HEALTHWhat’s That Spot On Your Back?

What’s That Spot On Your Back?

By: Robert Avsec

Has it really been nine years since Mrs. Avsec said that to me after I finished showering? Sure has. September 2012 to be exact. 

That morning, I rotated my upper body to get a closer look at the object of her attention and didn’t like what I saw: a small brownish spot, roughly the size of a shirt button, on the edge of my right shoulder blade about four inches from the top of the blade.  Needless to say, this spot wasn’t there before (actually, it wasn’t merely a spot, upon touching it Mrs. A said that it was raised a bit, almost like a scab).

How can I be so sure that it wasn’t there before?  Because I look for such things on a regular basis.  See, the original Mrs. Avsec, my Mom, had a long running battle with skin cancer spots on her face and before she passed away in 2015 (not from skin cancer) I couldn’t remember the last time that I saw her when she did not have a band-aid on her face protecting a recent removal by her dermatologist.

So, when I had my annual physical exam in February 2012 at the competent hands of my primary physician, Dr. Victoria Murphy, she was concerned about a reddish spot on my scalp. When I related Mom’s skin cancer history to the Doc, she referred me to a dermatologist colleague for a follow-up (I retired from the Chesterfield (Va.) Fire and EMS Department in December 2007 where we had annual departmental health assessments and I’ve maintained those yearly exams).

I saw Dr. Bruce Glassman a couple of weeks later and after giving me a full body examination to establish a baseline, he more closely examined the “spot of concern” on my scalp.  His exam helped him determine that it was probably not cancerous, but as a precautionary measure he “blasted it” with a healthy dose of liquid nitrogen (Talk about “brain freeze”! A Slurpee from 7-Eleven has nothing on that stuff!).  He said everything would be fine in a couple of days and said come back and see him in a year.

So, when we discovered the new “spot of concern”— which happened on a Saturday, of course—I placed a call to Capital Dermatology first thing on Monday morning.  Dermatology is obviously big business these days as the receptionist informed me that the first appointment I could get with Dr. Glassman would be October 18th

Not exactly the timeframe I was hoping for, so I asked if there was another physician I could see more promptly.  As luck would have it, an appointment for the following day—Tuesday—at 11:00 a.m. had just opened with another doctor, Dr. Simone McKitty, which I took without hesitation.

When Dr. McKitty looked at the “spot” she immediately diagnosed it as seborrheic keratoses.  Seborrheic keratosis (seb-o-REE-ik care-uh-TOE-sis) is a common skin growth. It may look worrisome, but it is benign (not cancer). These growths often appear in middle-aged individuals—yours truly! —and older adults. Some people get just one. It is, however, more common to have many and they are not contagious.

Dr. McKitty excised the growth and sent it away for testing just to be on the safe side, and then patched me up.  She also took a good look at my scalp and saw another little spot, like the one Dr. Glassman had treated, and took the opportunity to give me another “brain freeze!” (thankfully the biopsy she took came back negative).

As firefighters, we spend a great deal of time outdoors—both on and off the job—and most of us are not in the habit of applying sunscreen. Basal cell carcinoma (BCC) is caused by damage and subsequent DNA changes to the basal cells in the outermost layer of skin. Exposure to ultraviolet (UV) radiation from the sun and indoor tanning is the major cause of BCCs and most skin cancers.

So, what are the “take-aways” from my experiences, especially for you guys out there—because too many guys don’t pay close enough attention to their health, do they ladies?

  • Get a physical exam by a dermatologist every year.  This is vitally important because they need to know you, especially what you look like from head-to-toe, so that subtle changes can be noted and addressed appropriately.  You’re not going to get that “level of understanding” by suddenly “popping in” for an office visit because you have a “spot of concern.”
  • This is especially true of skin cancer.  Even the same type of skin cancer can look quite different from one person to another. This makes it hard to look at a picture and tell if you have skin cancer.  The best way to tell if you have skin cancer is to see a dermatologist.
  • Develop a habit of applying sunscreen daily to your most exposed areas of skin (e.g., face and arms). I keep mine next to my deodorant in the medicine cabinet.
  • And wear a hat. My current dermatologist tells me that he most commonly sees skin cancer on the scalp of his male patients.

So, if you don’t have that patient-physician relationship with a “skin doctor,” get to it!  ‘Cause none of us are getting any younger.

Photo by Inz Vagelis