Skin Cancer Check

I just had my skin cancer check that revealed two suspicious sites on my body. They are due for removal on the 7th August. I asked Gemini about what happens in the follow-up to their excision:

I am going to have a lesion on my skin removed in the near future because it is possibly a BCC (Basel Cell Carcinoma). The excised tissue will then be sent to a pathology lab for examination. If it is identified as BCC then what should I expect by way of follow up. It seems to me that by removing the BCC, the cancer has been removed.

Here was the response:

You're right to think that removing the BCC lesion usually means the cancer has been removed. Basal Cell Carcinoma (BCC) is the most common type of skin cancer, and it rarely spreads to other parts of the body. Surgical excision is a highly effective treatment, often leading to a complete cure.

However, a confirmed BCC diagnosis, even after successful removal, does typically warrant some follow-up. Here's what you should generally expect:

1. Pathology Report Review:

• Your doctor will review the pathology report from the lab. This report is crucial because it confirms:

  • The diagnosis: That the lesion was indeed a BCC.

  • The type of BCC: There are different subtypes (e.g., nodular, superficial, infiltrative, micronodular). Some types, like infiltrative or micronodular, can be more aggressive and have a higher risk of recurrence if not completely removed.

  • The margins: This is very important. The pathologist examines the edges of the excised tissue (the "margins") to see if any cancer cells are present at the cut edges.

    • Clear/Negative Margins: This means no cancer cells were found at the edges, indicating the entire tumor was likely removed. This is the ideal outcome.

    • Positive/Incomplete Margins: This means cancer cells were found at the edges. If this happens, your doctor will likely recommend further treatment, such as another excision to ensure all remaining cancer cells are removed.

2. Follow-up Appointments:

• Even with clear margins, regular follow-up appointments are recommended because:

  • Risk of new BCCs: People who have had one BCC are at a higher risk of developing new BCCs in different locations on their skin. This risk can be as high as 30-50% within 5 years.

  • Local recurrence: While less common with complete excision, there's a small chance of the BCC recurring in the same spot, especially if certain high-risk features were present (e.g., location on the face, certain subtypes, or larger/deeper tumors).

• Frequency: The frequency of these check-ups can vary depending on your individual risk factors (e.g., number of previous skin cancers, type of BCC, sun exposure history, immune status). Common recommendations include:

  • Every 6-12 months for at least 5 years.

  • Some doctors may recommend lifelong annual checks, especially for those with multiple BCCs or other risk factors.

• What happens during follow-up:

  • A thorough skin examination by your doctor (often a dermatologist), checking the original site and your entire body for new or suspicious lesions.

  • Discussion about sun protection and self-examination techniques.

3. Self-Examination and Sun Protection:

• Monthly self-skin checks: Your doctor will likely advise you on how to perform regular self-examinations of your skin, looking for any new growths, changes in existing moles, or abnormalities at the excision site.

• Sun Protection: This is crucial for preventing new skin cancers. You'll be strongly encouraged to:

  • Use broad-spectrum sunscreen with SPF 30+ daily.

  • Wear protective clothing (long sleeves, wide-brimmed hats).

  • Seek shade, especially during peak sun hours (10 AM to 4 PM).

In summary: While the excision often removes the cancer, the follow-up is about monitoring for recurrence at the original site and, more importantly, detecting new skin cancers early, as your risk significantly increases after a BCC diagnosis. It's about proactive surveillance and ongoing skin health management.

Blood Test Results

Blood test results back and all seems well. The only abnormality was the PSA score which above normal but not unusual for someone of my age. The doctor who reviewed the results has ordered a second test a month from now, something I think he's obliged to do in such a situation. I'll probably submit to it just to keep family off my back but that will be the end of it.

To his credit, the doctor downplayed the significance of a high PSA score in terms of indicating anything sinister. I watched a video by Pamela Popper, the titled Why PSA Testing is a Bad Idea and the takeaway was that "PSA is not a marker for cancer, and the risk of being harmed as a result of having the test is 30 times higher than the chance that a man will benefit."

Clearly the PSA test is yet another of those screening tests that generate huge profits for the medical mafia but do more harm than good. If the results of my second blood test were similarly as high as my first, I would be referred to a urologist who would subject me to a biopsy. This procedure is painful enough but as I've learned recently this is an ideal way to spread cancer cells around the body whereas as before they were totally encapsulated in the prostate gland.

Needless to say I won't be going down that path but many will because they still have trust in their doctors. Sadly, this trust is usually misplaced and given the seemingly limitless funding behind the promotion of these tests, this is hardly surprising. COVID did shatter the trust of some however, and hopefully their disillusionment will lead to a ripple effect throughout society. A massive reset of the medical "profession" is long overdue.

Car Sickness

As if I don't have enough problems at the moment, it seems that I may have developed car sickness in my old age. Yesterday, during a long drive in which I was sitting in the front seat of the car, I started to feel nauseous. I was prompted to ask the following question of Gemini and its response follows:

Is it common for older people to develop car sickness even though they never suffered from the condition when younger.

While motion sickness is often associated with children (who usually grow out of it), it is not uncommon for older people to develop car sickness or other forms of motion sickness even if they didn't experience it when younger. 

Here's why this can happen:

• Changes in the Vestibular System: As we age, there can be natural changes in the vestibular system, which is located in the inner ear and is crucial for balance and spatial orientation. These age-related changes can make the system less efficient at processing conflicting sensory information, leading to new or increased susceptibility to motion sickness. 

• Other Medical Conditions: Certain medical conditions that become more common with age can contribute to motion sickness, such as: 

• Inner ear disorders (e.g., Meniere's disease, benign paroxysmal positional vertigo (BPPV)). 

• Migraine headaches (people who get migraines are more susceptible to motion sickness). 

• Cardiovascular diseases. 

• Parkinson's disease. 

• Medications: Some medications commonly taken by older adults can have side effects that include dizziness or nausea, which can exacerbate or trigger motion sickness.  

• These can include certain antibiotics, NSAIDs, and some blood pressure medications. 

• Hormonal Changes: While more commonly associated with women (e.g., during pregnancy or with hormonal fluctuations), hormonal changes in general can influence susceptibility to motion sickness. 

• Environmental Factors: Factors like poor ventilation in a vehicle, strong odors, or focusing on screens (like reading a book or looking at a phone) while in motion can also trigger or worsen motion sickness in anyone, including older adults who might be more sensitive to these inputs as they age. 

• Decreased Adaptation: While generally, the body can adapt to repeated exposure to motion, this adaptability might decrease with age, making it harder for older individuals to habituate to motion that they previously tolerated.

If an older person suddenly develops motion sickness and it's a new or significant issue, it's always a good idea to consult a doctor. They can help determine if there's an underlying medical condition or medication contributing to the symptoms and recommend appropriate strategies for prevention and management.

Of these reasons, I would say that "changes in the vestibular system" is the most likely candidate as my sense of balance has certainly deteriorated over the years. The incident was just a one-off so I shouldn't read too much into it. However, it seems that I will be driving in the front passenger seat from now on to minimise the likelihood of a reoccurrence. Meanwhile, all I can do is monitor the situation.