomiting
  • Dizziness
  • Confusion
  • Lack of sweat and dry to the touch

Someone who is experiencing heat stroke might not realize they need help. Don’t delay. Get them to the emergency room. Also, check on elderly neighbors during a heat wave to ensure their safety.

Sunburns

Sunburn often appears within a few hours of being in the sun too long. You can usually treat mild sunburns by yourself at home: 

  • Cover your sunburned skin while it heals, especially when outside.
  • Drink water to avoid dehydration.
  • Leave blisters alone until they heal. Don’t peel skin — let it come off on its own.
  • Take a cool bath or shower. Try a bath with oatmeal or baking soda to soothe sore skin.
  • Take NSAIDs (non-steroidal anti-inflammatory drugs) for pain relief.
  • Use topical cooling and hydrating gels, creams and ointments, including hydrocortisone cream or aloe vera gel.

More severe sunburns may require medical attention. Seek immediate care if you are sunburned and you experience:

  • A fever over 103 °F (39.4 °C) with vomiting
  • Confusion
  • Signs of infection, such as blisters with pus or streaks 
  • Dehydration
  • Cold skin, dizziness or faintness
  • Blisters on the face, hands or genitals
  • Severe swelling of the affected area
  • Worsening pain, headache, confusion, nausea, fever or chills
  • Symptoms that get worse despite home treatments
  • Eye pain or vision changes

Poison ivy

When it comes to poison ivy, remember the rhyme, “Leaves of three, let it be!” Avoidance is the best way to prevent a rash from this itch-inducing plant. Poison ivy grows as a vine or small shrub with compound leaves that occur in threes. 

If you do get poison ivy:

  • Do not scratch the infected area
  • Wash your clothes and towels
  • Try over-the-counter lotions or steroid creams

Call your primary care doctor if the rash spreads to your face, eyes or groin.

Bee stings and bug bites

If you have a known allergy that has caused anaphylaxis or hospitalization, always keep an EpiPen nearby. If you are not allergic to bee stings but get stung, remove the stinger by scraping over it with your fingernail or a piece of gauze. Don’t use tweezers. Squeezing it can cause more venom to release into your skin. Clean the area with soap and water, apply ice to reduce swelling, and consider taking over-the-counter pain medication such as acetaminophen or ibuprofen. 

Remember that just because you’ve been stung by bees in the past and did not have a reaction, it doesn’t mean that you may not get a more severe reaction on a subsequent bee sting. There are many different types of bees and there are many different types of toxins.

Call 911 if you get:

  • Hives
  • Lip swelling
  • Tongue swelling

Don’t drive yourself to the hospital. Your reaction could intensify while you’re driving, and you could get into an accident.

The summer months also come with the risk of mosquito-borne illnesses, including eastern equine encephalitis (EEEV), a rare illness that can cause neurological issues. To protect yourself from mosquito bites, wear light, protective clothing, use bug spray and use more caution in the late afternoon and evening when bugs are more active.

Ticks are also very common in the Northeast. Use tick repellant for pets, wear protective clothing and always do a skin check after hiking or gardening.

Ride with us and get Closer to Free 

The Closer to Free Ride returns on Sept. 10, 2022 – and we need you! Now in its 12th year, the Closer to Free Ride fuels research and care at Smilow Cancer Hospital and Yale Cancer Center. Closer to Free gives riders of all levels the chance to experience five professionally designed and fully supported routes ranging from 10 to 100 miles long. If you’re not in the New Haven area, you can join our community remotely and ride your own route wherever you may be.

You may also consider sharing your energy and enthusiasm with the Closer To Free community as a volunteer when everyone comes together at the Yale Bowl for the first time since 2019.

Register as a rider or volunteer at www.rideclosertofree.org. Can’t ride with us this year? Consider making a donation to a specific rider or team

Take a walk and chat with YNHH doctors

Take a walk and chat with local doctors as part of Yale New Haven Health’s Get Healthy Walk ‘N Talk with a Doc. Walks are each Saturday through September from 9 - 10:30 am along the Farmington Canal Greenway Trail in New Haven. Walks begin at the entrance on the corner of Shelton Avenue and Starr Street and last approximately one hour. Parking is available at New Freedom Missionary Baptist Church, 280 Starr St., New Haven. Please arrive by 8:45 am on each walk day. For more information, email Andy Orefice or call 203-688-5671. 

A place to stay for family members

Did you know that Yale New Haven Hospital has a hotel for families and caregivers of patients who are admitted for short- or long-term inpatient hospital care? Located at the corner of Dwight Street and North Frontage Road in New Haven, The Suites at Yale New Haven is just two blocks from YNHH’s York Street Campus, Smilow Cancer Hospital at Yale New Haven and Yale New Haven Children's Hospital, and a short distance from YNHH’s Saint Raphael Campus. A shuttle is provided between the two campuses. Patients who prefer a day of rest before traveling home may book a stay at The Suites as well. 

The Suites offers all the comforts of home in a warm, welcoming setting. It includes 24 suites with extended stay options. Each suite, with full kitchen, can be reserved daily, weekly or monthly. A stay at The Suites includes complementary parking, wireless internet access, business center, exercise room, onsite laundry, 24-hour security and a 24-hour escort service to and from the hospital. 

Reservations are recommended. Call 203-654-7500 for details.

Find a Doc at YNHH

Are you looking for a physician? Call 888-700-6543 or visit our website’s Find a Doctor feature for information on physician specialties, office hours and locations as well as insurance plans accepted. Many of our physician practices offer telehealth video visits for your convenience. 

Billing questions?

Yale New Haven Hospital offers financial counseling to patients and families. Spanish-speaking counselors are also available. To make an appointment with a financial counselor, call 855-547-4584.