Wednesday, November 22, 2017

Skin Cancers Rise, Along With Questionable Treatments - The New York Times

John Dalman had been in the waiting room at a Loxahatchee, Fla., dermatology clinic for less than 15 minutes when he turned to his wife and told her they needed to leave. Now.

"It was like a fight or flight impulse," he said.

His face numbed for skin-cancer surgery, Mr. Dalman, 69, sat surrounded by a half-dozen other patients with bandages on their faces, scalps, necks, arms and legs. At a previous visit, a young physician assistant had taken 10 skin biopsies, which showed slow growing, nonlethal cancerous lesions. Expecting to have the lesions simply scraped off at the next visit, he had instead been told he needed surgery on many of them, as well as a full course of radiation lasting many weeks.

The once sleepy field of dermatology is bustling these days, as baby boomers, who spent their youth largely unaware of the sun's risk, hit old age. The number of skin cancer diagnoses in people over 65, along with corresponding biopsies and treatment, is soaring. But some in the specialty, as well as other medical experts, are beginning to question the necessity of aggressive screening and treatment, especially in frail, elderly patients, given that the majority of skin cancers are unlikely to be fatal.

"You can always do things," said Dr. Charles A. Crecelius, a St. Louis geriatrician who has studied care of medically complex seniors. "But just because you can do it, does that mean you should do it?"

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https://www.nytimes.com/2017/11/20/health/dermatology-skin-cancer.html?