Advanced Skin Care and Cancer Detection with Dr. Tyler Long

Advanced Skin Care and Cancer Detection with Dr. Tyler Long

In this episode of Open Forum in The Villages, Florida, host Mike Roth interviews Dr. Tyler Long, a board-certified dermatologist and founder of Spot Doc. Dr. Long discusses the importance of advanced skin cancer detection methods available at Spot Doc, particularly for the senior population in The Villages, Florida. He highlights the use of the Vectra WB 360, a high-tech imaging system that assists in early diagnosis and reduces unnecessary biopsies. Topics include the importance of sunscreen, UV protection, skin cancer risk factors, and a detailed explanation of the Vectra WB 360's capabilities. Additionally, Dr. Long provides practical advice for sun protection and explains various skin cancer treatments available at Spot Doc.

00:00 Introduction to Open Forum in The Villages

00:35 Meet Dr. Tyler Long: Dermatology and Skin Cancer

01:19 Understanding Skin Cancer Risks in The Villages

03:29 Effective Sun Protection Strategies

08:33 Alzheimer's Insights with Dr. Craig Curtis

09:46 Advanced Skin Imaging with Vectra WB 360

28:25 Conclusion and Supporter Shoutouts

Transcript

 Advanced Skin Care and Cancer Detection with Dr. Tyler Long

[00:00:00] Dolores: Welcome to Season seven of Open Forum in The Villages of Florida. In this show, we talk to leaders of clubs and interesting folks who live in and around The Villages. We also talk to people who have information vital to seniors. You will get perspectives of what is happening in The Villages, Florida area.

We are a listener supported podcast. There will be shoutouts for supporters.

[00:00:32] Mike Roth: This is Mike Roth on Open Forum in The Villages, Florida.

I'm here today with Dr. Tyler Long.

[00:00:37] Dr. Tyler Long: Mike, thanks for having me. 

[00:00:38] Mike Roth: Lemme tell our audience a little bit about you, Tyler is a board certified dermatologist and mole surgeon, and he founded Spot Doc in The Villages to bring advanced cancer detection to the community using tools like the Vectra WB 360, a full body image system. Dr. Tyler focuses on early diagnosis and therefore has fewer unnecessary biopsies and personalized care. Dr. Long believes every patient deserves clarity, confidence, and the most advanced technology available for use in their skin health. Why is skin cancer a high risk here in The Villages?

[00:01:24] Dr. Tyler Long: That's a great question, Mike. I think skin cancer is an important topic in the community, simply because the community loves to be outside. They tend to be over the age of 55, and have a lighter skin tone than the normal population. Those three factors are giant risk factors for skin cancer.

[00:01:44] Mike Roth: People of my generation.

Grew up and there was no such thing as a SPF 50 suntan lotion. Did

that dramatically increase our risk of developing a skin cancer condition? 

[00:01:56] Dr. Tyler Long: I hear a lot of patients tell me about how, they've never used sunscreen before when they're younger. Or maybe they like to use iodine, baby oil.

Sitting outdoors for as long as they can. I hear some stories about patients that, their parents told them to go play outside until they got a sunburn, and then that would be their kind of initiation into summer. But we found that those kinds of sunburns are actually a lot more problematic than we thought.

[00:02:23] Mike Roth: What do residents here in The Villages need to know who've moved down to Florida

from the northern climates? 

[00:02:31] Dr. Tyler Long: I think people that are moving down here, they've had vacations in Florida and understand the strength of the sun. 

you get closer to the equator, it's definitely a different type of UV damage or UV power, compared to northern states.

The peak UV here, midday tends to be an 11 or 12, where northern states they would never get above a nine. 

[00:02:52] Mike Roth: What is it that residents here in The Villages may be overlooking relative to skin cancer? 

[00:02:58] Dr. Tyler Long: Residents are overlooking the power of the sun, and

[00:03:02] Mike Roth: I think

[00:03:03] Dr. Tyler Long: I think they're underestimating how effective treatments can be, if we start now, we can still stop the progression of forming new skin cancer.

Any amount of UV block we can use is helpful for reducing the amount of mutations in the skin that lead to skin cancer. people do lose a little bit of hope thinking all the damage has been done but that's, not the case.

[00:03:27] Mike Roth: Let's talk for a moment about.

What sun blocking agents, people should use what are the best ones? 

[00:03:34] Dr. Tyler Long: That's a great question, Mike, because I had a patient earlier today ask me, what is the best spray on sunscreen? And I asked him, what's the best car? obviously that got a good laugh, but in reality, there is no perfect sunscreen. We're all really weighing the pros and cons of that certain sunscreen. But in general, the guidelines that I recommend for people picking a sunscreen is it has to have a minimum SPF, of 30. Realistically it is 15, but.

Patients and people tend to not put on enough to actually get that level of sunscreen. They put on a lot less than what's used in actual research. So I find that 30 is a good medium to get you to the minimum of at least 15. 

[00:04:13] Mike Roth: I heard there was no such thing as a sunscreen 50, and that's a made up number by the manufacturers? 

[00:04:20] Dr. Tyler Long: In general, the amount of sun protection you get from an SPF 30 to a 50 is very minute. for example, a sunscreen of SPF 30 means you can stay out in the sun twice as long without getting a sunburn. SPF 15, can block out 92% of UV radiation.

At SPF 30, that's 95% SPF 50 98% and SPF 70, 98, 9% you really start getting

Diminishing returns when you increase your SPF. SPF 15 can offer a lot of sun protection, but unfortunately people don't put it on as well as they should.

you asked which sunscreens would be the best on top of SPF? I think getting something that has a water protection rating is essential. That comes in 40 minutes to 80 minutes. 80 minutes is the maximum you can do. So I do recommend getting something that has an 80 minute water resistance.

And then lastly, something that you enjoy putting on people overlook that. I think it's important to get a sunscreen. That doesn't bother you. If it does bother you, you're not gonna use it. So really we have to weigh all of those different features of a sunscreen.

In general, I tell people we want to prioritize a mineral based sunscreen versus a chemical based sunscreen. A mineral based sunscreen either uses titanium or zinc.

The unfortunate side effect of titanium or zinc is it goes on extremely white, so you end up getting A pasty white appearance.

[00:05:48] Mike Roth: It Doesn't Stay white. I

 put a lot of Rub it down.

[00:05:52] Dr. Tyler Long: Yes. If you rub it in, it can decrease, but you do end up looking a little bit more white. And that white overcast people just tend to not like very much. There are nano types of sunscreen where the mineral is. broken down to the smallest molecule that they can continue to do while having some UV benefit.

A good brand for that one would be ELTA MD uses a nanoparticle. Those do rub in better, but I do like the mineral because of the broad spectrum that it provides. So SPF is actually rated for UVB. 

But there's also UVA and UVA is not something that's considered whenever we're doing SPF testing.

So UVB is what burns you. UVA is what is out at all times during the day. So from sunrise to sunset, the UVA radiation is the same. UVB peaks during peak hours, like 11 to three. But UVA still carries the possibility of causing mutations in the skin. 

[00:06:51] Mike Roth: Can we get sunburned or have skin damage from. the sun on a cloudy day?

[00:06:57] Dr. Tyler Long: Yes, you can. So even though it seems like it's overcast or a little bit more dim out. The high powered UV rays, in the light spectrum. are still present. it's essentially light, but more powerful than light, and we can't see it. That light is not stopped by the clouds. So even though we're getting less visible light, the UV light that's coming through. Is just the same 

[00:07:20] Mike Roth: Now, is there such a thing as a spray on mineral based suntan lotion? 

[00:07:25] Dr. Tyler Long: Yes, there is a spray on sunblock and the word sunblock has gone out of favor 'cause it doesn't block the sun.

Sunscreen is what we like to actually call it. There are spray on mineral base on screens. My favorite is "COOLA". 

[00:07:39] Mike Roth: So how would you spell this? C or K? 

[00:07:41] Dr. Tyler Long: C-O-O-L-A. 

[00:07:43] Mike Roth: "COOLA", yes, 

[00:07:44] Dr. Tyler Long: They have a spray on mineral based, but it doesn't eliminate the factor of, you still have to rub it in to really make sure that you're not looking pasty white.

when I say mineral based, those are the preferred types of sunscreens, the organic type, or we call chemical sunscreen. Those benzones, they've gotten a lot of bad rap in the scientific community because with those bin zones you end up getting contaminated with benzene. Benzene can be absorbed through the skin and possibly cause hormonal changes.

And it's quite clear that those sunscreens cause damage to the coral reefs. So those types of bin zones are actually outlawed in places like Hawaii.

[00:08:27] Mike Roth: I noticed that. They were very particular about what sunscreen you put on. 

[00:08:30] Dr. Tyler Long: Exactly. mineral kind of eliminates all of those factors.

[00:08:33] Mike Roth: And now we'll listen to Dr. Craig Curtis talk about Alzheimer's disease.

[00:08:38] Dr. Craig Clurtis: Amyloid is the spark, and tau is the fire. We have this spark barking for 20 years without symptoms. Once the spark causes the fire, the breakdown of tau inside the cell, we start to see symptoms. We are actively researching ways to stop tau as well. Is it possible to regrow new brain cells to replace the ones the tower was killed?

That's a hot topic. Scientists for the most part, do not believe that we can regenerate any brain cells. There have been a few research papers published in the last four or five years that hint that there might be some brain cell regeneration specifically in a part of the brain called the hippocampus.

Which ironically is where Alzheimer's disease starts, but it's really hard to prove that in humans.

[00:09:28]  Warren: With over 20 years of experience studying brain health, Dr. Curtis's goal is to educate the village's community on how to live a longer, healthier life. To learn more, visit his website, craigcurtismd.com, or call 3 5 2 5 0 0 5 2 5 2 to attend a free seminar.

[00:09:44] Mike Roth: Thank you, Dr. Curtis. Now Dr. Long why don't you tell our listeners about this new machine you have the Vectra WB 360.

[00:09:52] Dr. Tyler Long: The WB 360 is a machine built by Canfield. It's a medical imaging company, and essentially they've put. 46 stereo vision pods on two clam shells About the size of this room we're standing in.

[00:10:07] Mike Roth: A 10 by 10 area. 

[00:10:09] Dr. Tyler Long: It requires a 10 by 10 area. 

[00:10:11] Mike Roth: And the machine is open so people can walk into it.

Exactly. But it's like a much bigger. than an airport body scanner. 

[00:10:22] Dr. Tyler Long: Yes, exactly. A lot of people walk into the room and think, oh, this looks exactly like what they have in the airport. And it's really just as quick, just as easy and much more thorough in the idea that we're capturing the whole skin surface instead of just checking for, what have you.

[00:10:37] Mike Roth: So one side of the clamshell takes the front half of a person's body. And the other the back. Exactly. So you have a 360 degree angle? 

[00:10:47] Dr. Tyler Long: On

[00:10:47] Mike Roth: On the human being for every inch of skin on their body.there are approximately 19 million skin cells. 

[00:10:53] Dr. Tyler Long: Yes. All visible skin. Absolutely. So the patient stands into the machine and they assume a position elbows up hands by your waist, once you're ready, the technician will take the photo 

46 camera pods go off, and that captures over a hundred pictures, polarized and non-polarized. the AI will help develop an entire 3D image of your entire skin surface. 

[00:11:16] Mike Roth: Talk about that Polarized. What does that mean?

,

[00:11:19] Dr. Tyler Long: So in order to get a good idea of what. patterns are happening on the skin. We need to have polarized and non-polarized light. our skin is built to reflect light.

to look at certain spots and capture the correct amount of detail, we need to use non-polarized light. there is also a benefit of non-polarized light. Which can help us determine surface structures, a three dimensionality of the surface. we take both types of pictures to give us a full idea of what's happening on the skin.

[00:11:47] Mike Roth: So you can see a mole that's extending beyond the surface of the skin. Exactly. And you can actually measure that in the machine. Exactly. Good. So when did you actually.

get the machine started here in The Villages area, 

[00:12:02] Dr. Tyler Long: We opened back in August. We've been open for, about three and a half months.

[00:12:06] Mike Roth: are there advantages to the patient

by being scanned in this machine? 

[00:12:11] Dr. Tyler Long: Oh, absolutely. 

[00:12:12] Mike Roth: As opposed to going to a dermatologist who does a full body scan once a year. That's been the standard for years. 

[00:12:18] Dr. Tyler Long: Yes, it's been the standard for a hundred years, ever since dermatology started, that's how it was done.

But as technology has advanced, we've developed new techniques and new workflows for patients that have high risk areas. Dr. Allen Halpern who I'm in as a partner with in Spot Doc. At Memorial Sloan Kettering, has been capturing images of patients

like that.

[00:12:40] Mike Roth: And the patient comes back every year for a full scan. 

[00:12:44] Dr. Tyler Long: Yes. Alan Halper ever since we could take good quality photos of the skin, has been using photos to track spots. So that's where it all began.

The idea of tracking spots over time, because we've discovered that when spots are evolving or changing, that can be a concerning sign for skin cancer. Because when things aren't changing, it can't be cancer. 'cause cancer requires change. So taking these photos was the first step in providing a more thorough skin examination. 

[00:13:14] Mike Roth: So in your situation with this machine,

the patient steps into the machine every year on the same two spots.

And the cameras are in the same spots? Yes. So the photographs

are comparable year for changes in any abnormalities in the skin. 

[00:13:32] Dr. Tyler Long: whenever someone gets a repeat scan, we can look at every single spot that was on their skin We can tell exactly how they've changed. we use a little bit of machine learning and technology to help. Our human eyes digest how it's changed by overlaying heat maps and different types of diagnostic imaging to help us understand how it's changed and to what degree it's changed.

[00:13:55] Mike Roth: You're taking a very large surface of skin. Does the machine tell you when you're looking at a second picture a year later?

Which areas have changed? 

[00:14:04] Dr. Tyler Long: So the initial photo will track each spot. and create a file for each one. some patients have up to 4,000 spots that we are tracking in a single person.

Each spot becomes its own file. over time we can compare each of those spots when they come in next time, we'll still be able to see all 4,000 spots. And tell which are new. each spot has a little arrow next to it that indicates it.

When they get a repeat, a new arrow is green. this spot is actually new. This wasn't there last time. that can help remove some of the noise in a person that has 4,000 spots or a bunch of freckles It's really difficult to tell which spots are new, even just putting a photograph side by side and looking at it, the AI and machine learning will help us say, this one little spot is new, so it'll help flag those spots. we are, ensuring that we're not missing anything new or changing. 

[00:14:54] Mike Roth: I understand AI or lot of it. But you said machine learning.

What is the machine learning? 

[00:15:00] Dr. Tyler Long: as a talk about artificial intelligence there's layers of artificial intelligence. Machine learning is simply a rudimentary type of AI. AI is very broad. It could mean, chat GPT or your Amazon searching 

[00:15:14] Mike Roth: I think many of our listeners may have heard about.

AI being able to detect breast cancer better than

pathologists when they look at mammograms. 

Is this an extension of that for the whole body? 

[00:15:26] Dr. Tyler Long: The image-based processing is. Still in its early stages, and we don't know why things can have higher probabilities or how things are determined to be concerning.

We don't know exactly what the AI or machine learning is actually thinking. There's a lot of research on explained AI where we can relate it to a level of understanding that we perceive For example. There's been some image-based AI where you can take a picture of an object and it can guess that object really well.

We don't know why I picked that object. Sometimes it can be related to the actual carpet that the object is on. It's not seeing the object, it's just saying that, oh, I've seen a lot of pictures like this that also have this type of carpet related to this type of chair. So I think there's a gap that we have to figure out with ai, but explaining it and getting an explained AI model is gonna be something that we're actually working on.

[00:16:19] Mike Roth: Models tend to get better over time. Many people here in The Villages have had multiple biopsies over the years. For you at Spot Doc using this Vector, machine, 

be able to reduce the number of unnecessary biopsies? 

[00:16:34] Dr. Tyler Long: Okay. As our data shows Absolutely. the research also supports that notion.

For example, most research shows that the average amount of benign biopsies someone needs in order to find the melanoma. Is near 25 benign biopsies to find one melanoma. So with those odds, we're doing a lot of unnecessary procedures. 

anecdotally, from patients I speak to in the community, there are some offices that may be doing a lot of biopsies where every time you go in, you are generally expected to get a biopsy.

From our standpoint. Things really need to be quite obvious for me to do a biopsy. And those situations do occur. Non-melanoma, skin cancer, such as squamous cell carcinoma or basal cell carcinoma, are grouped as non-melanoma skin cancer.

And then the third, a big player in skin cancer is melanoma,

[00:17:26] Mike Roth: And that's the dangerous one 

[00:17:27] Dr. Tyler Long: that out of those three, that is the most dangerous. for melanoma, it's very hard to diagnose because it's a small brown spot. People tend to not have a lot of big scaly spots that aren't healing.

Our skin does a pretty good job at healing. So whenever we notice a spot that's not healing or is bleeding often, or is red and has specific features under endoscopy, that little magnifying glass that dermatologists like to use, those features are fairly easy to see in comparison to a very benign appearing brown spot that's just been slowly changing over time, which ends up being a melanoma.

[00:17:59] Mike Roth: using the Vectra machine will that cause more unnecessary biopsies? 

[00:18:07] Dr. Tyler Long: So a lot of people think that, yes, if we're increasing the amount of screening that we're doing, if we're being more thorough, they logically put that together with, oh, we're gonna need to test a lot more things.

But it's actually the opposite. So for indeterminate spots or spots that I'm just not quite sure on.

[00:18:24] Mike Roth: on,

[00:18:25] Dr. Tyler Long: Or spots that look maybe concerning at one point in time, but I have a sneaky suspicion that maybe it's just an inflammatory bump. Those spots I'll actually just recheck in a short amount of time to make sure that it's either healed or not changing.

So I actually favor doing more of a watchful waiting. 

[00:18:41] Mike Roth: Now for people who are listening right now and who have never

heard

of or seen a Vectra scan. What can they expect in their first visit? 

[00:18:50] Dr. Tyler Long: During the first visit, I generally prefer to get the full body scan.

I've had some people come in that elect not to do it, and that's perfectly acceptable and understandable. But most new patients will come in and get a full scan. After checking in, they'll come into the office. We get them into a gown, and then they step into the machine. At a comfort level, they are okay with whether it be having your underwear on or being completely nude, we're okay with both.

As long as you understand things that are covered can't be tracked unless we add them after the fact. once you step into the machine. You assume the pose, and that takes about one to two seconds. All the cameras flash, you step out, put your gown on, and we put you into a room. while you're in that room, speaking with the medical assistant, getting all your history or any problem areas, I review the results of that image.

when I look through that image, I'll filter out all of the noise so I can look at the most clinically typical spots in relation to all of your spots. 

[00:19:50] Mike Roth: So how long does it take after someone's. Come out of the machine, they've taken the picture for the machine to give you its output so that you can look at it.

[00:19:59] Dr. Tyler Long: Four minutes, 

[00:20:00] Mike Roth: Takes about four minutes. That's not bad at all. how often

should people be coming back for additional monitoring? 

[00:20:07] Dr. Tyler Long: It all depends on what we find in the exam. in general, I will capture about five to ten close-up images of the most atypical spots in a person.

Whether they're benign or

I can take a look at them from across the room and tell that they're just benign brown spots

Such as 

IC keratosis, one of those wisdom spots we call. it. I'll still take a picture of it if it's the most concerning spot relative to their model.

[00:20:31] Mike Roth: You take an extra picture. 

[00:20:33] Dr. Tyler Long: Yes. after I look at the 3D image, I'll flag the most atypical spots. when I am in the room reviewing the results, I'll do closeup images on the spots that I thought were the most concerning on that person.

[00:20:43] Mike Roth: So What about the spots that the machine can't scan

if we're standing in the machine?

What about the bottoms of the feet, which obviously can't be photographed 

[00:20:50] Dr. Tyler Long: So the big problem areas in relation to capturing images are gonna be in the groin. In the armpits, bottoms of the feet and in the hair on the scalp. Hands tend to be in areas as well that don't have as much granularity.

So those are all areas that I just add on to the full exam that I give you after the image. 

[00:21:08] Mike Roth: Okay. So there's some add-ons

for areas that don't get photographed? 

[00:21:13] Dr. Tyler Long: Yeah. 

[00:21:14] Mike Roth: Based on where you were standing. Okay. Now. For our listeners here in The Villages who are exposed to sun on a daily basis.

Yeah. Just walking out to get your newspaper. One of the simple things that they can do to protect themselves? Sure.

[00:21:28] Dr. Tyler Long: So I call this the hierarchy of sun protection. the hierarchy of sun protection at the minimum level, the foundation of reducing skin, cancer risk, and sun damage is unfortunately avoidance. I'm not gonna harp on that one because I know The Villages here definitely enjoy being outdoors and I'm not gonna tell you to not be outdoors.

[00:21:47] Mike Roth: You can't, convince people to play. Pickleball. 

[00:21:49] Dr. Tyler Long: That's the next level is covering up. So using UPF rated clothing, maybe A PFG. There are other brands that provide long sleeve Those actually have a UPF rating similar to an SPF rating. if you take off your shirt and pull it apart and see through it light's getting through that. these types of UPF rated clothing will 

provide the same level of benefit as being not in the sun. next to UPF rated clothing, I'd recommend using shade whenever you can.

The same concept of staying out of the direct sunlight. if you can't stay out of the direct sunlight and if you can't cover up, avoid peak hours. So 11 to three. I would make sure to do an early tee time or a later tee time during the summer. Definitely has the dual benefit of avoiding most of the heat for the day.

But if you can't do any of those, then cover up with sunscreen. Sunscreen is a last ditch effort for me. in areas that you can't cover up, sunscreen is a great option, but I wouldn't rely on it entirely. It does have its limitations. It does wear off over time. reapplying is important, especially if you're outdoors for a long period of time.

[00:22:53] Mike Roth: So our players of water volleyball. 

[00:22:56] Dr. Tyler Long: So I have a few players that have already been on top of it, wearing UPF, rated clothing to help reduce their sun. Exposure reapplying sunscreen on the back of the neck, ears, hands, and any exposed areas.is also important.

[00:23:11] Mike Roth: What about eyelids? 

[00:23:12] Dr. Tyler Long: Eyelids are important. 

[00:23:14] Mike Roth: Should people put suntan lotion on their eyelids? 

[00:23:17] Dr. Tyler Long: You can. It is problematic because it will run, it can get in your eyes. The benefit is that the eyelids tend to be less affected than the ears and the forehead and the nose, it's a weighing of benefits to applying to the eyelids.

Generally, I'd recommend just wearing it 

[00:23:32] Mike Roth: do you see a difference between a spray on sunscreen and a tube of liquid? 

[00:23:38] Dr. Tyler Long: Yeah.

[00:23:39] Mike Roth: Yeah.

[00:23:39] Dr. Tyler Long: One's a lot easier to put on.

[00:23:41] Mike Roth: Which ones work better? That's my question. 

[00:23:43] Dr. Tyler Long: The spray on sunscreen is a lot easier to use.

You do end up having to rub it in. and it's a lot easier to put on the recommended amount to reach that, research level SPF rating versus lotion, 

So I do prefer spray on. On the face. I do not just 'cause the aerosols tend to be problematic around the eyes and the nose, so I do prefer to do a lotion for the face. 

[00:24:08] Mike Roth: Interesting. 

Now if someone wants to find you to find out more about the vector scanning System. How do they do that? 

[00:24:18] Dr. Tyler Long: We have a lot of options to come into the office.

We are a new office, so we are accepting new patients and we have availability pretty much any time of the week. we have an online website that you can go on and actually schedule your own appointment. You can book directly from Google and you can even call us Walk in.

[00:24:36] Mike Roth: What is Zocdoc? 

[00:24:36] Dr. Tyler Long: Zocdoc is a platform for local providers, so essentially all the local doctors create a profile on Zocdoc, Z-O-C-D-O-C, they create a profile, upload their schedule, and you can book directly through Zocdoc, you can filter for all the providers in the area based on your insurance or services they provide.

it's an easier way for patients to find and compare doctors. 

[00:25:00] Mike Roth: I've never seen that. 

[00:25:01] Dr. Tyler Long: Yeah. It's actually very popular here in The Villages.

[00:25:04] Mike Roth: What are the extra services that you're providing besides the skin cancer screenings? 

[00:25:10] Dr. Tyler Long: As a skin cancer company, we prioritize finding and treating skin cancer. we want to stay in that lane and provide every service to treat any skin cancer we encounter. that includes treatments such as photodynamic therapy.

[00:25:23] Mike Roth: Big words. 

[00:25:25] Dr. Tyler Long: Photodynamic therapy. We call it PDT for short. So essentially what that is, is a treatment where you come into the office, we apply a photosensitizer, a light activated medication onto the face scalp or ears. We let you sit underneath a special light for about 15 minutes, and that'll cause all the skin cells that have mutations To kill themselves. it's a way for us to do a field treatment to reduce the downstream possibility of skin cancer it's a quick and easy way for us to treat actinic keratosis, those common types of precancerous cells. essentially those little red scaly spots on the face. are a sign of sun damage. We do something called electrodesiccation and curettage, or EDC we diagnose the skin cancer, numb it shave it off, burn the area and keep doing that until we reach normal skin.

skin cancer cells don't adhere to skin very well, so they peel off normal skin. . This method allows us to remove possible skin cancer by scraping off the top layer of skin cells and letting it heal 

And then we do things like excisions. That means that once we get a cancer diagnosis, cut out that skin to make sure we caught it all.

 [00:26:38] Mike Roth: Send those to a lab. 

[00:26:40] Dr. Tyler Long: Correct. Those labs will give us a result saying whether or not that skin cancer went to the margin. So we'll take a little bit of margin of normal skin just to make sure that we get it all. And then that's just based off research Some skin cancers need a four millimeter margin.

Melanomas sometimes need a one centimeter margin, so almost, three quarters of an inch margin of normal skin. So sometimes these little skin cancers can actually turn into pretty large. Areas of skin being removed. Just to make sure we get it all.

[00:27:09] Mike Roth: What is your opinion about using radiation for skin cancer?

[00:27:14] Dr. Tyler Long: I do think radiation is a really good option for skin cancer, but I do not think it's the best. radiation is great because it has the ability to avoid cutting into the skin. But the cure rate is lower than doing a standard type of skin surgery.

So while the cure rate is acceptable, it is not the best, 

[00:27:33] Mike Roth: what percentage are you talking about?

[00:27:35] Dr. Tyler Long: Radiation, can have a cure rate from 90 to 95% while surgery, for a basal cell has a 99% success rate. Radiation is great for select patients in select areas. if you have skin cancer on your back, it makes more sense to just cut it out, have a higher cure rate, and then call it a day.

' because there's a lot of skin on the back. If you have a spot on the eyelid or on the ear where you don't have much skin to repair the area, radiation may be a good option. 

[00:28:03] Mike Roth: Good. why don't you give our listeners a phone number where they can reach you

And your website.

[00:28:08] Dr. Tyler Long: Absolutely. if you wanted to call our office, it is (352) 914-3451, and our website is www.spotdoc.com. 

[00:28:20] Tyler 2: That's S-P-O-T-D-O C.com

[00:28:23] Mike Roth: Great. Thanks a lot, Dr. Long. 

You're welcome. 

[00:28:25] Dolores: Remember, our next episode will be released next Friday at 9:00 AM. Should you wanna become a major supporter of the show or have questions, please contact us at mike@rothvoice.com. This is a shout out for supporters, Tweet Coleman, Ed Williams, Duane Roemmich, Paul Sorgen, and Dr. Craig Curtis at K two in The Villages.

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