The following
program presents principles
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designed to promote good health
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and is not intended
to take the place of
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personalized professional care.
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The opinions and ideas expressed
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are those of the speaker.
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Viewers are
encouraged to draw their own
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conclusions about the
information presented.
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Hello, and welcome
to Health for Lifetime.
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I am your host Don Mackintosh,
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and today we're gonna
be talking about something
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that strikes fear
in people's hearts
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and that's the
word cancer, skin cancer
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more specifically.
And here to talk with us
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about this is Dr. John Chung,
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he is a dermatologist,
well, actually has a
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Residency in Family
Medicine and then after
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that he did another
Residency in Dermatology,
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and then he has
a special training
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and what's called Mohs surgery,
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what it's specifically
related I understand
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to skin cancer. That's correct.
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And you are practicing
now in Dalton, Georgia,
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the "Carpet
Capital of the World,"
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and evidently
there is also skin cancer
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there as well,
right. And people come from
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the surrounding
areas to see you because
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you are specialist in
the surgical procedure,
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Mohs surgery that I
think we will hear more
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about a little bit later, right,
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but then dealing
with skin cancer. Right.
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Well, welcome and
the first question
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that we wanna ask
you as you know how
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prevalent or what are
the forms of skin cancer
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that you see in your office?
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Well, three major
kinds; Basal cell carcinoma,
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Squamous-cell
carcinoma and Melanoma,
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okay. And there are
over one million cases of
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skin cancers every
year in United States.
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So let's look at that
first one more in detail,
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Basal cell
carcinoma. I am trying to figure
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out that means the basal cell.
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It's in the top of
the, it's in the lower part
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of the epidermis.
Okay, an epidermis is that
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outer layer. That's
correct, and it is a most
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common skin cancer in the world,
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and it is caused
by the harmful effects
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of ultraviolet rays. So
another it's being in the
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sun too much,
right. What's it look like?
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Well, it's pearly
papule or nodule with sometimes
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the ulceration and
with telangiectasia that
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is blood vessels on top of it.
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And sometimes it
presents as non-healing
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ulcers, sometimes it
just heals and it comes back
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again in the same area.
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So why is it's so dangerous?
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Well, it doesn't
metastasize, that is
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spread to the
other parts of the body
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but is very locally destructive.
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Sometimes we end up,
taking out the entire
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nose because it has
affected entire nose,
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sometimes entire ears taken off,
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lips and I had
one lady who neglected
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this tumor for
about 5 to 7 years,
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during that time it
had taken over the entire
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right side of her
face including the ear
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and the side of,
part of her neck.
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You have to take it all off?
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Yes, and it can be
very, it can be locally
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very destructive.
So it's not something
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to mess around with that,
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and how rapid
does it move or does
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it just depend. It
usually takes several years
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to do that. So if
you have any question
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make sure and go in and
set that, right exactly.
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So then what are the
odds of a person once
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they have been treated by you,
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getting another cancer?
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Well there's about
40 percent chance of
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getting another
basal cell carcinoma
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within 5 years.
40 percent chance,
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no matter how
well the treatment is
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or how good it is. Right, right,
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it's not that,
that one is coming back
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but rather you
are getting a new one.
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What about risk
of other cancers,
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is there a relationship?
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Absolutely, there
is increase in melanoma
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in this type of
patient, so when you have
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any skin cancer of any type,
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you need to have a
full body examination,
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okay, at least once a year.
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Okay, before
talking about you know the
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treatment options,
what about squamous-cell
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carcinoma? Well,
squamous cell carcinoma
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is a second most common,
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and there are 250,000 cases,
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new cases in the
United States every year.
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And out of that
about 2500 people die
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every year from
squamous cell carcinoma
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of the skin. So
that's very serious too.
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Yeah, because the
reason why you die because
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it metastasizes, it spreads,
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and the way it
looks it's more firm,
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scaly, papule or
nodule on sun exposed areas
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like the top of the
ears, nose, bottoms,
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bottom of the lip
because that's we get direct sun
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and arms, backs of the
hands, places like that.
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So let me ask you about the ear.
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My grandfather
had cancer on his ear
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and then they take
like a little chunk out
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but the squamous-cells
not in the cartilage area,
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its right above it.
Well, it starts in the skin
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but it can
destroy the cartilage.
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And does that spread
rapidly too from there?
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It can spread
rapidly. Because it gets into
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the blood stream
or something or what?
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Gets into the local lymph nodes
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and there it can go,
but you know it has to be,
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in order to do that lot of times
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the patient is
immunocompromised.
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Okay, so their
immune system is depressed
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for some reason,
right, maybe diabetes,
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maybe generalized infection,
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maybe something else.
HIV patients or sometimes
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there are organ
transplant patients
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and they are immunosuppressive.
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Taking steroids.
Immunosuppressive
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in that case. Okay,
right, immunosuppressive,
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so then we talked
briefly about the basal cell,
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we talked about squamous cell,
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now what about melanoma?
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Now that is a very,
very dangerous cancer,
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skin cancer.
It's a most dangerous
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and there are
about 54,000 cases,
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new cases of melanoma every year
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and I will say about
8 to 10,000 people die
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from that every
year. So you have less
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incidents than
squamous cell carcinoma
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but much more
deaths. And how long after
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someone's
diagnosed with melanoma,
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do they succumb to,
it just depends probably?
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Well it depends on
the, it depends on the
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depth actually,
so sometimes it may
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take years,
sometimes months we don't
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really know. What
does it look like?
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Well, it has, we
call it ABCDs of melanoma.
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A stand for
asymmetry, that means when
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you look at a ball
and if you have to cut
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it in half, one
side does not look like
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the other side, and
the border is irregular,
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it's not perfectly round.
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The color, there is
usually more than one color,
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two or three
colors, although, you know,
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that's not a harder
pustule because sometime
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we can have just a
jet black, just one
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color melanoma,
and D is diameter
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which is 6
millimeters or greater but
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I've seen
melanoma size maybe even
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1 or 2 millimeters so
you cannot go by the size.
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And what part of the body
do these usually occur on?
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Well, in males is a
trunk and anterodorsal.
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Okay. In females,
the back and the legs.
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So man is the
back and anterodorsal,
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for women back and
lower legs actually,
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lower part of the
legs. Okay, so the trunk
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for the man, the
back and the lower legs
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for the females. Yeah, you know,
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I had an
interesting case of a man
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who came into my
office one time with a tick,
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he couldn't take the
tick off. So he came on,
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was on his back and
it was biting a melanoma.
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It was biting a
melanoma. So you know,
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I told him that
tick was send by God,
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you know. But I
don't suggest that you know
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you depend on
ticks to find melanoma.
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You needed to see
dermatologist on a
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regular basis. Right,
now the family medicines
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specialist and, do
they pick up on this too.
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Yes, if they are well
trained. So let me ask
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you this, isn't it
usually true that someone
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doesn't just go
directly to a dermatologist
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but they are
referred. That's right.
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So you said, normally
go see your dermatologist,
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you mean ask your
family medicine person
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to refer you.
That's what we recommend?
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By what age? It's
just, you can start
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as an infant, but
usually there are melanomas
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and skin cancers don't
start until after puberty,
00:09:16.28\00:09:19.87
unless they have a
giant something called
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congenital nevus. What
was that congenital nevus?
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The congenital
nevus which is a huge,
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the larger the mole
when you are born with,
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born then the
higher risk of melanoma.
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Okay, so in those
of the cases you need
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to follow that much earlier.
00:09:41.21\00:09:42.47
Okay, let's talk
about treatment then,
00:09:43.15\00:09:45.22
going through the various
things we've talked about,
00:09:45.23\00:09:47.15
we talked first of
all basal cell carcinoma.
00:09:47.16\00:09:50.79
What's the treatment
for basal cell carcinoma?
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Well, you know, can I go back
00:09:53.83\00:09:56.25
little bit to melanoma.
00:09:56.26\00:09:57.42
Absolutely not,
you can go ahead.
00:09:57.43\00:09:59.78
Because a melanoma, I
think we need to know.
00:09:59.79\00:10:02.43
Couple more things about, yes,
00:10:04.24\00:10:05.30
some more serious,
lets get much as we can.
00:10:05.31\00:10:07.13
Yes you can,
melanoma can also occur
00:10:07.14\00:10:12.24
in Afro-Americans
as well as Asians.
00:10:12.25\00:10:17.40
okay. And they
occur most commonly
00:10:17.85\00:10:21.14
on the soles. The
soles of the feet?
00:10:21.15\00:10:23.08
The soles of the
feet and mucous membrane,
00:10:23.09\00:10:24.66
then palms, then
the nail beds. Nail beds
00:10:25.62\00:10:28.88
like inside. Right, exactly,
00:10:28.89\00:10:30.65
so those are the
places that you have to
00:10:30.66\00:10:32.44
watch out for in
African-Americans
00:10:32.45\00:10:36.66
and Asians. So on
the soles of the feet,
00:10:36.67\00:10:38.83
palms, and the
hands, nail bed where else?
00:10:38.84\00:10:40.91
And mucous
membrane inside the mouth.
00:10:40.92\00:10:42.84
Inside the
mouth, how are you gonna
00:10:42.85\00:10:44.31
pick up on this,
better look inside.
00:10:44.32\00:10:46.28
That's why I check
every single person
00:10:46.29\00:10:48.75
that I do, full
bodies and I look inside
00:10:48.76\00:10:50.55
the mouth. Now also
it can involve the eyes
00:10:50.56\00:10:53.09
as well. So, where in the eyes,
00:10:53.10\00:10:55.21
underneath the lids?
You can, actually something,
00:10:55.22\00:10:58.31
you have to do
dilation of the eye
00:10:58.32\00:11:01.07
by an ophthalmologist.
And you recommend that too,
00:11:01.08\00:11:05.07
you refer people
to an ophthalmologist.
00:11:05.08\00:11:06.66
Especially if they
had a history of melanoma,
00:11:06.67\00:11:08.27
you know, it will
be good to do that.
00:11:08.67\00:11:10.26
Okay, are we ready
sitting down and talk
00:11:11.13\00:11:13.09
more about treatment
for basal cell carcinoma.
00:11:13.10\00:11:15.04
No, not yet. Not yet?
Because I need to tell
00:11:15.05\00:11:16.82
you about the risk factors.
00:11:16.83\00:11:17.80
Okay, risk factors for melanoma.
00:11:17.81\00:11:19.22
Right, exactly.
Okay, what are those?
00:11:19.23\00:11:20.53
One is, one is, if you
are fair skinned your heart
00:11:20.54\00:11:24.26
is at higher risk. So it means,
00:11:24.27\00:11:25.24
I am higher risked.
00:11:25.25\00:11:26.22
You are higher risked than me.
00:11:26.23\00:11:27.65
I am higher risked than you.
00:11:28.27\00:11:29.39
And the other thing
is history of sun burns
00:11:29.40\00:11:32.39
especially as child,
sun burns, study shows
00:11:32.40\00:11:36.64
that up to about
age 30 at least half
00:11:36.65\00:11:39.91
the people have
one sun burn a year,
00:11:39.92\00:11:42.40
and sun burn is not
the tan but it is the
00:11:43.16\00:11:46.02
sun burn that
leads to lot of time to
00:11:46.03\00:11:49.72
squamous cell, I mean
the basal cell carcinoma
00:11:49.73\00:11:52.30
and melanoma whereas
squamous cell carcinoma
00:11:52.31\00:11:56.30
is more chronic cumulative.
00:11:56.31\00:11:58.30
I see. And also if you
have more than 30 moles,
00:11:58.67\00:12:01.94
if average you
have about 30 moles,
00:12:02.79\00:12:05.53
if you have more than
50, if you have more than
00:12:05.54\00:12:08.74
50 moles then you are at risk.
00:12:08.75\00:12:10.80
More than 50 moles.
Yes, and also if you have
00:12:11.16\00:12:14.62
atypical or
something of dysplastic moles.
00:12:14.63\00:12:17.09
What's that? This we
called that pre-melanoma,
00:12:18.04\00:12:20.69
if you have these
types of moles that
00:12:21.04\00:12:22.68
mean you are at
high risk for melanoma.
00:12:22.69\00:12:24.32
And the other important thing is
00:12:25.00\00:12:26.88
family history of melanoma.
00:12:26.89\00:12:28.37
I had a patient
who came in with,
00:12:29.28\00:12:31.06
with the father
and the mother both
00:12:33.01\00:12:35.09
died of melanoma,
sister and brother both
00:12:35.10\00:12:37.53
died of melanoma,
and one of the uncles
00:12:37.54\00:12:40.45
and aunt died of melanoma.
00:12:40.46\00:12:41.71
Wow! And when he
came in I was wondering
00:12:41.72\00:12:46.12
why they all died from melanoma,
00:12:46.13\00:12:47.87
and I looked at his
moles and they look,
00:12:48.44\00:12:51.31
they did not look like
the ABCDs so I just took
00:12:52.21\00:12:57.41
some samples here and
there and many of them
00:12:57.42\00:13:01.46
were severely
dysplastic and fewer
00:13:01.47\00:13:04.90
actually
melanomas. Was that right?
00:13:04.91\00:13:06.82
Then I realized at that time,
00:13:06.83\00:13:08.01
the reason why did
the other people died
00:13:08.56\00:13:10.40
is because they were just.
00:13:10.41\00:13:13.23
They missed it.
Right, because they look
00:13:13.24\00:13:15.23
almost normal,
not completely normal
00:13:15.24\00:13:17.99
but almost normal.
And then this person
00:13:18.00\00:13:18.98
make it. Oh, yeah,
this person we got it early,
00:13:18.99\00:13:21.65
so family history
is very important.
00:13:22.13\00:13:24.37
So from family history
it maybe like this guy,
00:13:24.96\00:13:27.78
they are atypical, they
don't look like a normal
00:13:27.79\00:13:31.57
melanoma and the
physicians may miss them,
00:13:31.58\00:13:33.63
so, that's right,
make sure and tell people,
00:13:33.64\00:13:35.24
right. I saw your physician.
00:13:35.25\00:13:36.83
That's why one of the questions,
00:13:36.84\00:13:37.90
anybody in your
family with melanoma,
00:13:37.91\00:13:40.14
if they say yes,
you have to be much more
00:13:41.06\00:13:43.02
ready to do biopsies
even slightly abnormal
00:13:44.75\00:13:47.93
moles instead of watching them.
00:13:47.94\00:13:49.19
So are these all the
risk factors you wanna
00:13:49.20\00:13:51.42
cover for
melanoma? Yeah, those are the
00:13:51.43\00:13:53.91
major risk factors.
The major ones, okay.
00:13:54.04\00:13:56.20
And the prognosis
depends on the depth,
00:13:56.21\00:13:58.51
how deep it has
gone into the skin.
00:13:59.35\00:14:02.21
It may get into bloodstream or
00:14:02.22\00:14:04.04
other things and
then it could be.
00:14:04.05\00:14:05.17
So earlier the better,
the earlier the diagnosis
00:14:05.18\00:14:07.72
because almost, you
have almost 100 percent
00:14:07.73\00:14:10.09
cure rate with early
detection and treatment
00:14:10.10\00:14:13.32
of melanomas.
We are talking with
00:14:13.33\00:14:14.93
Dr. John Chung, we
are talking about melanoma
00:14:14.94\00:14:18.28
right now. We're gonna come back
00:14:18.29\00:14:19.35
and we're gonna look
at treatment options for
00:14:19.36\00:14:21.22
both basal cell
carcinoma and squamous cell
00:14:21.23\00:14:25.16
carcinoma and the melanoma.
00:14:25.17\00:14:26.54
Join us when we come back.
00:14:26.55\00:14:27.52
Are you confused
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00:14:29.84\00:14:32.28
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00:14:32.29\00:14:34.53
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00:14:34.54\00:14:36.81
to sell new drugs and
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00:14:36.82\00:14:39.17
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00:14:57.53\00:14:59.67
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00:15:25.35\00:15:26.90
Welcome back,
we are talking with
00:15:29.66\00:15:30.97
Dr. John Chung. He
is a dermatologist,
00:15:30.98\00:15:32.99
he is trained
in family practice,
00:15:33.00\00:15:34.83
he is also a
specialist in Mohs surgery
00:15:34.84\00:15:37.61
which has to do with cancer,
00:15:37.62\00:15:38.81
isn't that
right? That's correct.
00:15:38.82\00:15:40.07
And we were talking
about basal cell carcinoma,
00:15:40.08\00:15:42.63
simple squamous or
squamous cell carcinoma
00:15:42.64\00:15:44.94
and then the dreaded melanoma.
00:15:44.95\00:15:46.81
You were giving
us the risk factors
00:15:46.82\00:15:48.44
and really letting us
now not to take this lightly,
00:15:48.45\00:15:51.34
make sure and
have it checked out;
00:15:51.35\00:15:53.41
even if you have any
suspicion whatsoever,
00:15:54.11\00:15:56.21
right. Prevention is
lot better than catch up
00:15:56.29\00:15:58.32
with melanoma.
Well, talk to us about the
00:15:58.33\00:16:00.31
treatment of these
very serious conditions,
00:16:00.32\00:16:04.53
basal cell carcinoma.
Okay, basal cell carcinoma
00:16:04.54\00:16:07.58
you can just treat
it, there are many ways
00:16:07.59\00:16:09.86
to treat basal
cell carcinoma actually.
00:16:09.87\00:16:11.65
One is just
simply cutting it out,
00:16:11.66\00:16:13.42
the other one is
you can cure it out that
00:16:13.84\00:16:16.77
is scraping it
out, okay, and the other
00:16:16.78\00:16:19.43
way is you can
actually freeze it,
00:16:19.44\00:16:21.13
freeze it really
hard and the other way is,
00:16:21.91\00:16:25.05
injection with
something called interferon.
00:16:25.06\00:16:27.80
Interferon is like a
cancer drug, isn't it?
00:16:28.19\00:16:30.00
Right, it actually
promotes your own body
00:16:30.01\00:16:32.76
to come and
attack this cancer cells,
00:16:32.77\00:16:34.65
okay. And also there
is a new medicine out
00:16:34.66\00:16:37.70
called Aldara cream,
Aldara cream. Aldara,
00:16:37.71\00:16:41.54
that also
promotes your immune system
00:16:41.55\00:16:45.56
to come and fight
that. That is usually used
00:16:45.57\00:16:48.04
for superficial type
of basal cell carcinoma
00:16:48.05\00:16:50.17
but by far the best
treatment which has a
00:16:51.07\00:16:53.85
highest cure rate is
that something called
00:16:53.93\00:16:55.91
the Mohs micrographic surgery.
00:16:55.92\00:16:57.70
Now Mohs micrographic
surgery can be useful
00:16:58.20\00:17:00.35
for basal cell carcinoma,
squamous cell carcinoma
00:17:00.36\00:17:02.82
and melanoma. We can
talk about that later.
00:17:02.83\00:17:06.54
So you look at it,
you are specialist in that
00:17:07.33\00:17:10.33
and people there
and your staff and you
00:17:10.34\00:17:12.42
just laser it out.
Well, okay, let's go to
00:17:12.43\00:17:16.91
Mohs surgery, what that is?
00:17:16.92\00:17:18.45
Okay. You know, when
you cut out a specimen
00:17:18.46\00:17:22.14
and then send it to
the lab, they cut it
00:17:23.38\00:17:25.21
vertically and
they look at 1, 1000th
00:17:25.22\00:17:27.98
of the margin, they
are looking at 1, 1000th
00:17:27.99\00:17:30.18
of the margin and
then based on that they
00:17:30.19\00:17:32.48
state that cancer
is out or not, okay.
00:17:32.49\00:17:35.17
Where as in Mohs surgery
you don't cut vertically,
00:17:35.64\00:17:38.36
you can cut kind of tangentially
00:17:38.37\00:17:40.38
and by the time
you are done dyeing
00:17:41.17\00:17:43.15
and all that, dye
with a special dyes
00:17:43.16\00:17:47.52
and cutting in
certain way, you are looking
00:17:47.53\00:17:50.10
at 100 percent of the margins.
00:17:50.11\00:17:52.08
Okay, so you are
not gonna miss something
00:17:52.09\00:17:54.33
that's on the
side. Right, on the side
00:17:54.34\00:17:55.92
or deep size, you are
looking at 100 percent
00:17:56.75\00:18:00.38
of the margins. So
that's why the cure rate
00:18:00.39\00:18:02.83
of Mohs surgery is
almost 100 percent,
00:18:03.49\00:18:05.93
and so especially
with basal cell carcinoma,
00:18:07.09\00:18:10.92
and now squamous cell
carcinoma you can treat
00:18:10.93\00:18:13.09
it with excision
or just cutting it out
00:18:13.10\00:18:15.50
or sometimes you
scrape it off especially
00:18:15.88\00:18:18.18
if it's early, and
also you can do probably
00:18:18.19\00:18:21.13
the best treatment
is Mohs micrographic
00:18:21.14\00:18:24.21
surgery which has
a highest cure rate.
00:18:24.22\00:18:26.47
The other thing about
Mohs micrographic surgery
00:18:27.69\00:18:29.42
is that you take out
basically only the cancer
00:18:29.43\00:18:34.18
and you follow the cancer.
00:18:34.19\00:18:35.45
So you spare normal
tissue and so you have
00:18:35.91\00:18:40.22
the smallest defect possible,
00:18:40.23\00:18:41.78
at the same time you
have the highest cure rate.
00:18:42.23\00:18:44.84
So smaller the
defect you have easier
00:18:45.80\00:18:49.50
time to close. So
what's the cancer look like,
00:18:49.51\00:18:52.01
someone told me
once, that the word cancer
00:18:52.02\00:18:53.40
means star fish, does
it look like a star fish
00:18:53.41\00:18:56.04
in there, you have to
go like tentacles this way,
00:18:56.05\00:18:58.14
that way, the
other way. Some of them,
00:18:58.15\00:18:59.97
you know, some of
them are just like a
00:19:00.28\00:19:01.76
round ball you
can just it cut it off
00:19:01.77\00:19:02.92
but some of them have roots.
00:19:02.93\00:19:04.20
And then how do
you know where to go,
00:19:04.21\00:19:05.92
you can just
kind a see with your.
00:19:05.93\00:19:07.67
When you cut it, you
cut the visible margin
00:19:07.68\00:19:10.15
but you can see,
what you think maybe
00:19:10.52\00:19:12.55
the outline of the
cancer then you take it out
00:19:12.56\00:19:15.14
and then you, we
have a lab in house that's
00:19:15.15\00:19:20.45
the way you do Mohs
micrographic surgery,
00:19:20.46\00:19:23.02
in house you cut it
and dye it and then cut it.
00:19:23.03\00:19:26.30
They look at all
these things and they see
00:19:28.26\00:19:29.66
if there is like in
the middle of the cell or
00:19:29.67\00:19:31.13
something and they
could figure out exactly.
00:19:31.14\00:19:32.66
Yes, we trace the
cancer until it's gone.
00:19:32.67\00:19:35.16
So and it's the same
treatment for melanoma
00:19:37.08\00:19:39.88
as well? Melanoma,
you can do Mohs surgery.
00:19:39.89\00:19:42.36
We actually do Mohs
micrographic surgery
00:19:42.37\00:19:44.84
for melanomas as
well, but you can treat
00:19:44.85\00:19:48.03
it a lot of time with
just regulate excision,
00:19:48.04\00:19:50.10
and those are the two major.
00:19:52.43\00:19:55.54
Usually people come to
you because of the higher
00:19:55.55\00:19:57.91
success rate of the
Mohs procedure, right.
00:19:57.92\00:20:00.16
How many people in United States
00:20:00.17\00:20:01.64
do that type of surgery?
00:20:01.74\00:20:02.78
Actually many,
many people are doing it
00:20:06.40\00:20:08.58
who are
dermatologists and some of them
00:20:08.59\00:20:11.51
are formally trained,
some of them are trained
00:20:11.52\00:20:14.18
by somebody else, not
but formal in a fellowship,
00:20:15.53\00:20:20.20
and so I can't tell
you exactly how many people
00:20:21.14\00:20:23.85
are doing it. But
the more, the better
00:20:23.86\00:20:27.43
and your
estimation because it's highly
00:20:27.44\00:20:29.03
affective, exactly.
So are we ready to move
00:20:29.04\00:20:33.14
on in terms of
treatment, we want to talk about
00:20:33.15\00:20:34.66
maybe an underling
cause like sun exposure.
00:20:34.67\00:20:37.10
Yes, let's talk
about the sun. Alright,
00:20:37.11\00:20:38.99
what's good and
what's bad about the sun?
00:20:39.00\00:20:41.01
Okay, well, you
know, people think,
00:20:41.02\00:20:44.14
you know dermatologists say;
00:20:44.54\00:20:46.52
you know sun is
absolutely bad avoided
00:20:46.53\00:20:48.31
at all cost. That
is not true, you know
00:20:48.32\00:20:51.53
because sun
actually has a lot of
00:20:52.12\00:20:55.14
beneficial effect.
Without the sun there
00:20:55.77\00:20:58.59
will be no life in
this earth. That's right,
00:20:58.60\00:21:00.29
not having green
plants, not have.
00:21:00.30\00:21:02.10
Absolutely, it's
absolutely vital for life.
00:21:02.11\00:21:04.66
And Florida will shut down.
00:21:04.67\00:21:05.93
Absolutely nobody
will be going there,
00:21:06.58\00:21:08.50
that's right. I am
probably going to move
00:21:08.51\00:21:10.49
back to Georgia. That's right.
00:21:10.50\00:21:11.77
Anyway there is photosynthesis
00:21:11.78\00:21:14.44
and also there is a,
in order for your vision
00:21:15.03\00:21:18.81
to develop, you
need light. Vitamin D,
00:21:18.82\00:21:22.76
all those different things.
00:21:22.77\00:21:23.79
Yes, and also
exactly vitamin D synthesis.
00:21:23.80\00:21:26.91
You absolutely need
although you can get it
00:21:26.92\00:21:30.21
from food
supplements, Vitamin D from
00:21:30.22\00:21:33.71
ultraviolet B is
very, very affective
00:21:33.72\00:21:37.07
and also sun cures
pathogens and it gives you
00:21:37.83\00:21:43.78
warmth, then also
helps with depression, right.
00:21:43.79\00:21:47.48
People who live in a
sunny area tend to be
00:21:47.49\00:21:49.35
happier and it helps
with multiple skin diseases
00:21:49.36\00:21:54.00
as well that we
talked about like,
00:21:54.01\00:21:55.88
like psoriasis,
even eczema, acne.
00:21:55.89\00:21:59.98
We'll talk about
eczema but, eczema is a type
00:21:59.99\00:22:02.37
of dermatitis. Oh,
it's the same word, yes,
00:22:02.38\00:22:04.47
alright. And acne,
and there are some other
00:22:04.48\00:22:06.68
diseases.
Drives them out. Right,
00:22:06.69\00:22:09.04
and now you don't
like, like food you know
00:22:09.47\00:22:13.06
too much of good
thing is not a good thing.
00:22:13.53\00:22:16.16
Right, right. So
what are some of the
00:22:16.17\00:22:18.89
harmful effects;
obviously skin cancer.
00:22:18.90\00:22:21.39
Now we talked about
before is a sun burns
00:22:21.86\00:22:25.98
that are bad. Sun
burns and if you have,
00:22:25.99\00:22:29.72
when you are young,
you are at high risk
00:22:29.73\00:22:31.51
for melanoma.
Exactly, because most of your
00:22:31.52\00:22:34.39
sun burns and sun
exposure you get before
00:22:34.40\00:22:36.69
age 18, and so we
have to be very careful
00:22:36.70\00:22:42.00
about and educate the
parents about too much
00:22:42.01\00:22:47.01
sun exposure
when they were young.
00:22:47.02\00:22:48.36
You need a sun but
not too much that will
00:22:49.76\00:22:52.94
cause sun burns. You
know I don't get on people
00:22:52.95\00:22:55.45
when they have a
little bit of tannest,
00:22:55.46\00:22:57.67
not a big deal,
but when they came out
00:22:57.68\00:22:59.76
with the burn,
when they are peeling
00:22:59.77\00:23:01.13
and they are
blistering that's when I,
00:23:01.14\00:23:03.87
you know kind of chastising.
00:23:03.88\00:23:05.78
And the other thing
is it can cause cataract
00:23:06.69\00:23:10.28
formation. Sun
exposure. Sun can, and aging,
00:23:10.29\00:23:15.95
two of the worse
things for fast aging is sun,
00:23:16.45\00:23:19.60
excessive sun and also smoking.
00:23:20.13\00:23:22.59
And there are
certain skin disease as well
00:23:24.08\00:23:27.61
that can be worsen
by the sun like lupus
00:23:28.16\00:23:32.27
and there is
something called polymorphous
00:23:32.28\00:23:34.16
light eruption,
and something called
00:23:34.17\00:23:36.98
porphyria, all those
things can get be worsen
00:23:39.15\00:23:42.74
by the sun. Okay,
so it's a good thing,
00:23:42.75\00:23:44.66
but it can be a bad
thing too, too much of it.
00:23:44.67\00:23:47.02
Absolutely and you
know people ask about
00:23:47.03\00:23:50.42
tanning bed, tanning
bed is not good for you.
00:23:51.36\00:23:54.37
Tanning bed actually
can lead to skin cancers.
00:23:54.38\00:23:56.36
So do not go the tanning bed.
00:23:56.83\00:23:58.87
No, absolutely not.
If you are operating
00:23:58.88\00:24:00.73
in tanning bed, shut
it down, that's what you
00:24:00.74\00:24:02.55
would say right?
Well in another words,
00:24:02.56\00:24:05.52
you are
concerned about it, right,
00:24:05.53\00:24:06.60
especially the more
fair skin, I mean the people
00:24:06.61\00:24:08.84
that go to those
usually are fair skinned,
00:24:08.85\00:24:10.49
right. Yes, because I
don't see. I don't see
00:24:10.50\00:24:12.29
many tan Amazon
people going to get a tan.
00:24:12.30\00:24:15.04
So you know if you
are someone like me
00:24:15.86\00:24:20.36
you know freckles
and you know I have tans
00:24:20.37\00:24:23.44
and just tiny
little spots all over me,
00:24:23.45\00:24:24.93
more risk for
that, do you see a lot of
00:24:27.82\00:24:29.70
people like me? I
do, I see a lot of, most
00:24:29.71\00:24:32.35
of the cancer surgery
that we do are in Caucasians.
00:24:32.36\00:24:34.70
Okay, alright,
anything else about the sun
00:24:35.42\00:24:40.01
that we need to talk about?
00:24:40.02\00:24:41.78
How about
protection from the sun?
00:24:43.83\00:24:45.10
Yeah, protection, I
mean wearing an over
00:24:45.11\00:24:47.34
coat to the neck.
Well, it's hard to do during
00:24:47.35\00:24:50.27
summer time, okay.
So you know there are
00:24:50.28\00:24:53.61
lot of good ways
to protect yourself,
00:24:53.62\00:24:55.60
is one is
sunscreens. And how you know
00:24:55.61\00:24:58.79
if it's good or bad?
Well, higher the number
00:24:58.80\00:25:02.44
the better, but higher
the number it can cause
00:25:02.45\00:25:06.30
more reactions, so
what I like to do is like
00:25:06.31\00:25:11.74
15, 30 or on there
will be good that is SPF
00:25:11.88\00:25:16.26
which means sun
protection factor, okay,
00:25:16.70\00:25:19.87
a special number
that's given, 15 to 30,
00:25:19.88\00:25:23.61
yeah 15, 30, okay.
That's not necessary, you know,
00:25:24.16\00:25:28.15
the other thing is
better if it's broad spectrum
00:25:28.68\00:25:33.84
that is, recovers
both ultraviolet A
00:25:33.85\00:25:36.75
and ultraviolet B,
okay. Now ultraviolet B
00:25:36.76\00:25:39.90
is about 60 hundred
times more carcinogenic
00:25:40.76\00:25:46.07
than ultraviolet A.
So you want to cover both
00:25:46.08\00:25:49.29
ultraviolet A and
B, right, 15 to 30.
00:25:49.30\00:25:52.44
Right because ultraviolet
A in combination of B
00:25:52.45\00:25:56.25
causes I mean exacerbates.
00:25:56.98\00:25:59.90
What about if I
lay, under the umbrella
00:26:02.89\00:26:04.63
and I don't get on the
sun anyways, isn't that okay?
00:26:04.64\00:26:06.39
No, about half, it
takes probably twice as long
00:26:07.60\00:26:13.64
to get us sun burn
because you have all these
00:26:13.95\00:26:17.10
scatter light through
all the ground and also.
00:26:17.62\00:26:21.54
So it does cut it
down some but it doesn't
00:26:23.53\00:26:26.06
totally protective you.
No, you can get sun burn
00:26:26.07\00:26:28.68
under umbrella.
What about going on
00:26:28.69\00:26:30.56
a cloudy day, just
make sure there are some
00:26:30.57\00:26:32.28
clouds there, I am
okay. No, about, you still get
00:26:32.29\00:26:36.89
about 70 to 80 percent
of ultraviolet through that.
00:26:36.90\00:26:41.50
Only problem is it's
actually is more dangerous
00:26:42.00\00:26:44.55
to go out during
cloudy day because.
00:26:44.56\00:26:46.80
You don't feel it.
You don't feel the heat
00:26:46.81\00:26:48.58
because that is also
it's by infra red that
00:26:48.64\00:26:52.37
gives you the heat,
but sun blocks infra red
00:26:52.38\00:26:55.80
and so you stay out
there, you are getting
00:26:56.17\00:26:58.32
the ultraviolet the
harmful ray and you,
00:26:58.33\00:27:01.13
there much longer.
We get about 1 minute
00:27:01.75\00:27:03.87
left what about
being in high altitudes,
00:27:03.88\00:27:05.93
still dangerous up
there? Yes, higher you go
00:27:07.07\00:27:09.56
the worse it is.
Because you are closer
00:27:09.57\00:27:11.36
to the sun? Right
every thousand feet that
00:27:11.37\00:27:14.48
you go up, you loose
about 4 percent higher
00:27:14.49\00:27:20.28
so it's totally; if
you go 5000 feet it's about
00:27:21.31\00:27:24.99
20 percent more
harmful. So watch out for
00:27:25.00\00:27:27.99
that sun, we've
been talking with
00:27:28.00\00:27:29.10
Dr. John Chung. He
is a specialist in the
00:27:29.11\00:27:32.39
Mohs type
surgery. He also deals with
00:27:32.40\00:27:35.00
dermatology on a
day and day out basis
00:27:35.01\00:27:37.08
there in Dalton,
Georgia. We are really
00:27:37.09\00:27:38.99
thankful that you
have been with us today,
00:27:39.00\00:27:40.36
and we've learned a
lot in this program about
00:27:40.65\00:27:42.60
things that are very
important, very serious
00:27:42.61\00:27:44.54
not to be taken
lightly and you've given us
00:27:44.55\00:27:47.50
really practical
counsel. I know that you are not
00:27:47.51\00:27:49.67
trying to take
the place of someone's
00:27:49.68\00:27:50.93
personal
physician, but if they follow
00:27:50.94\00:27:53.74
they're gonna be
really benefited.
00:27:53.75\00:27:55.05
Thank so much for watching
00:27:55.06\00:27:56.54
and may God bless you.
00:27:56.55\00:27:57.69