WEBVTT FILE

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For three decades, Ray
Parish has been an avid

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cyclist.

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 "I ride about four to five times a week, and I

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 average roughly 150 miles a week.

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 Sometimes when I'm feeling really energetic, I can

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 get into 250 miles a week."

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That adds up to lots
of time outdoors.

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So, when a fellow
cyclist and dermatologist

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suggested Ray start
getting routine skin

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checks, he agreed.

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 "There was one thing on the side of my neck that

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 she had taken pictures of and measured.

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 She took one look at it and she says, We're going

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 to biopsy it."

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A Biopsy, a test in
which a sample of skin is

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removed and analyzed under
a microscope, showed it

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was skin cancer.

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Skin cancer often forms in
areas exposed to sunlight

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but can occur
anywhere on the body.

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It begins in the
epidermis, the outer layer

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of the skin.

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There are several
different types of Skin

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cancer.

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Cancer that forms in the
cells in the top layer of

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the epidermis is called
Squamous Cell Carcinoma.

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Cancer that forms in
the lower part of the

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epidermis is known as
basal cell carcinoma.

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These two types are
sometimes called

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Nonmelanoma skin cancers.

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They're typically curable,
with treatment depending

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on the size, location
and type of cancer.

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Treatment methods include:
Electrodessication and

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Curettage, or ED&C for
short, which involves

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removing the surface of
the cancer with a scraping

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instrument, and then
applying an electric

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needle to the base
of the cancer.

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Cryotherapy,  in which
the growth is frozen with

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liquid nitrogen.

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Topical creams and
ointments applied to the

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skin, Laser therapy, which
uses an intense beam of

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light and Photodynamic
Therapy, which combines

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topical drugs with light.

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Or doctors may use a
procedure called an

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Excision, in which the
skin is numbed, and the

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cancer surgically removed
along with some healthy

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skin around it.

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A more precise type of
surgery, known as Mohs

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surgery, involves removing
layers of tissue one by

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one and examining them
under a microscope.

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This allows the doctor to
remove all the cancer, and

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as little healthy
tissue as possible.

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 "Mohs micrographic surgery has the highest cure rate

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 for skin cancer."

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Melanoma is a less common
but more serious type of

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skin cancer.

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It forms in Melanocytes,
the cells that give skin

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its color.

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 "If you can get a melanoma early when it's shallow,

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 you really are going to have a great prognosis.

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 But if it's ignored or not recognized, it can spread

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 to your lymph nodes, and metastasize throughout

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 your body."

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Doctors assign melanoma
a stage based on three

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pieces of information: T
stands for the tumor...

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its location, size,  and
how much it has grown.

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N refers to whether it
has spread to nearby lymph

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nodes.

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And M indicates whether
the Melanoma has

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metastasized or spread to
other parts of the body.

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For each of these
categories, doctors give a

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number ranging
from 0 to 4.

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The higher the number, the
more advanced the cancer

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is.

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 "If you catch the melanoma early and it's just a T1,

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 N0, M0, meaning no nodes, no metastasis, then

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 surgery usually is enough to take care of it."

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That was the case for Ray.

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His melanoma was detected
early, and his doctor

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treated it successfully
with surgery.

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 "He said the prognosis was good."

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When cancer has spread to
the lymph nodes, doctors

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typically remove them
as well as the tumor.

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Other treatments may be
used along with surgery or

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by themselves if the
cancer can't be removed

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surgically.

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These include:
Immunotherapy, which uses

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the body's immune system
to fight the cancer;

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Targeted therapy, which
targets substances that

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help cancer cells grow and
spread; Radiation, which

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uses high-energy x-rays to
destroy cancer cells; And

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chemotherapy, which kills
cancer cells throughout

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the body.

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 "All right, now I'm feeling your skin."

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Once you've had skin
cancer, it may come back

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after treatment and you're
at increased risk of

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additional skin cancers,
so follow-up visits with

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your doctor are crucial.

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It's also important to
perform self-exams at

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home.

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 "You shouldn't be embarrassed to show your

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 dermatologist anything.

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 It's important that you do."

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Having melanoma hasn't
stopped Ray from enjoying

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his favorite
outdoor activities.

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But he's now careful
to protect his skin.

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 "Instead of wearing shorts when I go fishing, I'll

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 wear a long sleeve shirt.

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 I will use a sun screen.

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 And a hat.

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 It's your life you're playing with."