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Alert Number 111
Date: July 27, 2024
The pictures in the attached Medscape review are not for the squeamish. Consider yourself warned.
I get at least a couple of letters each month from CLL patients who also had what they considered to be “nuisance skin problems” of actinic keratosis (AK), basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), only to find out later that these supposedly non-life threatening skin cancers can quickly become very aggressive and very dangerous in immune compromised people. CLL patients are immune compromised, and the problem becomes a lot worse if you have been through chemotherapy with drugs such as fludarabine, prednisone, or even the monoclonal Campath. If you are a CLL patient, fair skinned, middle aged, male, live in a hot and sunny location, go out to play golf / garden with no hat, use short sleeve shirts and no sun protection, if you have been through immune suppressive therapy with drugs such as fludarabine, corticosteroids, Campath, etc. - if any or all of these risk factors apply to you, please take the time to browse through (or better, study) this article. You are more likely to get skin cancer and it may indeed be a lot more aggressive than in normal people. It may even kill you if you ignore it.
The real shame is the “silo mentality” in many of the physicians who take care of us. CLL doctors don’t deal with skin cancer, and dermatologists are not familiar with the immune compromised status of CLL patients. I am personally aware of several patients who slipped through the cracks, CLL patients who died in a matter of months due to suddenly aggressive skin cancer. I am not kidding, folks. It is time your realized you personally have to take charge of your skin cancer risk, make sure your doctors are up to speed on this, and that they provide the care you need. As you read this Medscape review, bear in mind most of the statistics are referring to “normal” people - your risk as an immune compromised CLL patient is a lot worse.
By all means print out this Medscape review, as well as the several articles on skin cancer on our website. Use these as ammunition to convince your oncologist to take your skin cancer concerns seriously. Write to us if you wish to locate the full texts of any of the literature articles we reviewed. Here are a couple of links to get you started.
Dying to Get a Tan?;
Mayo Best Practices.
We now have about 1,000 members getting these Topics Alerts. I am willing to bet most of you have at least a few of the risk factors listed above. A shockingly large percentage of you will develop BCC, SCC or AK at some point in your lives, as you continue your fight against CLL. Without prompt and appropriate medical attention to the skin cancer issues, it will not be a happy story for you. Sorry to be a bore about this, but if even a fraction of you read and act upon this information, this Alert will have saved many people from an untimely death due to skin cancer complications.
We had a saying in India, “Only mad dogs and Englishmen go out unprotected into the noonday sun”.
Please don’t be a mad dog.
Chaya
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Editor's Note: Please note that the attached files are fairly large and may take a few minutes to download to your browser or pdf viewer.
Online Medscape Review: Epidemic of Nonmelanoma Skin Cancers: Prevention, Diagnosis and Treatment
Printable PDF Version: Epidemic of Nonmelanoma Skin Cancers: Prevention, Diagnosis and Treatment
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NOTICE: This page from the Topics Alert archive was originally emailed to subscribers of Topics Alert, a free service of CLL Topics Inc. If you are not a subscriber and you wish to receive email Alerts, please register at the Topics Alert subscription page. The content of this page is intended for information only and it is NOT meant to be medical advice. Please be sure to consult and follow the advice of your doctors on all medical matters.
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