Local doctor offers cautionary tale about skin cancer

BOSTON — Dr. Jeffrey Karp is a bioengineer and scientist at Brigham and Women’s Hospital – but recently he became a patient.

Karp, at the urging of his wife, finally went in for a routine dermatology check-up.

“I had a full body check-up and everything seemed to be fine,” Karp said. “Then I remembered this little red mark that was on my face.”

That mark was usually obscured by Karp’s surgical mask – something worn more often in recent years because of the pandemic.

“And I asked the dermatologist if she could take a look at it,” Karp said. “And she said, it’s a little shiny. And then she looked closer and said, do you mind if we do a biopsy?”

That biopsy came back positive for basal cell carcinoma, one of three types of skin cancer – the others being squamous cell carcinoma and melanoma.

Karp was expecting to undergo surgery, but doctors decided to treat the lesion using an immunostimulant cream called Aldara. One of its side effects is inflammation, which Karp is experiencing in the area of application as a prominent red patch.

But Karp isn’t hiding his face – nor his story.

In fact, he decided to post to social media about his experience with a skin cancer diagnosis in the hopes others won’t put off getting a dermatological check-up.

“It’s just actually been remarkable how many people have contacted me to say that now they’re going in to get something checked out,” Karp said. “Somebody, their spouse had melanoma, and they were trying to encourage them to go, but now they saw the post and are going.”

Karp said he realizes this is probably one of the most important uses of social media.

“To try and build awareness,” he said. “And I think we can all learn so much from each other.”

Karp is one of a growing number of Americans diagnosed with skin cancer every year. Thomas Rohrer, MD, a dermatologist in Chestnut Hill with SkinCare Physicians, said depending on the type of cancer, incidence is increasing 50 to 100 percent.

“The one exception, which is a good thing, is that melanoma seems to be plateauing and they’re actually predicting a decrease this year,” Rohrer said.

Melanoma is the most serious of the skin cancers, as it readily metastasizes. But Rohrer said the cure rate for melanoma has gone way up – primarily because it’s usually caught early.

One thing all skin cancers have in common: more than 90 percent of them are triggered by excessive exposure to the sun. UV-B radiation from the sun is associated with skin cancer; UV-A radiation with sunburns and development of cataracts.

NASA said over the last 30 years the total amount of solar radiation reaching the Earth’s surface has increased, but that trend does not seem to be continuing – in large part because of an international treaty limiting emission of gases that harm the ozone layer. Still, at the moment and on balance, anyone out in the sun is likely getting more radiation than they would have decades ago.

Rohrer said the more sun someone gets over a lifetime, the greater the likelihood cancer will develop – because damage from sunlight is cumulative.

“Your skin can’t tell the difference if you’re on a beach tanning yourself or just out walking your dog for 5 or 10 minutes,” he said. “It just keeps adding up.”

That’s why he and other dermatologists recommend limiting time in the sun and using clothing and sunscreen to help protect the skin.

“As dermatologists we’re not telling people they have to live under a rock,” Rohrer said. “Sure, go out and do the things you like. But do it smart. Put sunscreen on. I like an SPF 50 or greater. Wear a hat that has a wide brim around it. There’s a lot of great sun protective clothing. Get some sunglasses that are polarizing. Anything you can do to minimize your exposure, to protect yourself while you’re out there enjoying the world, is a good thing.”

And remember to reapply sunscreen every couple of hours; more often if you go in water, Rohrer said.

That was a mistake Karp made as a kid – when he’d apply sunscreen once. despite playing multiple rounds of golf.

“I think about wearing sunscreen now to prevent further damage in the future,” he said.

As for the past damage, Karp said he’s learned the importance of early detection of skin cancers.

“Some of them grow really slowly. Some can grow super fast,” he said. “And you never know until you go and get it checked out.”

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