Skin Solutions

Routine checks can detect skin cancers early.

After his discharge from the United States Air Force, Larry Crawford became a pilot for a large Midwestern corporation and flew all over the globe. He retired in 2005, when he was diagnosed with liver cancer, and underwent a liver transplant in 2009. That surgery changed Larry’s life in many ways, including one way he never expected.

Jason Welch, MSN, NP-C, at Blue Ocean Dermatology in Port Orange treats Larry Crawford for multiple skin cancers.

Larry counts on Blue Ocean Dermatology to treat
his ongoing skin cancer.

“One of the drugs they put me on for my transplant causes skin cancers to develop,” Larry explains. “It’s an anti-rejection drug for my transplanted liver. The connection to the skin cancer was discovered up in Maryland, where I was living at the time. I knew I’d be on that drug forever, so skin cancer would be an ongoing issue for me.

“When I moved to Florida in 2012, I found a local dermatologist, but I was quite dissatisfied with that group. Then, someone here in New Smyrna Beach gave me the name of Jason Welch at Blue Ocean Dermatology, and I decided to try him out.”

Jason L. Welch, MSN, NP-C, is a certified nurse practitioner specializing in dermatology at Blue Ocean Dermatology in Port Orange. Jason explained that Larry would need routine appointments to manage his ongoing condition. Jason also gave Larry some advice for steps to take at home.

“The first thing Jason told me was to do skin examinations on a regular basis because the skin cancers pop up all the time,” Larry recalls. “Most of the time, they’re squamous cell cancers, but a couple of times, they’ve been basal cell cancers.”

The three most common types of skin cancers are squamous cell carcinomas, basal cell carcinomas and melanoma. Squamous cell carcinomas start in the squamous cells, which are thin, flat cells that form the top layer of the epidermis, the outer layer of skin cells.

Basal cell carcinomas form in the basal cells, which are the round cells found under the squamous cells. Melanoma forms in the melanocytes. These are the cells that create the pigment melanin that gives skin its natural color. Melanocytes are located in the lower part of the epidermis.

“As far as doing skin checks, this isn’t my first rodeo,” Larry quips. “I’ve been through this quite a bit over the last few years. I can usually tell when something is a skin cancer or precancer. My wife checks my skin as well. We generally know if something’s a problem, and we stay on top of it.

“When a suspicious area appears, Jason first does a biopsy. If it comes back positive for cancer, he cuts it out for me. Jason’s ‘body shop’ has always accommodated my needs.”

Cancer and Precancer

Skin cancer is the most common cancer affecting Americans, Jason discloses. More people in the US are diagnosed with it than all other cancers combined. One in five Americans will develop skin cancer by the age of 70.

“Skin cancer starts out as a precancerous condition called actinic keratosis,” Jason informs. “Actinic keratosis affects more than fifty-eight million Americans. The earlier we find this precancerous condition, the less likely it will develop into skin cancer.

“There are several treatments we offer for actinic keratosis. The most common is cryosurgery, which involves freezing the affected areas. We’re also equipped for Blue Light and Red Light Therapy, where we treat a large surface with a cream, then put the patient under a special lamp. There are also various prescription creams we can use.”

Several factors put people at higher risk for developing skin cancer. These include performing outdoor activities between the hours of 10 a.m. and 4 p.m., aging, genetics and skin type.

“There are four basic skin types, and we determine which skin type people have by how they typically respond to being in the sun,” Jason notes. “If people always burn and peel, and their color is light with a lot of freckles, they’re skin type one. People with this skin type are the most susceptible to skin cancer.

“Skin type two is people who burn, then tan, then the tan fades. People with skin type three typically have a little more color to their skin. They generally don’t burn; they tan. People with skin type four are those with darker skin. Skin in this type can generally tolerate the sun.”

When skin cancer does develop, there are different methods for treating it. The standard of care is Mohs surgery. During Mohs surgery, the surgeon cuts out the cancer and has the margins examined at the time of surgery. This generally offers the best opportunity to remove the entire cancer.

“There are nonsurgical treatments we can use if the skin cancer is found early enough,” Jason reports. “These methods include cryosurgery using liquid nitrogen; electrodesiccation, which uses electricity to destroy the skin cancer; and superficial radiation with the SRT-100, which delivers a low dose of radiation to the affected area. The key is early detection.”

Standing Reservation

When Larry first met Jason, he liked the nurse practitioner right away. With Larry being former Air Force and Jason being a former Marine, the two hit it off very quickly. Jason made a lasting impression on Larry.

“Jason is very knowledgeable,” Larry describes. “I’d rather no one but Jason cut on me. His staff is exceptionally knowledgeable as well. I feel a great level of comfort when I’m at Blue Ocean Dermatology. I’m exceptionally pleased with Jason and his group.

“My skin cancer is an ongoing issue as long as I’m on that anti-
rejection medication, and I’ll be on it for the rest of my life. To treat my skin cancers, I’m sticking with Jason from here on. I guess I’ve got a standing reservation at Blue Ocean Dermatology.”

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    • Blue Ocean Dermatology

      Blue Ocean Dermatology provides outstanding medical and aesthetic dermatology to people of all ages. All services are performed with integrity and honesty, and with high regard to humane concerns.... Read More

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      Stanley N. Katz, MD, obtained his medical degree from New Jersey Medical School (UMDNJ) in 1974. He has since played vital roles in a broad range of medical disciplines, his specialization being achieved in dermatology. With a diverse b... Read More

    • Nitra H. Welch, MSN, NP-C

      Nitra H. Welch, MSN, NP-C, received her Bachelor of Science degree in Nursing from Troy State University in Troy, AL. She was an ICU nurse for eight years. She earned her Master of Science degree in Nursing and her family nurse practi... Read More

    • Jason L. Welch, MSN, NP-C

      Jason L. Welch, MSN, NP-C, received his Bachelor of Science degree in Nursing from Florida State University in Tallahassee.  He was an ICU nurse for seven years. He earned his Master of Science degree in Nursing and family nurse pract... Read More