Epi 52: Dr. Nick Countryman shares skin cancer prevention tips

Daniel

so you weren't there, you just saw you saw it on the news. Okay. Yeah.

Vince

Um, and then I don't know if you have any favorite drivers or not, but obviously this is Tony Canon's last year, which, yeah, I kind of gotten, uh, wrapped up into him and follow him and so that, that should add a little more a another element cause he's been a fan favorite for, I dunno, the last five or 10 years, something like that. Um, when you guys go to the race, where do you typically sit?

Nick

Usually somewhere between the start, finish and first turn.

Vince

Okay. Yeah. So you're just down from us. We're usually first turn area. Um, have you taken your kids now? And have they bought in?

Nick

Um, plus or minus? Yeah. I don't know if it's an every year thing, but, uh, they like the, the ride. It's a lot of work getting in there, bringing in food and drinks and stuff. So, uh, and it's a long day, but it's fun. They, they enjoy it. That's

Vince

the key. So my parents had set a rule when we were kids that you had to be nine before you could go. Okay. And as the kid's like, what, what, what's that all about? Now that you're a parent? I'm like, oh, I get it. Yeah, because you had like a four year old, you take the race and they just melt down. It's like, yeah. Sorry buddy. Like, we're here for the duration. Like we're not, we're not leaving. Yeah. It's a long day,

Nick

25 and like

Vince

It's like, well, you could lay down, take an half if you can.

Nick

Well, I, because of, uh, the topic. Yeah. Joseph New Newgarden has done some public awareness stuff for melanoma, so I've always been a new garden fan since the beginning, and I met him when he was first. Coming into, uh, the circuit and, uh, hit the big time. And so he did some stuff pretty early on. Um, and I think we, we've seen most years they're gearing out like wristbands to show like UV exposure and some sunscreens out there too. So, um, I think that he's been a part of that. And I think that Indy cars, um, I Mass has been good about sponsoring

Vince

How, how do those wristbands work and how accurate are they? And the reason why I ask that is cuz like I could see people saying, oh, they're interested, so I'll put one on. And if it like all of a sudden just goes off to church or like, that might freak some people out. Yeah.

Nick

I don't know much of the technology around that. I think it's probably pretty goofy, but it's like, you know, like, um, glow in the dark balls. I mean like you don't have time 'em out in the sun very long to get 'em to glow in the that's the same with those. Yeah. a terrible idea for people that are visual and they're like, until they get sunburned, they can't really tell.

Daniel

Yeah. It's a nice reminder just right halfway through the race, like, okay, you should probably. Throw some more back on.

Vince

Now I'll say if it had a way of determining, okay, I, I put that first layer on at, you know, 8:00 AM. But by one I should reapply if it had some sort of

Nick

Yeah.

Vince

To let you know that. I don't know how the

Daniel

I mean you, I mean, you could with different, if it changed different colors, so like application one was like, became visible after a little bit of time, and then application two and then three, and then four. We should probably stop talking about it and just patent it and make it happen.

Vince

seven beers by 1:00

Daniel

There you go. Yeah. Yeah.

Vince

You may not. You may change colors, but be like, yeah, whatever. Yeah.

Daniel

true. More

Nick

likely you'd see technology on like a watch or something like that, that might say, all right, you've gotten exposed to so much. I mean, we say every two hours. I mean, if you're gonna be out in the heat of the

Daniel

shoot every two

Nick

it's a lot with golfers. I say at the turn, you know, like, cuz that's around two hours usually. Especially, usually you're sweating a little bit if you're walking. Um,

Vince

whoops. So

Daniel

yeah, I'm like, I'm adding up the amount of time I've played golf. I'm like, I am not applying as often as I should be applying.

Nick

that's why I stay pretty busy.

Daniel

Yeah. Yeah.

Vince

You're so, you're welcome.

Daniel

yeah. Yeah. Golf. Yeah. It's like a chiropractor advertising at a go-kart track.

Nick

track. Yeah. Sworn neck and

Daniel

We have

Vince

an idea. As we kind of enter into the whole pickleball world, we know how many sponsor

Daniel

There we go. Yeah. Okay, Heard it here first. Right.

Vince

Hey guys, welcome back to their episode of the Summits podcast. Thank you all for joining us from wherever you get your podcast, for tuning in from the Heroes Foundation YouTube channel. Thank you for doing so and guys on the YouTube channel, uh, something for you that's absolutely free of charge If you haven't hit that subscription button. Please do so now it'll take a second and it's only f it's absolutely free. Uh, also while you're doing that, hit that little notification bell icons so you can be notified when new episodes drop like this. Very one. All right guys, we got a good one for you here today. Uh, local homegrown product I've known for a long time.

He and his brothers and sisters. Um, Dr. Nick Countryman is joining us here at the Summits podcast. Um, Nick, welcome to the podcast.

Nick

Thank you. Appreciate you having me.

Vince

I had to say Nick or Dr. Countryman, or

Nick

please, Nick. Thank

Vince

There you go. I figured we'd known each other long enough. Um,

Daniel

I'll still call you Dr. Nick Countryman because I just met you, right? Yeah,

Vince

It's that level of respect.

Daniel

exactly.

Vince

Um, why don't you, uh, give everyone a little introduction to yourself.

Nick

Sure. Well, thanks very much for having me. I'm really honored. Obviously, uh, this is a subject near and dear to my heart. We enter, uh, into the time where we start to talk about skin cancer awareness, and that happens to be my passion. So I'm a dermatologist here with do threat and dermatology in town, and, uh, we have a really robust group of dermatologists, uh, spread out throughout central Indiana. That, uh, do a great job taking care of our community. And I specialize in the group with, um, uh, with skin cancer. So I do a in-office procedure that we, um, are able to remove skin cancers, primarily the head and neck.

Uh, we do, um, uh, the pathology on site and then we, uh, once we can clear tumors, We are able to, uh, reconstruct, uh, patients here in my office. So, uh, it's a really neat way of treating a very common disease that, um, you know, has continued to increase in our, in our, uh, country, um, in skin cancer. And so, uh, something that I'm really passionate about and, um, glad that you guys invited me to be here and talk a little bit about that and about what we need people to know about it.

Daniel

Yeah,

Vince

Yeah, no problem. Um, question for you, at what point, so for, for our listeners', uh, benefit, um, Nick and I somewhat grew up together. Nick and, and my younger brother Joe are the same age. So they, they grew up together. Uh, Nick's older sister, Heather and I were in the same class, and then his older brother, Brad and my sister, older sister were in the same class. Uh, so we've known each other. The family's known each other for a long time.

At what point? Two, a two part question. At what point did you. Know that you wanted to become a doctor, and then secondarily to that, when did you decide, Hey, dermatology is where I want to go or what I wanna practice?

Nick

Yeah. So, uh, yeah, our families have known each other for a long time. I guess, uh, you guys lined up with my sister and my brother and your sister. They could have been arranged, but it'd been really weird if Joe and I were arranged there. That didn't work out. Uh, but no, uh, known the Todd filling for a long time. Spent some time down in, uh, Fort Myers, Florida. Had some good times down there getting too much sun.

Um, but, uh, your family was always generous to take me along. I remember riding in the backseat of the van, just laying on the floor, sleeping on the way down there, but a lot of good times. So, um, yeah, so science was always my interest in school and so, as you know, AP chemistry and, uh, high school and uh, biology just. It definitely peaked my interest. So then I went to Notre Dame and studied biochemistry. Uh, and at that point, you know, there's a couple different ways you can go. You can go towards more of the science, um, path and research and, um, different types of basic science research in the laboratory or clinical research or, you know, medicine.

And I was, you know, very interested in both. But definitely kind of just being a people person. I think that, uh, more naturally medicine kind of felt like the right path, and so I, you know, headed to, in that direction, um, and, uh, applied to medical school and was accepted. I. Um, I wasn't sure what I wanted to do. I used to chase my dad around with my toolbox and knew that I liked using my hands and a lot of medicine is procedural and so definitely spent a lot of time in the operating room as a medical student. Very interested in orthopedic surgery and ear, nose and throat surgery, uh, but then was introduced to dermatology, um, and specifically most surgery and skin cancer and, um, After spending some time in some basic science research slab in dermatology, and then in the operating room, I kind of put it all together and kind of found this subspecialty within dermatology that piqued my interest.

So I'm able to kind of use, you know, my science background, but also love the procedural side of what I get to do, um, treaty skin cancer, day in and day out for my patients.

Daniel

Nice.

Vince

You, me, you mentioned the subspecialty, what is that? Subspecialty,

Nick

So it's called MO surgery or MO'S dermatologic surgery or Micrographic surgery. Um, so, um, the way that dermatology works, you do a one year internship after medical school, um, followed by a three year residency. Um, and then you're eligible to a board certified dermatologist. And, um, and then you could do several different paths. You can, you know, after that. Um, but I went on to do a fellowship.

Um, for a year, um, to specialize in, um, you know, the skin cancer and, um, the procedure that I described and, um, the reconstructions from those. So just allowing me to have a little bit more expertise in the average, um, dermatologist, um, you know, in this field,

Vince

Right. Um, if you would describe the most surgery for us. Sure.

Nick

Um, so super exciting. Super exciting. All right, so all the patients that uh, uh, present to my office have a biopsy proven skin cancer. The most common

Vince

they've already been diagnosed at that point? Exactly.

Nick

exactly. So, um, most common being basal cell carcinoma and squamous cell carcinoma. We kind of. Put those in this field of non-melanoma skin cancers. Um, and those two comprise about, um, 90% of all skin cancers, maybe a little bit more in our country. Um, and there's as many, as, you know, 5 million of those diagnosed every year in the United States alone. That's. As many as all their cancers

Daniel

Yeah.

Nick

Fortunately, you know, these are primarily treatable, um, locally, um, aggressive tumors that can be removed with different methods, including most surgery. Um, and then the other percentage, uh, is melanoma. So we treat superficial melanomas as well, um, in our office. So, um, the patients come in usually with the diagnosis of one of those three. There's a few other rarer tumors that we treat. Um, and then, um, I meet the patient, we mark out the tumor. It's primarily neck up.

We do some really aggressive or recurrent, uh, tumors off of the head and neck on the genitalia. Hands and feet are another place that we operate and we mark out the tumor. We anesthetize. It's all done on a local anesthesia, which is an advantage because the patients don't have to. Put to sleep. Some of our patients are aged, they're not great candidates to get put to sleep. But even for young people, you know, anesthesia does, has its downsides if we can keep 'em awake. So they come in, get anesthetized, all local anesthesia, and we cut out the tumor, we cauterize bandage 'em, and then we take it to our laboratory. We do a frozen section technique where we, uh, freeze the tissue, we cut very thin sections, we stain it, and then I interpret it.

So there's some major advantage of me cutting out and then interpreting it in my own lab. so at that point there's two, uh, outcomes. One, the tumor's been completely removed, the patient's ready to get, uh, reconstructed. Two, there's some tumor remaining. We are able to map that out and sorely go back and remove that area. So not only achieving a very high cure, but leaving a very, um, small wound, um, taking only what we need, nothing extra. Um, so we call it a tissue sparing procedure. So in that way, we were able to achieve high cure rates as high as 98 to 99% for basal cell carcinoma, um, and leaving the small wound. Why is that important?

Well, many of these things are an anatomically, uh, functionally, aesthetically important area. So we're talking, you know, just this morning. I treated, um, tumors on the eyelid, on the nose, on the ears, on the lips. All those are pretty important areas for various reasons. And aesthetically very important when you take off, uh, you know, a several centimeter tumor on somebody's nose, that's pretty important.

You know, not only a functionally but aesthetically. So, um, Being able to not achieve those high cures, but allows us to then reconstruct the wounds, leaving normal tissue behind. So then we set out to do all different types of things. We do some pretty cool stuff in the office, as simple as letting things heal naturally. But then we stitch things side to side together. Uh, just this morning I took somebody's forehead and put it onto their nose to reconstruct a really massive wound from a superficial melanoma. So, you know, everything in between. Um, but you know, even though many of the tumors that I treat are not life-threatening, um, many of them are quite disfiguring.

And, um, so I think, you know, as part of this conversation, you want to educate, you know, the people listening about, you know, early intervention and, um, educating about, um, you know, screening and about protection. But, um, that was a long-winded way of trying to keep it exciting. No,

Vince

it's okay. So, uh, you mentioned, sorry, you mentioned carcinomas and melanomas about roughly how many different types of skin cancers are there are. Are those the two primary?

Nick

Yeah. So there are a lot, um, but a vast majority of 'em are made up of basal cell carcinoma, squamous cell carcinoma, and melanoma. Those are ones that, you know, most people will have heard of. Um, the basal cell and squamous cell carcinoma are very common, mostly treatable, locally aggressive tumors, um, millions, but, you know, death are in only a couple thousand. Melanoma is much less common. That's probably cancer society suggests. Probably around a hundred thousand melanomas this year. Um, but they'll probably be close to 10,000 deaths, maybe a little bit less.

Vince

Cause it's very aggressive.

Nick

It's a much more aggressive tumor that tends to spread beyond the local area, metastasized to other areas of the body. Um, so that's the one that's the most deadly of all.

Daniel

So, so for these removals, are you doing it all by hand using. Different tools, machinery, technology. How are you doing? Especially it's not like you said, like on the eyelid and some of these very sensitive areas and small areas. How, how do you, how do you handle those?

Nick

Yeah, it's uh, I think my son's gonna try to put me outta work and try to figure out a robot that's gonna do it all. But we do it all by hand, so, um, Really the instrumentation hasn't come too far along. We use sharp blades and scissors. Um, and most of it's all done by hand. Okay. Same with all the processing behind the scene. It's all done by technicians who are trained to be able to process the tissue. Um, but uh, we use some, you know, cautery machines and some lasers and other things for specialized procedures, but, It's pretty much just fine work. I use surgical loops that I can see fine detail and um, really precisely removed, especially when you get around like the eyelid and things like that.

That's super helpful. But yeah, no like, uh, really special like machines or lasers, like these cool robots that other people are using. But my son Luke's, like during the pandemic, he's like, we just need a robot. You can just do this for home dad. I'm like, yeah, I don't know if that'll work very well.

Daniel

That's interesting. I was, I actually just was watching a video the other day talking about like different, um, you know, scalpel blades, like down to obsidian blades and sapphire blades and things like that. So is that something that comes up for you guys at much at all or

Nick

ours are pretty basic. Stainless steel is what we kind of stick with. They're super sharp and, uh, they work pretty darn

Daniel

Okay. Yeah. Yeah. Cool.

Vince

Well, Nick, I know, uh, your cancer story or stories, but obviously our, our listeners don't. What, uh, based on the, the, the theme of the Summits podcast, what is your story?

Nick

Um, yeah. So, uh, you know, the, my life's been very blessed. Uh, I, um, have had just an incredible childhood raised by two great parents, but unfortunately neither is still with me. Um, I lost my mom when I was 27 years old to lung cancer. Um, and, uh, more recently lost, uh, my dad to, um, To colon cancer. Um, I grew up with grandparents, um, you know, all four of my grandparents, all of them living, you know, on my street. Um, my grandmother lived 105 and another into their nineties and others into their eighties.

So that's kinda what I grew up expecting, so to say, um, that I was, you know, blown away when my mom died in her mid fifties. I would say it'd be an understatement. Um, so, um, cancer definitely hit close to home. Um, and, um, you know, every day I wish I could see my mom, you know, watch my children, you know, grow up and, you know, I know she does from heaven, but, uh, it's not the same to have her here to, um, you know, give advice.

And same with my dad. Um, you know, even though he was in his early seventies, it still just felt too young, um, to lose him. Um, And, um, so many other family friends who've, you know, who've lost a battle of cancer. Definitely mom and dad have definitely nearest to my heart.

Daniel

Yeah.

Vince

Yeah, I know, um, your sister, Heather, and my wife have, uh, have that common bond of losing their moms that are certainly way too early of a, an age. Yes. Um, and they've, I know they've shared many of those stories. Heather was obviously very present when, um, somebody's mom passed away several years ago, and then, Never would've guessed that they would've had a real reversal as early as it did.

Right. Um, and I know they've talked quite a bit, um, about that since, um, yeah. It, it sucks. I mean, I don't know any other way to put it.

Nick

it does. I mean, like I said, it's really blessed to have great parents and it's never long enough whether they're 55 or if they're 95. Um, but um, definitely cancer can take people all too, too soon. And, uh, Really appreciate the work you guys do to try to, you know, allow people to not have that same fate and so they can spend more time with their loved ones for, for years, much longer than they should.

And skin, you know, lung cancer has come a long way since my mom was diagnosed, you know, um, you know, 20 years ago. And same with, uh, even, you know, with things that are happening in colon cancer. So I just hope that people in the future will have more opportunities than what my parents did to enjoy life and, and their families.

Vince

Well said. We appreciate your guys' support. I mean, you guys were there the early beginning days if, if you will, of the Hairless Foundation. So it's certainly been a, a, a huge part of our success. Um, flipping back to, uh, skin cancer a little bit, you know, now that we're in the month of May, which is, uh, skin Cancer Awareness month,

Nick

Right.

Vince

um, what is some of the, uh, I guess, educational tidbits you would provide to folks on ways that can try to prevent themselves from getting skin cancer?

Nick

Yeah, so, uh, that's, it's a great, uh, thing and, you know, um, American County of Dermatology, which I'm a part of, um, has spent a lot of resources to try to educate the public, um, in the United States. We haven't done a great job, you know, with protection of not only, um, ourselves but our children. And we've done a lot of work to try to, um, improve that. Um, you know, it's really simple stuff. And, you know, as we talked about earlier, um, you know, it seems, you know, you know, almost insulting to tell people, but it's as simple as protection.

And then, um, It's screening and it's, you know, it's, uh, monitoring yourself. So, um, the most important is really just protecting your skin from the ultraviolet rays of the sun. So ultraviolet, uh, you know, radiation is probably the number one predictor of, um, the development skin cancer. Um, and so as simple as seeking shade when you're out. Uh, during the heat of the day, particularly between 10 and two, um, is critically important. And then wearing Sun Protective Clothing, um, you know, it's critically important to protect our skin from those damaging rays, and it's the best way to do that is with, uh, clothing. So, um, there's a lot of really good products out there.

A lot of the sporting good school stores, um, sell 'em. You can get 'em on Amazon, you can get 'em, you know, all different outlets on, on the internet. We sell 'em in our retail store at the office. Um, but a lot of that's come a long way. In my own family, we wear sun protective hats. So we recommend hats with, um, you know, four inch brims on 'em to try to protect your ears and your neck. Um, that's super helpful. And of course, sunscreen. I mean, it seems. Facility. Nobody loves to talk about this topic, but we recommend an SPF of 30 or better in a wide spectrum, which means it covers UVA and uvb. Um, and all those things are on the labels. So SPF 30 or greater, um, usually it says broad spectrum or um, UVA and uvb.

Um, and then just using that, I tell people, you know, if you buy it and put it on your shelf, that doesn't help a whole lot, so you gotta really use it right. And you gotta use it, uh, regularly. So if you're gonna be sweating or in and out of the pool, you're gonna re reapply after you dry off. If you're gonna be out for extended periods of time, more than two hours, you wanna gonna want to reapply.

If you're gonna be playing golf for four hours or five hours, depending on how quickly you're playing or how much beer you're drinking, um, then you're gonna wanna reapply it at the turn. So, um,

Vince

if you're gonna Indy 500, you put it on at 8:00 AM Yeah. Apply again at noon.

Nick

Sounds good. Apply

Vince

again maybe at four

Nick

something. Yeah, if you're still out there at four. It's been a long day and a lot of crashes, but, uh, yeah, no, I think that, yeah, that, that's a good idea. You know, just every couple, few hours just keeping it, pulling it out and reapplying because it does not last all day if you're outside. Getting the sun beaten down on you all day does not last. Um, and then using plenty of it, a lot of people, um, just use a little bit of it and we use kind of like a shot glass, um, cuz a lot of adults can, you know, imagine that if you ever have the time and you're putting on some sunscreen, squeeze something into a shot glass, that's what we'd say to recommend that to cover.

And it's a lot. Um, so probably more than what you probably use.

Daniel

Yep, yep. I can, I can agree to that.

Nick

Okay. Okay, so, um, Yeah, so there's a big one. So secreted shade, sunscreen, sun protective clothing and hats. And then protecting your lips is another one that we try to remind. Remind people you can put sunscreen right over your lips, but also people like chapsticks and things like that. Get one with SPF in it. There's a lot of 'em that have it in it now. And then the eyes are the other one. You can get skin cancer in your eyes. So protecting them with, um, good, uh, sunglasses can be super helpful, especially if you're out the race or other things. And the last thing I've warn people about is that, um, Even if you're in the shade, sun reflects.

So if you're on the beach or if you're next to a pool, you gotta be really careful because a lot of people are like, I had sunscreen on, I was in the shade. They're sitting next to the, you know, the, the pool or on the, on the beach in the sand or the waters reflecting it. And I've seen a lot of people get in trouble, even my own family in that situation.

Vince

Yeah. Or even snow skiing,

Nick

So can Exactly. Thank you. Yes.

Vince

it's cold here. Not, not a big deal. And on a sunny day and they get back and their face is

Daniel

Yep. yeah,

Nick

Yep. We Yep. No, we've all been there. And the other thing is people you know say, well, it was cloudy out and it's like, unfortunately the clouds do not protect you very well, so. Even on a, a sunny or on a cloudy day, my kids, I tell 'em, put their sunscreen like, dad, it's cloudy out. It's a joke around her house. I'm like, it doesn't matter. Like I know dad.

Daniel

Yeah.

Nick

So, uh, just remember, even if it's cloudy out, you know, you still can get a pretty good sunburn.

Vince

Yeah. Um, on, on the self-exam part, or even just, uh, if you're visiting your doctor, um, I, I get a, I get a physical exam. I get executive physical every year. I know that's for whatever reason, that's sadly kind of not the norm. Um, and it's part of that they do like this, um, I don't know what it's called, but basically I, this camera scans and, and finds, you know, freckles or moles or whatever,

Nick

right?

Vince

and it has a, takes a closer look at once to kind of stand out. What do you recommend for those who, you know, either don't see their doctor enough, don't get annual physicals? If they're, especially if they're getting up in, in my age or our age and, and, and older, obviously I'm clearly older than both of you guys. Um, But, but also if, if, if they're not seeing a physician and they just say, Hey, I got this kind of funny looking mole, what should they look for?

And it, what is that trigger point? Say, Hey, may, maybe I should go have a professional look at this.

Nick

Yeah. Um, a great question. So, yeah, no, most of us don't have the privilege of getting, you know, a wall mapping or a some picture done by, you know, uh, somebody regularly. And that's okay cuz there are ways that, you know, we can monitor ourselves or we can have significant others. Help monitor us because backs and, you know, backsides are harder to see and mirrors. Um, so we keep it really simple. So we try to educate all our patients, um, about, uh, kind of warning signs of moles, bad moles. Um, so we use a, just a easy thing to remember a b cde. Okay. I can remember that, right? I mean, we all know her alphabet.

So e a is for asymmetry. So most moles should be symmetric, so you should be able to cut 'em in half, flip 'em on themselves, and they should pretty much look like each other on both sides. B is the border. The border should be regular, so sometimes the borders are a little jagged or irregular. That can be a warning sign for, uh, an atypical mole or melanoma. C is color, so usually they should be kind of one color tan or brown. But if they're tan and brown and dark brown or black, um, that can sometimes be a concerning sign. Then diameter. So usually we use the kind of rule of thumb, the back of a pencil eraser. So, um, if it's much larger, not necessarily a.

Predictor melanoma, but bigger ones oftentimes have a higher risks for being atypical or cancerous. And then ES for evolution are evolving. So something that's changing over time, we usually worry about, um, usually moles. They grow, they stop growing. People can get new moles into their forties and maybe even their fifties, but beyond that, probably not. Um, they probably are getting other benign growth, but not moles that, so new spots at that age. So A, B, C, D, E, asymmetry, border color, diameter evolving are the things that we try to teach our own patients every day when we see 'em in the clinic, especially ones that have lots of moles so they can monitor at home, cuz it's also pa oftentimes patients.

Where there are significant others who are spotting something like that's a new one that's different. That one has these types of features and they oftentimes are part of the same care team that we are to get those things biopsied early for early detection and treatment.

Vince

Yep. All right. Cool. Good to know. Um, if someone notices something like that, Obviously first thing they should do is go have a professional look at it like yourself. What is, what is the process for, for you guys evaluating that? I mean, you're, you're kind of following those same guidelines, but Sure. With a much more professional manner and experience. Um, but then what, what triggers to say, you know what, yeah, this needs to be, this needs to be treated, or I need to remove that, or what have you, I mean, what's the criteria there?

Nick

yeah, so it's, it's not, it's not easy, it's not straightforward. Um, you know, I, I recommend, uh, people see, you know, a team, you know, run by a board certified dermatologist. We, you know, spend our days monitoring patients that have, you know, melanoma cy melanomas or atypical moles and other types of skin cancers. So trying to find a team that's centered around a board certified dermatologist giving your best chance. You know, for, um, monitoring these things, and if you've had a history of these things or your family has, you should see these people probably annually.

But if you've, you know, not seen a dermatologist and you find something that you're concerned about, you know, the first point of care can be your primary care doctor. Many times they can help triage, you know, if you need to see a dermatologist, but most people, you know, um, have access to dermatologists one way or the other. Um, there's free skin cancer screenings throughout the month of May. All over our city, all over our state. You can just Google it, search it up. And you can find free skin cancer screens. Those are mostly colleagues, um, like myself, you know, out there giving peop all patients, whether you have insurance or not access to a screening.

And if you, if they find something concerning, they can get you in touch with people in our community that can help, you know, take the next step. Um, but if, you know, you have insurance and you're able to see a, a, a dermatologist or part of that team, um, The process would be that you'd then have that evaluated by, you know, somebody on our team. And if it requires, uh, further, you know, um, evaluation, you'd be numbed up and the lesion would be biopsy. You'd be sent to a pathologist. We have a board certified dermatologist in our group, Dr. Hyatt, and she would, uh, take a look at the lesion underneath the microscope at that point, and then she can see whether.

The histological pattern is one of melanoma or atypical will requiring additional therapy and what that would be. Or if it's something that actually, you know, it had some weird features, but it actually isn't normal. Um, and depending on what happens there, that will then dictate how that patient's treated.

Vince

Yep. Okay. Perfect. Um, anything we're missing?

Nick

Um, I don't think so. We covered a lot of ground.

Daniel

Um,

Nick

I think, uh, I mean I brought some props, but I don't know how many people watch this in videos and how many people listen to this. Yeah, I know. Um, we could all put on some hats if you want to. Uh, I said

Vince

is that a hair joke?

Nick

Yeah. Well, you don't have any hair to protect the top of your head, even though a hat would help. Um, but, uh, no, I think we covered a lot of ground and, uh, I think, uh, yeah, all the highlights that I wanted to hit.

Vince

Okay, perfect. Well, thank you for coming in.

Daniel

Yeah, thank you.

Vince

that.

Nick

That was my pleasure. Thanks for having me. You're welcome. That was fun.

Vince

And you guys, hey, you heard it from Dr. Countryman. Check out or Google it for screen free skin cancer screenings in the month of May. It's May is Skin Cancer Awareness Month. To check that out. See if you haven't checked yourself. Um, and you might have a suspicious mole or something. Get yourself looked at. Don't wa, don't wait. Thank you all for joining us on this episode of the Summits podcast. We appreciate you guys from listening in from wherever ear podcast or tuning into the Heroes Foundation YouTube channel.

Thank you for doing so. Don't forget absolutely free. Hit that subscription button if you haven't. Until then, don't forget Beat Cancer.