DEAR DR. ROACH: I am fair-skinned and have had sunburns in the past, so I have been diligent about looking for rough, scaly skin patches that might turn into cancer and dark irregular patches that might be melanoma. But I had not read anything about watching for a pore that bleeds, heals and bleeds again. I have a place like that on my nose and just thought it was thin skin. There was no bump, no redness, no scaling; just occasional bleeding. Then it would heal and everything seemed fine.
Now I find out from my dermatologist that it is basal skin cancer, it grows down into the skin, and I will have to have Mohs surgery to remove the cancer and plastic surgery to repair it. I want everyone to know to watch for this kind of symptom and get to a doctor immediately if they have it. — W.R.
ANSWER: A basal cell carcinoma is a skin cancer, probably the most common cancer in the U.S., and is most common among light-skinned people. It’s unusual in people with very dark skin. It is more common in men, and increases in frequency with age. As you note, sunlight is the major risk factor, although sunburns aren’t necessary to develop BCC. Use of tanning beds also greatly increase the risk for skin cancer, and I strongly discourage their use.
BCCs can appear in several different forms. They often appear as a nodule on the face, with dilated blood vessels that can bleed and ulcerate (causing a shallow pit). On the trunk, they can appear as a superficial red patch. They also can appear as firm, deeper, scar-like lesions.
Because they can appear in such a varied manner, ANY new skin lesion, especially in a light-skinned person with sun exposure, should be evaluated by a professional. Any nonhealing sore or one that periodically bleeds is particularly at risk.
Although BCCs rarely, if ever, spread outside the skin, they can grow locally and be disfiguring. Once one has occurred, additional skin cancers are much more likely, so a periodic total skin exam by a dermatologist is essential.
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DEAR DR. ROACH: I developed a ganglion cyst in the palm of my hand virtually overnight. Where did it come from, and how do I get rid of it? It’s very annoying. — V.L.
ANSWER: A ganglion is a cystic structure that is associated with a tendon sheath or joint. They most commonly occur in the wrist. It’s not clear why they occur: One theory is that they are from the tissue around a joint that makes joint fluid, the synovium.
They often go away by themselves, but a surgeon can remove fluid from them with a syringe, and sometimes inject medication to keep them from recurring. Surgery is occasionally necessary for painful ganglia that keep recurring.
I urge you to resist the advice you will get to whack it with a book (traditionally, a Bible). That can cause many small ones.
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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. To view and order health pamphlets, visit www.rbmamall.com, or write to Good Health, 628 Virginia Drive Orlando, FL 32803.
We’ve put a new spin on three-bean salad. Fresh green beans are tossed with green and black soybeans — delicious, and good for you too.
1 pound green beans, trimmed and cut into 1 1/2-inch lengths
1/2 (16-ounce) bag (1 1/2 cups) frozen shelled green soybeans (edamame)*
3 tablespoons extra-virgin olive oil
1/4 cup balsamic vinegar
1/4 cup red wine vinegar
1 tablespoon sugar
1 1/2 teaspoons salt
1/4 teaspoon ground black pepper
1 can (15 ounces) black soybeans, rinsed and drained
1 can (15 ounces) pink beans, rinsed and drained
1 small red onion, finely chopped (1/2 cup)
1. In a 12-inch skillet, heat 1/2-inch water to boiling over high heat. Add green beans and cook 5 minutes or until tender-crisp. Place frozen soybeans in colander; drain green beans over soybeans. Rinse with cold water until cool; drain well.
2. In a large bowl, with wire whisk, mix oil, vinegars, sugar, salt and pepper until blended. Add green-bean mixture, black soybeans, pink beans and onion; toss to combine. Let stand 1 hour to allow flavors to blend, or refrigerate until ready to serve. Makes about 8 cups, or 16 accompaniment servings.
*Note: One package (10 ounces) frozen baby lima beans may be substituted for edamame if desired.
• Each serving: About 100 calories, 4g total fat (1g saturated), 4g fiber, 6g protein, 11g carb., 0mg cholesterol, 295 mg sodium.
Stir-fry is the easiest way to get your veggies and to have something that is quick and easy. If you need to serve an extra body, just throw in a few more veggies.
3 cups purchased raw stir-fry vegetables
8 ounces skinned and boned uncooked chicken breast, cut into 1/2-inch pieces
1/2 cup Kraft fat-free mayonnaise
1 teaspoon dried minced garlic
1 tablespoon reduced-sodium soy sauce
1/2 teaspoon ground ginger
2 cups cooked rice
1. In a large skillet or wok sprayed with butter-flavored cooking oil, cook vegetables for about 5 minutes or until just tender, stirring often. Remove from skillet.
2. Add chicken pieces to skillet and cook for about 4 minutes or until tender. Add cooked vegetables. Mix well to combine. Stir in mayonnaise, garlic, soy sauce and ginger. Remove from heat.
3. For each serving, place 1/2 cup rice on a plate and spoon about 1 cup chicken mixture over top. Serves 4.
TIPS: 1) 1 cup raw broccoli, 1 cup raw cauliflower, 3/4 cup carrots and 1/4 cup green onion may be used in place of purchased stir-fry vegetables. 2) Usually 1 1/3 cups uncooked instant or 1 cup regular rice cooks to about 2 cups.
A recent study found that best-selling cookbooks offer readers little useful advice about reducing food-safety risks. And, much of the advice they do provide is inaccurate and not based on sound science.
According to Ben Chapman, associate professor of agricultural and human sciences at North Carolina State University, “Cookbooks tell people how to cook, so we wanted to see if cookbooks were providing any food-safety information related to cooking meat, poultry, seafood, or eggs, and whether they were telling people to cook in a way that could affect the risk of contracting foodborne illness.”
Researchers evaluated nearly 1,500 recipes from 29 cookbooks that appeared on the New York Times best-sellers list for food and diet books. All of the recipes included handling raw animal ingredients, such as meat, poultry, seafood, and eggs. They looked at three things:
Does the recipe say to cook the dish to a specific internal temperature?
If so, has it been shown to be safe? (e.g., cooking chicken to 165°F)
Does the recipe spread food-safety myths (such as “cooking poultry until juices run clear”) that are unreliable for determining if a dish is safe?
Only 8% of the cookbooks reviewed mentioned cooking the dish to a specific temperature and some were not high enough to reduce the risk of foodborne illness. Also, 99.7% of recipes gave readers subjective indicators to determine when a dish was done. None of those indicators were reliable ways to tell if a dish was cooked to a safe temperature. That’s important because recommended temperatures are based on extensive research, targeting the most likely pathogens found in each food.
Time to cook was the most common indicator in the reviewed recipes. Time alone is unreliable, due to factors that can affect how long it takes to cook something— such as the size of the dish and how cold it was before baking. Other common indicators used included references to color or texture of the meat and vague language such as “cook until done.”
You can’t tell whether meat is safely cooked by looking at it! Be sure to use a food thermometer so food reaches a safe minimum internal temperature. To view a chart of safe cooking temperatures, visit: www.foodsafety.gov/keep/charts/mintemp.html
If you have further questions about food safety, nutrition, or health-related topics, you can speak directly with a Home Economist by calling the toll-free ISU AnswerLine. It is staffed Monday-Friday from 9 am–noon and 1–4 pm. To reach AnswerLine, call:
1.800.262.3804 (in Iowa) 1.800.854.1678 (in Minnesota) 1.800.735.2942 (Relay Iowa phone linkage for deaf and hard-of-hearing individuals)
• “When packing for the kids to go to camp, here’s a tip we’ve used over and over again: Put all elements of each outfit (top, bottom, undergarments, socks, etc.) folded into a gallon-size zipper-close bag. I add a plastic grocery bag as well. Each day, the child puts on a fresh outfit, then puts yesterday’s clothes into the plastic grocery bag. You can tell what’s been worn, and it’s all ready at the start of day — no looking for socks or underwear!” — M.H. in North Carolina
• Keep your car’s back seat clean with a sheet. Drape a twin-size sheet over the back seat. Tuck in all around. Use scissors to make a small opening for the seat belts. Now dirt and crumbs will be contained in the sheet, and you can shake it off when you get to your destination or home! Works great for road trips and beach days.
• When Mom or Dad travels for work, it can be hard on the parent and kids staying home. Try this trick: Record yourself reading a story. The child can play the recording as he or she follows the story in the book. Or, make a video for younger kids.
• Need a quick travel cup or kids’ sippy cup? Use a plastic cup, then cover it with a square of plastic wrap secured with a rubber band. Finally, insert a straw through the plastic. There you go!
• “Here is a guaranteed no-scrub tip for a clean coffeepot: Fill coffeemaker with water, drop a dishwasher pod in the carafe, and brew the hot water right on top of it. After brewing, let sit 10-15 minutes, and it’ll be clean as a whistle.” — C.L. in Oregon
Send your tips to Now Here’s a Tip, 628 Virginia Drive, Orlando, FL 32803.
Arthritis: Long-Term Pain May Need Long-Term Care
(NAPS)—Many people think the stiff joints, aches and pains of arthritis are just part of aging.
In fact, while arthritis can result from years of wear and tear, the average age of onset is 47. It’s also true that arthritis plagues more than 65 percent of the oldest Americans, especially women. While there are several types of arthritis, the two most common are rheumatoid arthritis and osteoarthritis. Both cause inflamed joints but in different ways:
• Rheumatoid arthritis is an autoimmune disorder and affects not only the joints but major organs such as the heart.
• Osteoarthritis is caused by the degeneration of the cartilage in joints. This can be attributed to wear and tear, whether from aging or trauma.
Long-Term Care And Arthritis
Long-term care is needed if you can no longer perform everyday tasks by yourself due to a chronic illness, injury, disability or aging. This type of care includes either cognitive or physical assistance with simple tasks such as bathing, eating and dressing—activities most people do every day without a second thought. This care may seem manageable but it can be the cause of unnecessary financial and emotional strain. When it comes to arthritis, it’s estimated that more than $150,000 is spent on care costs over a lifetime. These costs include lost wages, medical treatments and medical care.
The Society of Actuaries stated in 2014 that 17 percent of women’s home care claims are due to arthritis and it’s the second leading cause of assisted living claims, for both men and women, behind Alzheimer’s disease. According to Jesse Slome, executive director of the American Association for Long-Term Care Insurance, 10 percent of nursing home claimants receiving benefits are women diagnosed with arthritis.
Where To Get Help
Fortunately, the Federal Long Term Care Insurance Program (FLTCIP) offers comprehensive long-term care insurance coverage for care services in a variety of settings and your choice of caregiver. Care may be provided at home by informal caregivers such as friends, family members and other private caregivers, as well as formal care by licensed caregivers. Informal caregivers cannot have lived in your home at the time you became eligible for benefits, but they can live in your home after you become eligible.
In addition, the FLTCIP’s care coordination services offer you and your qualified relatives information about long-term care resources, such as local care providers and relevant community programs, as well as valuable support to your family as you manage with the conditions of arthritis.
Many members of the federal family are eligible to apply for FLTCIP coverage, including federal and U.S. Postal Service employees and annuitants, active and retired members of the uniformed services, and qualified relatives. Certain medical conditions, or combinations of conditions, will prevent some people from being approved for coverage. You need to apply to find out if you qualify for coverage under the FLTCIP. To find out if you or a loved one is eligible to apply, visit www.LTCFEDS.com/eligibility. For personalized assistance, call (800) LTC-FEDS [(800) 582-3337]/TTY (800) 843-3557 to speak with a program consultant.
More About The FLTCIP
Established by an act of Congress in 2000 and overseen by the U.S. Office of Personnel Management, the FLTCIP is designed to meet the specific needs of the federal family. The FLTCIP provides industry-leading benefits and offers flexible options that allow enrollees to tailor coverage to meet their needs.
The FLTCIP is sponsored by the U.S. Office of Personnel Management, issued by John Hancock Life & Health Insurance Company, and administered by Long Term Care Partners, LLC.
With care, you can keep arthritis from seriously impeding your lifestyle.