# Skin Cancer Prevention: Tools & Expert Insights with Dr. David Wong

An episode of [Project 100 with Mark Bouris](https://invisiblenetwork.ai/podcast/1767053714), 9 Feb 2025, 1 h 11 min.

Audio: https://p.podderapp.com/2544644999/traffic.omny.fm/d/clips/2fb3740d-3436-44af-8cc0-a91900716aa5/05ac4e52-79fb-46b8-849c-b305000bd6d0/c513b0d1-04f7-45ff-a443-b305000c23b5/audio.mp3?utm_source=Podcast&in_playlist=ef13e652-7a19-41fd-9d0f-b305000bd6dc

All content and media by Project 100 is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. **** Dr. David Wong is a highly respected dermatologist and an expert in all things skin related. Graduating from Sydney University with First Class Honours in 1983, he built his expertise through training at Royal Prince Alfred and Prince of Wales hospitals. After earning his Fellowship from the Australasian College of Dermatologists in 1988, he’s spent his career balancing private practice with his role as a Visiting Medical Officer at Prince of Wales Hospital. We took a deep dive into skin cancer, melanoma, and Australia’s growing crisis. We covered how to better protect your skin - the mindset needed for prevention like managing daily sun exposure -and which sunscreen works best. Plus, some interesting insights on how celebrities manufacture flawless skin and much more. Follow Project 100 on Instagram. Follow Mark Bouris on Instagram, LinkedIn, Twitter & YouTube. See omnystudio.com/listener for privacy information.

## Transcript

[0:00] Speaker 1: So we've got we've gone from a world champion boxer
[0:05] Speaker 1: today in here, then we went we did the premiere,
[0:08] Speaker 1: then now we're talking to her what I considered be
[0:10] Speaker 1: world champion dermatologists.
[0:12] Speaker 2: But anyway, here we.
[0:12] Speaker 1: Go, Doctor David Wong, welcome to Project one hundred.
[0:18] Speaker 2: Mate, thank you for having me.
[0:20] Speaker 1: Well, thanks, we're going to come out because, like I know,
[0:22] Speaker 1: you're a very busy guy. And when I and I
[0:25] Speaker 1: got to declare I am a let's call a patient,
[0:28] Speaker 1: I definitely consult with David and he's been my not mine,
[0:34] Speaker 1: but lots of people. But the person I go to
[0:36] Speaker 1: over a long time, through my previous general practitioner who
[0:42] Speaker 1: sent me to David, like probably twenty years ago. And
[0:46] Speaker 1: just first first off, just to be clear to everybody, David,
[0:52] Speaker 1: could you please confirm I've had no aesthetic enhancement's done
[0:56] Speaker 1: at your.
[0:56] Speaker 2: Clinic, not through me, through me.
[0:59] Speaker 1: Well that's what in the case, it's good, been through
[1:00] Speaker 1: somebody else, but I appreciate that. No. So to become
[1:05] Speaker 1: a dermatologist, what does it take? So do you become
[1:07] Speaker 1: a doctor of medicine? First?
[1:09] Speaker 2: Yeah, so basically you enter the undergraduate program and you
[1:12] Speaker 2: train as a general practitioner. So you do five or
[1:15] Speaker 2: six years at medical school. After you finish, you usually
[1:18] Speaker 2: required to have at least two years of postgraduate training,
[1:21] Speaker 2: so usually intern resident, and then you apply for a
[1:24] Speaker 2: training position. And at the moment, training in dermatology is
[1:28] Speaker 2: quite tight, so often people have a few years more
[1:30] Speaker 2: before they actually get under the training program.
[1:32] Speaker 1: When you've been tired, it's hard to get they're not
[1:34] Speaker 1: enough positions. There's not enough positions. No, So there's a
[1:37] Speaker 1: lot of people want to become germatologists, there's quite a lot,
[1:40] Speaker 1: but they never actually get a role.
[1:41] Speaker 2: They don't get the role because training positions are basically
[1:44] Speaker 2: subsidized by federal government, so they're at the hospital teaching hospitals.
[1:48] Speaker 2: There are a few public private type situations, but there
[1:51] Speaker 2: are only a few, and there's never enough. So you know,
[1:55] Speaker 2: when people apply, there's always a long waiting list. You've
[1:57] Speaker 2: got plenty to choose from. Wow.
[2:00] Speaker 1: So, and how long is you're sort of postgraduate course
[2:04] Speaker 1: in dermatology, you're in specialization? How long is so.
[2:06] Speaker 2: It's four years? Another four years, another four years?
[2:08] Speaker 1: So how long have you been practicing as a dermatologist overall?
[2:13] Speaker 2: So I was quite lucky because I finished school at
[2:16] Speaker 2: an early age. I finished med school nineteen eighty three.
[2:22] Speaker 2: I got straight onto the program, and at that time
[2:24] Speaker 2: the program was only three years, so I was done
[2:27] Speaker 2: in nineteen eighty eight. So I was twenty eight at
[2:29] Speaker 2: that time.
[2:30] Speaker 1: So you've done nearly forty years. At almost forty years,
[2:34] Speaker 1: and you're still going strong.
[2:35] Speaker 2: Still going strong, but you know, looking night to the future.
[2:38] Speaker 2: I think once you told me there's only so many
[2:40] Speaker 2: weekends left in your life. So I'm conscious of that.
[2:44] Speaker 1: So probably one hundred is about a couple of things.
[2:48] Speaker 1: It's about sort of a little bit from a selfish
[2:50] Speaker 1: point of view. It's me trying to work out what
[2:53] Speaker 1: have I got to do to live to one hundred.
[2:54] Speaker 1: It doesn't mean we'll live to one hundred, but what
[2:56] Speaker 1: are the things I need to be aware of relative
[2:58] Speaker 1: to myself? And it's about me having access to people
[3:01] Speaker 1: like you and you and I sharing stuff, information and
[3:05] Speaker 1: distributing that amongst our listeners when they wouldn't ordinarily have
[3:09] Speaker 1: access to someone like you, or have someone access to
[3:11] Speaker 1: someone like me who has access to someone like yourself.
[3:14] Speaker 1: And it turns out that apart from heart attacks or
[3:18] Speaker 1: heart issues, cancer generally general cancer that's all. Types of
[3:23] Speaker 1: cancers are the second largest killer in the world today.
[3:27] Speaker 1: Skin cancer is probably in Australia would be one of
[3:31] Speaker 1: the highest ranking types of cancers to kill people overall,
[3:37] Speaker 1: would that be right? That's correct, So it's probably coming
[3:40] Speaker 1: in to take an or third relative to breast cancer
[3:42] Speaker 1: or something.
[3:43] Speaker 2: Breast cancer, bowel cancer. You know. I guess the thing
[3:47] Speaker 2: is that skin cancer is a big issue in this country.
[3:49] Speaker 2: I think when I looked up some stats, you know,
[3:51] Speaker 2: it costs close to two billion dollars, So that's a
[3:54] Speaker 2: lot of money to pay for just skin cancer alone.
[4:00] Speaker 2: A big problem, and it continues to be a big problem.
[4:02] Speaker 2: You know. If I look at my I mean I
[4:03] Speaker 2: keep individual stats of how many melanoms I see. This
[4:07] Speaker 2: gives me an idea of whether I'm picking up the
[4:09] Speaker 2: melanomes early or late. And I think, you know, since
[4:11] Speaker 2: the beginning of this year, which is just just over
[4:14] Speaker 2: three weeks in, I've already had ten cases.
[4:16] Speaker 1: Wow.
[4:17] Speaker 2: You know, So.
[4:19] Speaker 1: Do you sort of get into the technical detail or
[4:23] Speaker 1: the physics of why Australia might have more melanomas or
[4:26] Speaker 1: more kissing cancers than say other countries. Have you ever
[4:29] Speaker 1: gone through that process?
[4:30] Speaker 2: I think, well, yes, there are colleagues of mine that
[4:33] Speaker 2: are very interested in those sort of statistics, and you know,
[4:37] Speaker 2: and statistics are how you interpret them. But basically white
[4:41] Speaker 2: people living in a country where it's too much sunshine.
[4:43] Speaker 2: It's as simple as that.
[4:45] Speaker 1: And is there's something to do with our lifestyle.
[4:47] Speaker 2: Too, yeah, outdoors lifestyle. So you know you think of
[4:50] Speaker 2: the old saying mad dogs in englishmen and only people
[4:52] Speaker 2: out in the sun, you know, every other country, like
[4:54] Speaker 2: even if you look at in Europe, all right, so
[4:57] Speaker 2: that people often have a siesta in the middle of
[4:59] Speaker 2: the day avoid the midday sun, you know, which is
[5:01] Speaker 2: the most damaging.
[5:02] Speaker 1: Yeah. So, I mean we are in the middle of
[5:05] Speaker 1: summer right now whilst we're recording this, and this is
[5:07] Speaker 1: going to be posted in the middle of summer or
[5:09] Speaker 1: a little bit, you know, towards the end of summer,
[5:10] Speaker 1: but it'll be definitely posted in February. Australians are becoming
[5:16] Speaker 1: more aware of the danger's skin cancer or becoming more
[5:20] Speaker 1: aware but just being disregarding it just as much as
[5:24] Speaker 1: in the past, do you just in your opinion.
[5:26] Speaker 2: All right, in my opinion, I think people are better.
[5:29] Speaker 2: I think you know, in schools you know, no play
[5:32] Speaker 2: policy has been in place for quite some time. I
[5:34] Speaker 2: think most parents are well aware of the dangers of
[5:36] Speaker 2: sun exposure and get the kids who use sunscreen. But
[5:40] Speaker 2: if we look back, you know, it's generational change. Okay,
[5:44] Speaker 2: so the change in clothing to change and how we live.
[5:47] Speaker 2: So many years ago, when we were growing up, going
[5:49] Speaker 2: overseas for a holiday was very unusual, you know. Nowadays
[5:54] Speaker 2: you know three, you know, three or four holidays a year.
[5:56] Speaker 2: People are going overseas. They're seeking usually a sunny climate,
[5:59] Speaker 2: so they're getting more sun exposure as a total than
[6:02] Speaker 2: what they would have used to be.
[6:03] Speaker 1: So in other words, they have two summers, so they
[6:05] Speaker 1: have our summer and then when this train winter turns up,
[6:08] Speaker 1: they take off overseas for.
[6:09] Speaker 2: A europe another's.
[6:11] Speaker 1: That's pretty interesting, so it doesn't get down to that
[6:13] Speaker 1: sort of fine details in a statistical sense in terms
[6:17] Speaker 1: of exposure. Do you have you run any or alternately,
[6:22] Speaker 1: are you aware of any studies that show that our
[6:27] Speaker 1: tendency to get skin cancer, that will skin disorders as
[6:31] Speaker 1: a result of to my sun has some correlation to
[6:35] Speaker 1: the number of times we are exposed to son I
[6:37] Speaker 1: mean by seasons.
[6:38] Speaker 2: I don't think there's definitely that research done. But I
[6:41] Speaker 2: mean the research showing that the more sunburns that you
[6:44] Speaker 2: have in your youth definitely increases your risk of melanoma.
[6:48] Speaker 1: Yeah, do you think that people? Because when I was
[6:50] Speaker 1: a kid, people put baby ail on. Yes, And I
[6:57] Speaker 1: had a girlfriend, you know, when I was sixteen seventeen
[7:00] Speaker 1: said here, put that on. And I remember I got
[7:02] Speaker 1: like ridiculously sun burned, Like I had no idea with
[7:05] Speaker 1: the half an hour an hour, I wouldn't even know
[7:06] Speaker 1: how long I was in the sun for. But I
[7:07] Speaker 1: remember being at home being really humburned. But it was
[7:12] Speaker 1: sort of considered a thing. It's some coconut oil. And
[7:15] Speaker 1: you used to fair again a bondo and there was
[7:17] Speaker 1: a guy that used to spray you with coconut oil.
[7:19] Speaker 2: Correct, cook you correct, and people, you know, people used
[7:23] Speaker 2: to do that every summer. Getting sunburned was like part
[7:25] Speaker 2: of the ritual. I mean, I remember when I came
[7:28] Speaker 2: to Australia in nineteen seventy four, went to school, people said, oh,
[7:31] Speaker 2: let's meet you out of the beach. I got burnt once.
[7:33] Speaker 2: I never went back. I thought, I don't need this.
[7:35] Speaker 2: You know, your skin's actually telling you it's painful. Why
[7:37] Speaker 2: would you be doing it to yourself? But you know,
[7:40] Speaker 2: if you don't know better, you don't think any better.
[7:42] Speaker 2: You continue to burn, and every time you get your
[7:44] Speaker 2: skin burnt, you've done damage to the DNA.
[7:47] Speaker 1: So let's have a look at that for a second.
[7:49] Speaker 1: So you say, we've done damage to the DNA, So
[7:53] Speaker 1: please explain what that means. So the layer of skin
[7:57] Speaker 1: what gets burnt, the top layer or the bottom layer,
[7:59] Speaker 1: or some other layer.
[8:01] Speaker 2: It depends on how much exposure that you have. So
[8:04] Speaker 2: usually when you get sun burnt, that's usually uv B light.
[8:07] Speaker 2: So the in the spectrum of light that we get
[8:09] Speaker 2: on Earth, we get visible light UVB and UVA. Uv
[8:13] Speaker 2: B light is a light that burns us and it
[8:16] Speaker 2: burns the top layer of skin, the epidermis, and generally
[8:18] Speaker 2: weish then sheet that layer of skin off at the
[8:21] Speaker 2: same time. Usually when you've had too much uv B light,
[8:23] Speaker 2: you probably also have too much uv A light. UVA
[8:26] Speaker 2: light penetrates deeper and probably affects the pigment cells more
[8:29] Speaker 2: than that. Those are the pigment cells, the ones that
[8:33] Speaker 2: create melanoma.
[8:34] Speaker 1: Right, So there's something below the top layer of your skin, yes, yes,
[8:37] Speaker 1: and so I presume UVB and U V A A
[8:41] Speaker 1: both coming out of the sunlight at the same time, like, yes, correct, yes,
[8:44] Speaker 1: But so why would somebody more likely get burnt than
[8:49] Speaker 1: say another person. Let's say someone my skin color relative
[8:52] Speaker 1: to say someone who's born an Ireland and has got
[8:54] Speaker 1: red hair and green eyes, and let's call it, let's say,
[8:58] Speaker 1: much fairer skin. Why does their skin get much more
[9:02] Speaker 1: burned than mine?
[9:03] Speaker 2: I probably I like using analogies when I explain to patients,
[9:07] Speaker 2: And probably the most common analogy that I use will say,
[9:10] Speaker 2: think of your skin like the paintwork in your car,
[9:12] Speaker 2: all right, and you are the born with rolls roist
[9:14] Speaker 2: paint work maybe like your skin or you're born with
[9:17] Speaker 2: Once upon a time, Japanese cars were cheap, poor paint work.
[9:21] Speaker 2: And so if you don't have good paint work and
[9:23] Speaker 2: you're exposed to the same elements, then that paint works
[9:25] Speaker 2: on a deteriorate more quickly. And unfortunately, we don't have
[9:28] Speaker 2: any technology to give you a new layer of paint.
[9:31] Speaker 2: You only have what you're born with.
[9:33] Speaker 1: So does that mean then that But that doesn't mean
[9:37] Speaker 1: for someone like me that I can't get skin cancer?
[9:40] Speaker 2: No, I mean okay. So let's say you're now fifty yeah,
[9:43] Speaker 2: and you're a Rolls voice and you're a Rolls Royce
[9:45] Speaker 2: and that roll's worse the stat by the beach for
[9:47] Speaker 2: fifty years. Do you think the paint work on the
[9:49] Speaker 2: bonnet or the roof is as good as on the side.
[9:53] Speaker 2: It's not, so you know the amount of damage.
[9:57] Speaker 1: So I have been assume you've taken on some and
[10:00] Speaker 1: we'll talk about the processes a little bit later, but
[10:03] Speaker 1: you have taken off some things on my skin, burned
[10:05] Speaker 1: them off. They were basal something or other what you call.
[10:11] Speaker 2: So my recollection is the ones that I burn off,
[10:13] Speaker 2: basically solar erotoss case, that's it. Yeah, yep, So solar
[10:16] Speaker 2: keratosis are probably they're a low grade. They are abnormal
[10:20] Speaker 2: cells in the top layer of the skin, but they're
[10:22] Speaker 2: not invasive skin cancer yet, so they're pre cancerous. Some
[10:27] Speaker 2: of them will never turn into cancer, but a small
[10:29] Speaker 2: minority will given time. Depending on your age. You know,
[10:34] Speaker 2: if you're young, we actively treat. As you get into
[10:36] Speaker 2: your eighties and nineties, depending on what your general health
[10:38] Speaker 2: is like, we may not treat because it's not worth
[10:40] Speaker 2: the discomfort or the distincrement.
[10:42] Speaker 1: So in terms of discomfort all our members, you sort
[10:45] Speaker 1: of had a thing is apted. I mean we had
[10:47] Speaker 1: two different we'll go through two processes. A couple of
[10:49] Speaker 1: those couple of processes we did because I was on
[10:53] Speaker 1: TV a lot of the time, and I remember saying, look,
[10:55] Speaker 1: I don't want a bad red mark there. And we
[10:58] Speaker 1: wait until another period arrived and you put me through
[11:02] Speaker 1: a bit more lengthy process with applying some cream and
[11:04] Speaker 1: you ask me go in the sun, and well they
[11:06] Speaker 1: shine like at no time, they shine a light on me,
[11:07] Speaker 1: and it sort of everything dropped off. But if I
[11:10] Speaker 1: hadn't have had that, I'll come back to the process.
[11:12] Speaker 1: But if I hadn't have had those things done maybe
[11:15] Speaker 1: ten years ago, what would be the case? Now?
[11:17] Speaker 2: Do you think chances are that you probably would have
[11:20] Speaker 2: had something that needs to be cut out, cut out,
[11:23] Speaker 2: cut out?
[11:23] Speaker 1: So more significant, Yeah, more significance. So in terms of
[11:29] Speaker 1: that particular what did you call it again? Keratosis?
[11:33] Speaker 2: Right?
[11:34] Speaker 1: So solar keratosis. So what does that look like? How
[11:39] Speaker 1: does a person know they got solar keratosis?
[11:42] Speaker 2: So typically they feel like a bit of gritty skin.
[11:45] Speaker 2: So it's like you've been to the beach and there's
[11:47] Speaker 2: a bit of sand left on your skin. So you
[11:49] Speaker 2: might find and you might touch it and you feel
[11:51] Speaker 2: that there's this rough bit on your skin. You play
[11:52] Speaker 2: with it, it seems to disappear, but within a week or
[11:55] Speaker 2: ten days it's back again. So it's this recurrent bit
[11:57] Speaker 2: of rough skin.
[11:58] Speaker 1: It was like a sort of like a scab, but
[12:00] Speaker 1: not quite a scaf for me.
[12:01] Speaker 2: Yeah, but there's no blood there. There's just a rough spot.
[12:03] Speaker 1: There's no blood there, And if you pick that off,
[12:06] Speaker 1: what does that damage you?
[12:08] Speaker 2: It doesn't damage you, but you often find out it
[12:10] Speaker 2: feels a bit sensitive and then the skin heels over
[12:13] Speaker 2: and then the spot redevelops.
[12:15] Speaker 1: Right, So that is not cancer in itself, but it
[12:17] Speaker 1: could perform into cancer. Just let's take me through the
[12:21] Speaker 1: treatments of those, because you did say when someone has
[12:23] Speaker 1: one of those, maybe you don't do anything because of
[12:25] Speaker 1: scarring and potential discomfort, et cetera. But I have to say,
[12:29] Speaker 1: of the treatments that you gave me, I think I'd
[12:31] Speaker 1: like two or three different styles of treatments. I didn't
[12:33] Speaker 1: have any scarring and I didn't have any discomfort. There's
[12:36] Speaker 1: a been annoying because I had a way a couple
[12:38] Speaker 1: of days to drop off after you know you did
[12:41] Speaker 1: what you did. But what are the three treatments?
[12:43] Speaker 2: Okay, So the most common treatment that we use is
[12:45] Speaker 2: basically freezing with liquid nitrogen, So that's carried out by
[12:48] Speaker 2: the doctor in the office, and that's it's like a
[12:50] Speaker 2: cold burn, and because cold numbs the skin a bit,
[12:53] Speaker 2: it's not as painful as if we were to use heat.
[12:56] Speaker 2: And that's the most commonly used treatment. When people have
[12:59] Speaker 2: a lot of spots. Then you know, when you're having
[13:01] Speaker 2: thirty forty spots frozen, it's pretty unpleasant, particularly if it's
[13:04] Speaker 2: on your forehead, because you get like an ice cream
[13:06] Speaker 2: headache from it. Really all right, And I would also
[13:10] Speaker 2: be a little bit reluctant to use too much freezing
[13:12] Speaker 2: in someone that has a more olive skin because the
[13:15] Speaker 2: freezing can damage the pigment cells, so then you have
[13:17] Speaker 2: white marks left behind, right, And even if you were
[13:20] Speaker 2: fair skinned, if you freeze something really hard, you will
[13:23] Speaker 2: create a white scar. So the next options are usually
[13:27] Speaker 2: a cream. So it's a cream called fluoruruicil. The trade
[13:30] Speaker 2: names are E few Dix that people might be familiar with,
[13:33] Speaker 2: and it's a cream that people put on themselves, so
[13:35] Speaker 2: it's not the doctor putting it on, it's a patient
[13:37] Speaker 2: and they can put it on anywhere from one week
[13:39] Speaker 2: to three or four weeks. The longer they put it
[13:42] Speaker 2: on for, the more flamed and angry the skin skin gets.
[13:45] Speaker 2: So I don't know if you remember, but a few
[13:47] Speaker 2: years ago Barnaby Joyce was using that cream and so
[13:50] Speaker 2: I had this red, crusty face when he was on TV. Yeah,
[13:54] Speaker 2: and so it's pretty unpleasant and most people that do
[13:56] Speaker 2: it have difficulty wanting to do it again, but it's
[13:59] Speaker 2: probably very cost effective treatment. And then the last treatment
[14:03] Speaker 2: is what's called photodynamic therapy. This is what you had
[14:06] Speaker 2: where a cream is put onto your face. We generally
[14:08] Speaker 2: put that cream on, leave it on for about half
[14:11] Speaker 2: an hour, then we put sunscreen on your face. Then
[14:13] Speaker 2: we send you into sunlight. That's for yeah, yes, the
[14:16] Speaker 2: sunlight study activates the medicated cream which has been more
[14:19] Speaker 2: selectively absorbed by the abnormal cells. And that happens over
[14:22] Speaker 2: two hours. And because the cream's expensive, we generally give
[14:25] Speaker 2: you a bit of red light at the end of
[14:27] Speaker 2: it to activate any residual cream. And that's like having
[14:29] Speaker 2: done three weeks of efewdex in a row in one.
[14:32] Speaker 1: Day, and it seems to I have. It's not as
[14:36] Speaker 1: long as an effect, but it worked. So my skin
[14:40] Speaker 1: feels relatively clear. I mean, I always get nervous from
[14:42] Speaker 1: a city in front of you. You're looking in my skin,
[14:44] Speaker 1: I'm thinking of myself. He's just pick something out, especially
[14:47] Speaker 1: because you have this look about you in from your
[14:50] Speaker 1: eyes something what you've seen. So that's for that particular skin.
[14:56] Speaker 1: Let's call it a skin disorder because it's not really
[14:58] Speaker 1: cancert what's next.
[15:00] Speaker 2: So after solar keratoses, the most common form of skin
[15:04] Speaker 2: cancer we'd see is it's called basal cell carcinoma. Okay,
[15:08] Speaker 2: the late term used to be called rodent ulcer because
[15:10] Speaker 2: it was very slow growing and like a little rat,
[15:12] Speaker 2: it would just eat away your skin. Depending on location
[15:15] Speaker 2: determines how nasty it is. So if you had it
[15:18] Speaker 2: on your general body, it's not such a big issue.
[15:20] Speaker 2: But around the eyes, nose, ears, that's where people lose
[15:25] Speaker 2: potentially lose their eye. Really, yes, yes, and that that's
[15:29] Speaker 2: is that actual cancer. That's an actual cancer.
[15:31] Speaker 1: Yeah, So you have to cut that out.
[15:33] Speaker 2: In general terms, you have to cut them out. There
[15:35] Speaker 2: is a subtype which is very superficial for which creams
[15:39] Speaker 2: and photodynamic therapy can work for. But once they're going deeper,
[15:42] Speaker 2: then surgery is generally the most commonly used treatment, unless
[15:46] Speaker 2: you were really frail or inoperable, then sometimes radiotherapy is used.
[15:51] Speaker 2: I mean, there are some people who get multiple basal
[15:54] Speaker 2: cell castinomers, and that's generally a genetic disorder, and there
[15:57] Speaker 2: is a medication that can help to shrink them, but
[15:59] Speaker 2: that has significant side effect.
[16:01] Speaker 1: So are you saying people actually get it on? Are
[16:03] Speaker 1: you saying you to the round your eye or in
[16:06] Speaker 1: your eye people get cancer.
[16:07] Speaker 2: It won't be in the eye, but it can be
[16:08] Speaker 2: right next to the eye, so where the tear ducts
[16:10] Speaker 2: are right, so it will just keep going in deeper
[16:13] Speaker 2: and deeper. You know, I remember we don't see it
[16:15] Speaker 2: very often, but maybe going back ten years ago, we
[16:18] Speaker 2: had one lady come in to the hospital who had
[16:20] Speaker 2: just neglected her cancers. Her eyeballs almost hanging out because
[16:24] Speaker 2: the cancer eroded right through her nose. And you know,
[16:28] Speaker 2: there are a pictures if you google it, you'll find
[16:30] Speaker 2: pictures of that sort of thing. Slow growing, but ultimately
[16:33] Speaker 2: it can be devastating.
[16:34] Speaker 1: So and is there a third type of cancer.
[16:37] Speaker 2: Well, then from basil cells, squamous cell cancer. So squam
[16:41] Speaker 2: of cell cancer is a rapidly growing skin cancer. I
[16:44] Speaker 2: think if you, Richie Beno had a rapidly growing squam
[16:48] Speaker 2: a cell cancer that spread and that actually ultimately causes demise.
[16:52] Speaker 2: They can appear from some from nothing to something within
[16:55] Speaker 2: a couple of weeks, and again, depending on location can
[16:58] Speaker 2: determine how aggressive they are. We commonly see them on
[17:01] Speaker 2: the head and neck. I'm always telling people or men
[17:04] Speaker 2: that have no hair to wear a hat because that's
[17:06] Speaker 2: a very common location for it.
[17:08] Speaker 1: And is there something beyond squens Then.
[17:11] Speaker 2: The next is melanoma. So melanoma is the most common
[17:14] Speaker 2: of the really bad skin cancers. So if you were
[17:18] Speaker 2: to say to me, which kin cancer would you pick
[17:20] Speaker 2: to have, you'd always picked up a basil cell next
[17:22] Speaker 2: after that, scream myself, you have adequately removed. That's the
[17:25] Speaker 2: end of story. You don't have to worry about it.
[17:27] Speaker 2: But melanoma is the cancer where even sometimes when you
[17:29] Speaker 2: pick it up early, there is a small percentage of patients,
[17:32] Speaker 2: maybe one or two percent, that will it will come
[17:35] Speaker 2: back again, sometimes even ten fifteen years later. So you
[17:37] Speaker 2: can't say just because it hasn't been there for five years,
[17:40] Speaker 2: you're cured.
[17:41] Speaker 1: So if I was then to say to you, will
[17:45] Speaker 1: you know I'm not going to. I'm not in a
[17:47] Speaker 1: position to go and see a dermatologist. I don't really
[17:51] Speaker 1: want to ask for a GP. But because I don't
[17:54] Speaker 1: think I've got any of these things? How would I
[17:56] Speaker 1: identify all four of those? You already? How do you
[18:00] Speaker 1: do the first one?
[18:01] Speaker 2: Yeah? Yeah, So I guess it's whether or not you
[18:05] Speaker 2: observe yourself closely, so you look. Sure it shouldn't right,
[18:08] Speaker 2: we should be, but it's like you know, you look
[18:11] Speaker 2: for change things that weren't there. If something's appeared and
[18:14] Speaker 2: it wasn't there before, should get it checked. If something
[18:17] Speaker 2: starts to bleed, look typically for basal cell. It's something
[18:20] Speaker 2: that sort of bleeds, forms a scab and heals, then
[18:23] Speaker 2: it starts all over again, so it never fully heals.
[18:26] Speaker 2: A square of cell is often tender, okay, so you'll
[18:29] Speaker 2: feel like a boil, but instead of being like a
[18:31] Speaker 2: boil that sort of oozers past it and settles down,
[18:34] Speaker 2: it keeps growing and then melanoma is generally when you
[18:38] Speaker 2: get them early, they're like a flat patch of pigment.
[18:40] Speaker 2: So they're smooth, but they're just like a stain on
[18:42] Speaker 2: your skin. You say, where did I get that stain from?
[18:44] Speaker 2: Why is that stain multi colored?
[18:47] Speaker 1: So you have a You told me about a code A, B,
[18:50] Speaker 1: C D E.
[18:51] Speaker 2: Yeah, so commonly it's taught as ABCDE for melanoma.
[18:54] Speaker 1: So A that's for melanoma. Right, that's for melanoma. Right,
[18:57] Speaker 1: So what does A what do these things stand?
[18:59] Speaker 2: So? A is symmetry. Okay, So if you look at
[19:02] Speaker 2: the spot and you cut it in half, does one
[19:04] Speaker 2: half look like the other half? So generally melanombs are asymmetric.
[19:08] Speaker 1: So in other words, they're not the same one side correct.
[19:11] Speaker 2: BS for border. So a border that is irregular, so
[19:14] Speaker 2: almost like a coastline, it's got ins and outs of
[19:16] Speaker 2: it is not good. You normally like to see a
[19:18] Speaker 2: fairly smooth border.
[19:21] Speaker 1: Just on that one. On B. When you say fairly
[19:23] Speaker 1: smooth border, you mean you don't want it having a
[19:25] Speaker 1: little bays, yeah, yea, and like a little harbor well
[19:30] Speaker 1: inlet's ye yeah, that's out crops. You want to be
[19:33] Speaker 1: like pretty much like fairly round or smooth yep.
[19:36] Speaker 2: Correct? Okay, Okay, the next one is color. And again
[19:40] Speaker 2: you're looking for a symmetry of color. So from my perspective,
[19:44] Speaker 2: it has to be at least three colors, okay, and
[19:47] Speaker 2: any of those colors even light brown, meatium brown, dark brown.
[19:51] Speaker 2: Pink to me is a significant color. So often people
[19:53] Speaker 2: don't relate to pink. Most meloanombers that I see are
[19:56] Speaker 2: not black. So that's out there that you know, a
[19:59] Speaker 2: black more dangerous. Well that's the exception for me. That's
[20:02] Speaker 2: the exception rather.
[20:02] Speaker 1: Than a rule in your experience, is that right?
[20:05] Speaker 2: Yeah, So I'm trying to pick up the ones that
[20:07] Speaker 2: people don't know they have.
[20:08] Speaker 1: Yeah, yeah, yeah. And see a d.
[20:10] Speaker 2: D is diameter, So it's quite a crude measure. Generally,
[20:13] Speaker 2: anything that's bigger than about the end of a pencil,
[20:15] Speaker 2: you would pay attention to it.
[20:17] Speaker 1: What about those people who just use iPads, they don't
[20:19] Speaker 1: have a pencil, and at the end of a pencil.
[20:21] Speaker 2: I hope what the end of a pencil is. So
[20:23] Speaker 2: we say six.
[20:24] Speaker 1: Millimeters six six millimeters and e.
[20:29] Speaker 2: Ears for elevation, Well, there's two years elevation. So generally
[20:33] Speaker 2: as in raised raised, So generally, to me, a spot
[20:37] Speaker 2: that's always been raised, the risk of that being sinister
[20:40] Speaker 2: is very small, right, Okay, So I'm more interested in
[20:44] Speaker 2: marks that are smooth that you cannot you can see,
[20:47] Speaker 2: but you cannot feel, okay. And then ear is also
[20:50] Speaker 2: for evolving, so changing, So that mark may have been
[20:54] Speaker 2: at one stage round, now it's not round anymore. Or
[20:57] Speaker 2: let's say it had two colors and now it's got
[20:59] Speaker 2: a third color. I would use that.
[21:02] Speaker 1: So so abc D. I mean, that's that's a pretty
[21:06] Speaker 1: good dumb reference point for people just generally. But you're
[21:09] Speaker 1: only going to see what's on the front unless you
[21:12] Speaker 1: are some way of looking behind you.
[21:14] Speaker 2: That's courage your back.
[21:15] Speaker 1: And the skin cancers don't necessarily have to be in
[21:18] Speaker 1: places where you've had sign correct. It can be anywhere.
[21:22] Speaker 2: There can be anywhere.
[21:23] Speaker 1: It could be on your butt, it could be on
[21:24] Speaker 1: your love bottom of your foot.
[21:25] Speaker 2: Yeah, so I've moved. I've removed skin cancers from virtually
[21:29] Speaker 2: every part of the body, so armpits, genital area. You
[21:33] Speaker 2: you know, I don't always look to check genital area.
[21:35] Speaker 2: People say, look, I've got something, they can have a
[21:37] Speaker 2: look the name.
[21:37] Speaker 1: Look.
[21:38] Speaker 2: Okay, but you can be unlucky enough to have a
[21:40] Speaker 2: melanoma that's in the back of your eye, or it
[21:42] Speaker 2: can start in your goalblander orches starting in.
[21:44] Speaker 1: Your inside your body.
[21:45] Speaker 2: Inside. There are pigment cells inside your body. They're not
[21:49] Speaker 2: the same. There may not be the same genetic subtype
[21:52] Speaker 2: of melanoma, but there are pigment cells throughout our body.
[21:55] Speaker 2: It's just that the skin has the most pigment cells
[21:59] Speaker 2: and therefore, statistic the risk of one of those turning malignant,
[22:02] Speaker 2: particularly if you've had some exposure, is much higher.
[22:05] Speaker 1: Right, And is that because so if I could just
[22:08] Speaker 1: rephrase it, perhaps, is it because you can get a
[22:12] Speaker 1: skin cancer on maybe virtually every organ, but your skin
[22:15] Speaker 1: is your biggest organ. Yes, and that's just the organ
[22:18] Speaker 1: that you're mostly dealing with, and it's also the one
[22:20] Speaker 1: that's exposed to the sun. But irrespective that, you can
[22:24] Speaker 1: get a skin cancer on some other.
[22:25] Speaker 2: Organs, yes, well, a type of skin cancer.
[22:29] Speaker 1: Eyah, But how would someone ever even know?
[22:33] Speaker 2: Well, that's why generally, on the skin you can pick
[22:35] Speaker 2: up and diagnose these things early, you know, because we
[22:38] Speaker 2: can see with the naked eye those other ones. Generally,
[22:41] Speaker 2: by the time you are symptomatic, you're in trouble. Yeah, okay,
[22:45] Speaker 2: So you know, every year, every major teaching hospital will
[22:49] Speaker 2: have someone present with metastatic melanoma in their brain and
[22:53] Speaker 2: there's no history or sign of anything on the skin,
[22:56] Speaker 2: people presume that it's coming from an internal melanoma.
[22:59] Speaker 1: That's funny because my father passed away last year and
[23:04] Speaker 1: when he got when they did the pet scan on him,
[23:06] Speaker 1: they said he had cancer everywhere, but like virtually every
[23:10] Speaker 1: part of his body, including his skin, but then his
[23:13] Speaker 1: brain as well, but nobody could tell us where the
[23:18] Speaker 1: where it started primary, where the primary cancer was yet
[23:20] Speaker 1: because unfortunately passed away very quickly. But which is good.
[23:25] Speaker 1: But one of the things he used to do all
[23:27] Speaker 1: his life and born in Greece, lived you know, no
[23:30] Speaker 1: such during the war, no such thing as you know,
[23:35] Speaker 1: and he put on his skin and probably outdoor he
[23:38] Speaker 1: lived there. He was a farmer who has lived outdoors
[23:40] Speaker 1: and then but every day of his life in Australia
[23:43] Speaker 1: he would sit outdoors early in the morning, from eight
[23:47] Speaker 1: in the morning to about nine point thirty in the
[23:49] Speaker 1: sun because he had this great north facing backyard in Mossman.
[23:54] Speaker 1: It was just so beautiful, especially the winter because it
[23:56] Speaker 1: was always warm, and he took the view that he
[23:59] Speaker 1: said it kept him life and it's funny some there
[24:02] Speaker 1: are some scientists now, particularly neuroscientists out there saying that
[24:06] Speaker 1: we should look into the sun first thing in the morning,
[24:08] Speaker 1: like not at lunchtime. You get twenty minutes of sun
[24:12] Speaker 1: into our eyes, onto our skin, et cetera. And my
[24:15] Speaker 1: old man he believed in that, but not for the
[24:17] Speaker 1: scientific reason. Is he just more anecdotal? Is that something
[24:22] Speaker 1: that people should be considering, like did you see is
[24:24] Speaker 1: it ever safe to get the sunlight on you? Or
[24:27] Speaker 1: is it the morning morning sun or the late afternoon sun?
[24:30] Speaker 2: What is it?
[24:31] Speaker 1: Well?
[24:31] Speaker 2: I think it is it's safe to get some sun
[24:33] Speaker 2: on your skin because you know, traditionally that's how you
[24:35] Speaker 2: get your vitamin D. Yeah, but you know over time,
[24:39] Speaker 2: you know, if you think about what humans wore many
[24:43] Speaker 2: centuries ago, they wore very little clothing, so there are
[24:45] Speaker 2: plenty of skin exposed, they get enough vitamin D. And
[24:48] Speaker 2: with fashions we now protect our skin more so we're
[24:50] Speaker 2: getting less vitamin D. So getting some sun exposure is important.
[24:54] Speaker 2: But the areas that are easiest for the get sun
[24:57] Speaker 2: exposure are the areas that get sun all the time,
[24:59] Speaker 2: So the ones that are going to be more damage.
[25:02] Speaker 2: So not just from the risk of skin cancer, but
[25:04] Speaker 2: the risk from your skin getting thinner, not looking so good,
[25:07] Speaker 2: looking more wrinkled, more discolored. That's what the sun will
[25:11] Speaker 2: do to you.
[25:12] Speaker 1: So what would you say about that? Because I know
[25:16] Speaker 1: a lot of people are doing this and there's a
[25:18] Speaker 1: lot of discussion about it on various channels. What would
[25:22] Speaker 1: you say to those people who say the first thing
[25:24] Speaker 1: in the morning, you should get twenty minutes of direct sunlight.
[25:28] Speaker 1: Now they say first thing, and they usually say before
[25:31] Speaker 1: eight am in their defense.
[25:33] Speaker 2: So I would say that your chances are you won't
[25:37] Speaker 2: get burnt getting that sunlight first thing in the morning.
[25:39] Speaker 2: But the sunlight at the beginning of the day and
[25:42] Speaker 2: the end of the day, that's when there's the most
[25:43] Speaker 2: uva light.
[25:44] Speaker 1: In the first thing in the morning.
[25:45] Speaker 2: Really, yeah, first in the morning and last because the
[25:48] Speaker 2: sun's further away, So it's how the rays penetrate, right,
[25:51] Speaker 2: That's what I understand, And so you're getting more uva light.
[25:54] Speaker 2: Uva lights are like that pigments your skin. And if
[25:58] Speaker 2: we then look at you know, one stage, we had
[26:01] Speaker 2: a lot of people going to tanning salons. Okay, so
[26:04] Speaker 2: tanning salon's basically had uva L type lights, so you
[26:08] Speaker 2: would tan without getting burnt because they're because we're bypassing
[26:11] Speaker 2: the uv B. You took the UVB out of the equation,
[26:13] Speaker 2: you're getting UVA light. And then we started to get
[26:16] Speaker 2: reports of younger people getting melanoma that had you know,
[26:20] Speaker 2: low risk factors. So there were the Asian people getting
[26:22] Speaker 2: melanoma from having all this UVA light. So the UVA
[26:26] Speaker 2: damages your pigment cells more, it gets in deeper, it's
[26:31] Speaker 2: in deeper. And also the thing is that if you
[26:33] Speaker 2: if you are, we all know that as we get older,
[26:36] Speaker 2: we get more and more brown and white marks on
[26:38] Speaker 2: our skin. So the more UVA light presumably going to
[26:41] Speaker 2: get more discoloration.
[26:42] Speaker 1: So that's you know, I've got those some white spots
[26:45] Speaker 1: loss of pigment, yeah yeah, and lots of pigment.
[26:49] Speaker 2: Yeah, so they are white white yeah yeah yeah.
[26:51] Speaker 1: So is that because of sun exposure?
[26:52] Speaker 2: Yeah, sun exposure.
[26:53] Speaker 1: So and what's happened? So the sun exposure has done
[26:57] Speaker 1: what to that part of my skin?
[26:59] Speaker 2: Somehow? Somehow there's the pigment cells there don't work right,
[27:02] Speaker 2: so they don't produce pigment.
[27:05] Speaker 1: And it does therefore mean because I have those that's
[27:08] Speaker 1: call the white spots. If it goes into the If
[27:11] Speaker 1: I go out into the sun and I get exposed
[27:13] Speaker 1: to UVB and UVA, is there any danger because they
[27:17] Speaker 1: don't need they will burn more easily. Yes, that that
[27:20] Speaker 1: area burn more easy. It'll go more red or pick
[27:22] Speaker 1: or whatever the case man be interesting. So given the
[27:25] Speaker 1: vitamin D conversation that you know, it was a big
[27:29] Speaker 1: conversation during COVID because everybody's sort of saying, you know,
[27:31] Speaker 1: you need to take five thousand international units of vitamin
[27:34] Speaker 1: D per day in order to beat COVID, because allegedly
[27:38] Speaker 1: everyone was locked in home and they couldn't get outside
[27:40] Speaker 1: in the sunlight, especially those people who don't have the
[27:42] Speaker 1: opportunity live in a house, they live in an apartment,
[27:44] Speaker 1: and perhaps they don't have a balcony. Whatever, How do
[27:47] Speaker 1: people what is how do people get enough vitamin D?
[27:50] Speaker 1: Then if it's probably not a good idea to be
[27:53] Speaker 1: their first thing in the morning end or the last
[27:55] Speaker 1: thing in the evening, because they most people work, I
[27:57] Speaker 1: shouldn't say anymore. A lot of people don't go to
[28:00] Speaker 1: work during the day. They actually work from home, but
[28:03] Speaker 1: they end up going to the beach because I live
[28:05] Speaker 1: near the beach, and I can tell you, like this
[28:08] Speaker 1: week it was packed and thinking these people are not
[28:11] Speaker 1: at work, They're probably on their laptop. But anyway, so
[28:14] Speaker 1: how do they bow to people? Enough sunlight? And is
[28:16] Speaker 1: it a recommended enough amount?
[28:18] Speaker 2: Well, I think it's recommended that you know, in summertime,
[28:21] Speaker 2: somewhere between eight to ten minutes of sunlight on arms, legs,
[28:25] Speaker 2: and faces enough to get you the vitamin D that
[28:27] Speaker 2: you need, right you know, when the weather's cooler wintertime,
[28:30] Speaker 2: because you have less exposed skin, then you may need
[28:33] Speaker 2: up to an hour to get enough vitamin D. So
[28:35] Speaker 2: you know, but you know, I take vitamin DE supplements.
[28:40] Speaker 2: That's what I've been talking.
[28:41] Speaker 1: About, as do I. Yeah, yeah, but there's that supplement.
[28:45] Speaker 1: Does that replace having to go into the sun? Do
[28:47] Speaker 1: you think?
[28:48] Speaker 2: Well? It can. It can help reduce your need for
[28:51] Speaker 2: the sun.
[28:52] Speaker 1: In a physiological sense as opposed to as opposed to
[28:55] Speaker 1: maybe psychological.
[28:56] Speaker 2: Reasons, that's a bit different.
[28:57] Speaker 1: It's a different and or recreation, et cetera. But it's
[29:01] Speaker 1: in the physiological sense because vitamin D is necessary to
[29:05] Speaker 1: create a number of a number of other processes in
[29:08] Speaker 1: our body.
[29:09] Speaker 2: But I think you know, the vitamin The vitamin D
[29:12] Speaker 2: story is not fully out there. I mean I've been
[29:14] Speaker 2: looking for but I haven't seen it on research of
[29:17] Speaker 2: what happens with the Middle Eastern populations. So the Middle
[29:20] Speaker 2: Eastern population there are very sunny climates, but they're also
[29:23] Speaker 2: very heavily clothed and protected. You know, the women wear
[29:26] Speaker 2: veils and stuff like that. So I wonder do they
[29:29] Speaker 2: have a problem with vitamin D in their society.
[29:32] Speaker 1: I was once a chairman of a listed bio tech
[29:36] Speaker 1: company in Australian but it operated quite heavily in Northern Europe,
[29:40] Speaker 1: and we owned one of the biggest D deficiency protocols
[29:47] Speaker 1: for pathology and and and we used to look at
[29:52] Speaker 1: the stats of Northern Europe relative to Australia, particularly in
[29:55] Speaker 1: their winter, so many people would be diagnosed as being
[29:59] Speaker 1: vitamin deficient, which is where you would take they would
[30:02] Speaker 1: take vitamin D. And we didn't sell vitamin D, but
[30:03] Speaker 1: we just did the pathology and whereas Australia we're never deficient,
[30:07] Speaker 1: rarely deficient here rarely. But it's an interesting discussion which
[30:12] Speaker 1: is going on because five thousand international units's that's actually
[30:15] Speaker 1: quite a lot of vitamin D relative to other things
[30:19] Speaker 1: that we take and some people say even live oounce.
[30:21] Speaker 1: But it's a big, very interesting conversation because me much
[30:25] Speaker 1: eas if you just walked in the sun from the
[30:28] Speaker 1: train station to your office and got ten minutes with
[30:31] Speaker 1: the sun on your face.
[30:32] Speaker 2: Yes, but if we didn't live so long, there wouldn't
[30:35] Speaker 2: be an issue. You could do that. Yeah, I think
[30:36] Speaker 2: the longer we live, the more total sun you've had,
[30:39] Speaker 2: the more sun exposure, the more damage your skinners. So
[30:41] Speaker 2: that's that's the payback then.
[30:44] Speaker 1: Actually, on that topic, that's a really interesting topic because
[30:47] Speaker 1: I have read that for example, just at sea level
[30:51] Speaker 1: we get exposed to so many I think the measure
[30:56] Speaker 1: is called sea bits or something that of radiation measure
[31:02] Speaker 1: of radiation, but it's it's not necessarily sunlight. It's a
[31:06] Speaker 1: different type of radiation, something we probably can't see. But
[31:09] Speaker 1: and an over a lifetime there is an amount, and
[31:15] Speaker 1: of course lifetime's a bit subjective, but they measured that.
[31:19] Speaker 1: They say that average lifetime is eighty years of age
[31:21] Speaker 1: over a lifetime, we should only get fifty secrets in
[31:23] Speaker 1: this exposure. But then when you get in an aeroplane
[31:26] Speaker 1: you get exposed much more because you're getting a much
[31:28] Speaker 1: higher That's why pilots retire early but retire young.
[31:32] Speaker 2: And there is a study that's shown that airline pilots
[31:35] Speaker 2: get more melanoma.
[31:36] Speaker 1: And I was going to ask you on that topic,
[31:39] Speaker 1: is their studies equipment in terms of sun radiation or
[31:43] Speaker 1: sun exposure that we like in a measured sense that
[31:48] Speaker 1: we should be able to we should know, we shouldn't
[31:50] Speaker 1: get that any more than that.
[31:52] Speaker 2: I don't. I don't. I don't think it was I
[31:53] Speaker 2: think there are too many there are too many variables. Yeah,
[31:56] Speaker 2: you know, there are genetic successibility, so there is a
[31:59] Speaker 2: genetic disorder that these people aren't born with the right
[32:03] Speaker 2: enzymes to repair DNA damage. And these these children will
[32:07] Speaker 2: start getting sol like Erotos's non melanover skin cancer. Generally
[32:13] Speaker 2: they're dead by the age of twenty. WHOA, okay, because
[32:15] Speaker 2: these things just go ballistic.
[32:17] Speaker 1: Well, how do you how do you know, say someone's
[32:19] Speaker 1: listening is they just had a child, child's three four
[32:22] Speaker 1: years of age. What are you looking for?
[32:23] Speaker 2: Well, they were coming because they've got they've developed sunspots.
[32:26] Speaker 2: They will start to love rough skin. Why they've got
[32:28] Speaker 2: this rough skin a sunspot being the rush skin. Yeah,
[32:31] Speaker 2: they would be the first. That would be the first sign.
[32:34] Speaker 1: And then they're not burned David. With a certain tope skin,
[32:37] Speaker 1: you know.
[32:38] Speaker 2: They look they look like normal until their skin starts
[32:41] Speaker 2: to change. They will start to freckle more easily. So
[32:44] Speaker 2: their skin is not as they as they're growing, they're
[32:48] Speaker 2: not aging the same way as we would expect. Wow.
[32:51] Speaker 1: So if I could just talk to you about skin
[32:54] Speaker 1: for a moment, I mean a bit more detailed in Australia.
[32:59] Speaker 1: Around the world too, for that matter, there's the big
[33:01] Speaker 1: debate about statins yep, because you know, if you're cholesterols
[33:07] Speaker 1: more than you know whatever, it is six and a
[33:09] Speaker 1: half when and yelled down HDL measures, you know, sort
[33:12] Speaker 1: of out outside the range because ranges are very subjective
[33:15] Speaker 1: and we don't we don't really know where the range
[33:17] Speaker 1: are right up. But it doesn't matter. Let's just accept
[33:19] Speaker 1: the ranges from a pathology point of view. And the
[33:22] Speaker 1: first thing that happens is you do Peo put you
[33:24] Speaker 1: on the statin, and it could be any type of statin,
[33:26] Speaker 1: but this is humance, you know, one of the usual ones, crestal,
[33:29] Speaker 1: one of those sorts of things. And I was reading
[33:33] Speaker 1: somewhere that our skin is thirty percent cholesterol. It's h
[33:39] Speaker 1: fair amount of cholesterol in it, like our brain does too.
[33:43] Speaker 1: Is it dangerous about taking statins that may somehow end
[33:49] Speaker 1: up having reference in your skin's ability to withstand radiation
[33:54] Speaker 1: effects or even just just aging.
[33:57] Speaker 2: Okay, not that I'm aware of. I'm not aware of.
[34:00] Speaker 1: Because it's an interesting idea, because if we don't have
[34:04] Speaker 1: enough cholesterol in a body, something might not work. Who knows,
[34:07] Speaker 1: you know, Like someone says, you take twenty milligrams of
[34:09] Speaker 1: this mark, but it's not customize for me.
[34:14] Speaker 2: No, it's not.
[34:15] Speaker 1: It's because no one's saying, well, we'll give you twenty
[34:18] Speaker 1: milligrams of this and we do a blood test tomorrow
[34:21] Speaker 1: and by the way, you can go down to nineteen
[34:23] Speaker 1: and a half. It's not ty traded up or down
[34:26] Speaker 1: relative to the effect on cholesterol. And no one really
[34:29] Speaker 1: knows how much cholesterol I actually needed my system for
[34:33] Speaker 1: me to for sells to rebuild and get on with
[34:36] Speaker 1: their life, including the skin. Is there any does your industry,
[34:42] Speaker 1: your specialty ever think about these sorts of things or
[34:45] Speaker 1: do you just sort of say, look, that's a hard
[34:49] Speaker 1: issue that's for the cardiologists.
[34:51] Speaker 2: No, I mean I think you know, So with any
[34:54] Speaker 2: medication that comes to the market, side effects are reported
[34:57] Speaker 2: initially in the research stage. You know, every single thing
[35:00] Speaker 2: that happens with the patient is recorded as a potential
[35:03] Speaker 2: side effect, and then once the drug comes onto mass market,
[35:06] Speaker 2: then there's feedback as to what's happening. So we do
[35:08] Speaker 2: see very rare drug reactions from different medications, and the
[35:13] Speaker 2: higher it is then we often that may lead to
[35:15] Speaker 2: the medication being withdrawn. So we do see some side
[35:18] Speaker 2: effects from status. So people can get hives or a
[35:21] Speaker 2: carrier from it. They may get a bit slightly dry skin,
[35:24] Speaker 2: but we don't have any major safety signals that should
[35:27] Speaker 2: show that it's a problem. But sometimes these may not
[35:30] Speaker 2: show up for ten twenty thirty years, you know, I
[35:32] Speaker 2: mean currently, one of the very popular drugs that are
[35:36] Speaker 2: used for treating blood pressure is called a thihs are diuretic. Okay,
[35:40] Speaker 2: it's often used in combination with a lot of other
[35:43] Speaker 2: blood pressure larning medications. But research from about three years
[35:46] Speaker 2: or three or four years ago showed that anyone that's
[35:48] Speaker 2: on one of these thars are diuretics, it makes their
[35:51] Speaker 2: skin more sunsensitive, and so the group of patients that
[35:54] Speaker 2: are on this. You know, with fair skins on it
[35:56] Speaker 2: can increase their tendency to develop sun spots as well
[36:00] Speaker 2: as non melanoma skin cancer. So routinely when I now
[36:03] Speaker 2: see a patient that's for the first time they come in,
[36:06] Speaker 2: if they have a significant load of solokerotosis and they're
[36:09] Speaker 2: on that sort of medication, I will say to them,
[36:11] Speaker 2: you need to talk to your cardiologists or your general practitioner.
[36:15] Speaker 2: Think about it. They could switch you off this medication.
[36:17] Speaker 2: Now they don't have a burden of disease. Then I'll say,
[36:19] Speaker 2: we just observe you and see what happens.
[36:22] Speaker 1: So I think it sacoflies with some antibiotics as well.
[36:25] Speaker 2: Yes, some antibious make you so sensitive to the sun.
[36:28] Speaker 2: There are some heavy duty anti fungal drugs that are
[36:32] Speaker 2: used often in people that are transplant patients or emini
[36:35] Speaker 2: suppress and they increase the risk of skin cancer. It's
[36:37] Speaker 2: well known. But you know you're you're juggling which is
[36:40] Speaker 2: more important.
[36:41] Speaker 1: So you can I just touch on that fungal thing.
[36:43] Speaker 1: Because you and I have discussed this that when it
[36:47] Speaker 1: comes to fingernails, that's considered skin. That's part of your
[36:51] Speaker 1: part of my territory. It's skin. So there are fungal
[36:54] Speaker 1: diseases that you can get in your toes, and I
[36:57] Speaker 1: guess probably hand fingernails as well. And there are a
[37:02] Speaker 1: lot of things out that you can buy from various
[37:04] Speaker 1: places to try and get rid of them. And I said,
[37:07] Speaker 1: I'm a biggert sucker in the world for Instagram, and
[37:09] Speaker 1: I tend to buy things of Instagram. I shouldn't, but
[37:10] Speaker 1: I do, and they're generally speaking don't work. Can you
[37:15] Speaker 1: just explain that that fungal process that people get into
[37:17] Speaker 1: their toes? And I had, I am what someone of
[37:21] Speaker 1: the bers had one of my toes, and and how
[37:23] Speaker 1: do you get rid of it? It used toggest need
[37:25] Speaker 1: some tablets, but they're pretty bad.
[37:27] Speaker 2: It's really it's really difficult to get get rid of
[37:29] Speaker 2: fungal nail disease in the toenails. If you hadn't fingernails,
[37:33] Speaker 2: that's much easier because the nails grow so much quicker,
[37:36] Speaker 2: all right, But in general, to get fungal disease in
[37:39] Speaker 2: your toenails, you probably tend to get tinier between your feet,
[37:43] Speaker 2: so there will be a genetic susceptibility to why you
[37:45] Speaker 2: get tinier of your feet. Okay, So when you walk
[37:49] Speaker 2: around beerfoot. So whether it's at a swimming pool, a gym,
[37:53] Speaker 2: you go on holiday, you're in a you've rented a
[37:56] Speaker 2: hotel room, whether people walk beerfoot, if they have tenure,
[37:59] Speaker 2: then you'll pick it up between your toes. We wear
[38:01] Speaker 2: and close shoes, so once you're your feed are in
[38:04] Speaker 2: that slightly more hot human environment that allows the fungus
[38:08] Speaker 2: to grow. And then while the fungus is there between
[38:10] Speaker 2: your toes, you then traumatize the turnail. So let's say
[38:13] Speaker 2: you're lazy, you don't cut your turnails. The tournails along,
[38:15] Speaker 2: you have a pair of shoes that's tighter, you go
[38:17] Speaker 2: for a run, you damage that nail. And that is
[38:20] Speaker 2: how I believe the fung The fungus gets into the nail,
[38:23] Speaker 2: and once it gets into the nail, it just you know,
[38:25] Speaker 2: usually see it as a yellow streak going towards the
[38:27] Speaker 2: nail cuticle. And because the turnail is so slow to grow,
[38:31] Speaker 2: you know, you think of how often you would cut
[38:33] Speaker 2: your fingernails compared to cutting your turennails. And the fact
[38:36] Speaker 2: is that you keep wearing shoe wear, you keep traumatizing
[38:38] Speaker 2: the nail. It's really difficult.
[38:40] Speaker 1: And at the end of the day. What are the
[38:43] Speaker 1: ways to get rid of it? I mean the.
[38:46] Speaker 2: Tree, so the treatments, I mean, you could use paints.
[38:49] Speaker 2: The problem is that the paints often can't penetrate the
[38:52] Speaker 2: thickness of the nail plate to get rid of the fungus. Okay,
[38:55] Speaker 2: but you'll you'll see those things advertised or available the chemist.
[38:59] Speaker 2: The next thing would be oral medication. So there are
[39:03] Speaker 2: drugs around. There's one drug that the government does subsidize for,
[39:06] Speaker 2: but you need to take it for a good three months.
[39:09] Speaker 2: It has the risk of sometimes irritating or damaging your
[39:11] Speaker 2: liver or your kidney, so to me, and the curator
[39:14] Speaker 2: is like forty percent. We're not talking about seventy or
[39:16] Speaker 2: eighty percent. So if you're gonna have to keep taking it,
[39:19] Speaker 2: what risk are you're doing to your liberal kidney? We
[39:21] Speaker 2: don't know. So if you were taking it, you'd need
[39:23] Speaker 2: to have blood tests. And there are a few other
[39:25] Speaker 2: drugs like that, but they all have their issues, you know.
[39:28] Speaker 2: Even the one that is the safest, you probably would
[39:30] Speaker 2: need to take it for at least twelve to eighteen
[39:32] Speaker 2: months continuous to try and get the nail out.
[39:35] Speaker 1: Yeah, that's crazy.
[39:36] Speaker 2: There are laser treatments. So a lot of padatists do
[39:38] Speaker 2: have lasers. The lasers sort of heat up the nail
[39:41] Speaker 2: to an extent where it kills the fungus. It's painful
[39:44] Speaker 2: and expensive.
[39:45] Speaker 1: Yeah, I tried it. I tried it. It was painful and
[39:48] Speaker 1: expensive and did it work. It didn't work. There you
[39:50] Speaker 1: go because it came back.
[39:52] Speaker 2: Yeah, it comes back. It comes back. So because the
[39:56] Speaker 2: fungus can live in dead skin, so that get skin
[39:58] Speaker 2: will be in your carpet, you'll be in your shoes.
[40:01] Speaker 1: You just traumatize the nail. That's what you told me
[40:03] Speaker 1: to get rid of the shoes. They said to throw
[40:04] Speaker 1: away your shoes, throw away your socks, and start.
[40:06] Speaker 2: All over again.
[40:07] Speaker 1: Yeah, but that's an expensive that's an expensive ex size
[40:09] Speaker 1: and aza ape iss going to one hundredercent successful, Yes, but.
[40:12] Speaker 2: Then you have to make sure that you never walk barefoot.
[40:14] Speaker 2: But other people walk barefoot.
[40:16] Speaker 1: So that is it is a sort of a genetic
[40:19] Speaker 1: you see.
[40:19] Speaker 2: You see sometimes see families of people that are really bad,
[40:22] Speaker 2: you know, nail fungus, and there'll be someone in the family,
[40:25] Speaker 2: you know that's the other wife doesn't have anything because
[40:27] Speaker 2: she doesn't have the same genetic material, the father's passed
[40:29] Speaker 2: it on to the kids.
[40:31] Speaker 1: So given, and then you know you've just indicated genetics
[40:35] Speaker 1: actually plays role in relations to skin cancers. And you
[40:38] Speaker 1: know you're you're propensity was one a person's propensity to
[40:44] Speaker 1: get a skin cancer. It can be genetics. Can it
[40:47] Speaker 1: also be part of your environment and your social exposure
[40:50] Speaker 1: to the sunlight, et cetera. Is there other foods that
[40:55] Speaker 1: can cause skin cancers? Other things we might be eating.
[41:00] Speaker 2: So I don't think so much from eating. But if
[41:06] Speaker 2: you know one of the things that causes lip cancer's
[41:11] Speaker 2: spicy food are really okay spicy food alcohol. Seeing when
[41:15] Speaker 2: your lips burn because you're reading chili, you're irritating you
[41:18] Speaker 2: all the time. So repeated irritation on any part of
[41:22] Speaker 2: your skin can lead to a cancer developing.
[41:25] Speaker 1: What about these people get their lip injections to make
[41:28] Speaker 1: their lips fatter, Well, that's not in irritant, but they
[41:31] Speaker 1: look like they look when I say them, they look irritated.
[41:34] Speaker 1: It looks red, you know what I mean.
[41:35] Speaker 2: Like, oh, they're puffed out. Yeah, you're puffed out. That's
[41:38] Speaker 2: no issue that well, as far as we know, this
[41:40] Speaker 2: stage is not an issue. Right, But you know you know,
[41:43] Speaker 2: one of the classic things that we're taught at med
[41:45] Speaker 2: school is that in New Guinea people to the beetle
[41:48] Speaker 2: nut yep right as a as a as a habit
[41:52] Speaker 2: and they have an increased risk of lip cancer.
[41:54] Speaker 1: From Okay, that's very that's very interesting. So if you
[41:59] Speaker 1: were if I were to ask you, Okay, David, I'm
[42:01] Speaker 1: a thirty year old person, todate, I haven't really had
[42:05] Speaker 1: too much exposure to the sun, just the average. Haven't
[42:08] Speaker 1: never really been burned to me times once or twice.
[42:11] Speaker 1: What are the things that tips that you would say
[42:14] Speaker 1: to me to give myself my best possible chance to
[42:18] Speaker 1: prevent skin cancer and park or put aside annual checks
[42:24] Speaker 1: and you know, get check ups the obvious.
[42:26] Speaker 2: Well, I think the thing is, you know, whenever you're
[42:29] Speaker 2: going to be outdoors, take precautions to not get sunburned.
[42:33] Speaker 2: Every sunburn you get is going to increase your risk
[42:35] Speaker 2: of skin cancer. You know, if you're a male at
[42:37] Speaker 2: thirty of your thinning, always make sure you wear a hat,
[42:40] Speaker 2: even if a baseball hat, to protect the top of
[42:42] Speaker 2: your scalp, because the scalp gets direct sunlight, so it.
[42:45] Speaker 1: Gets you got a lot of hair.
[42:46] Speaker 2: If you've got a good head of hair, that's fine.
[42:49] Speaker 2: But if you don't wear a hat, I think that
[42:52] Speaker 2: you know, and for most men, by the time they
[42:56] Speaker 2: realize they're bold, they've been baldy for some time and
[42:58] Speaker 2: that's when they do most of their.
[42:59] Speaker 1: Damage that's made. I mean, I actually feel like a
[43:02] Speaker 1: bit thinn in myself, a bit of mine.
[43:04] Speaker 2: We often as we get older.
[43:05] Speaker 1: Yeah, so should wear a hat.
[43:07] Speaker 2: Yeah. So A good easy way for you to tell
[43:10] Speaker 2: is when you when you come out of the shower,
[43:11] Speaker 2: when you hear's wet and flat, get someone to take
[43:13] Speaker 2: a photograph on the top of your head. See how
[43:15] Speaker 2: much bold scalp you can see.
[43:17] Speaker 1: And should they be looking at should they be looking
[43:20] Speaker 1: for discolouration or but do you get it? They just
[43:23] Speaker 1: actually get like a something that's red or something that
[43:27] Speaker 1: ABCD will they can?
[43:30] Speaker 2: They can. So, I mean, if you look at someone
[43:31] Speaker 2: that's you know, still has a bit of hair and
[43:33] Speaker 2: had some on their scalp, you'll see that the scalp
[43:36] Speaker 2: looks pink. You'll see that it probably has pigment in it,
[43:39] Speaker 2: so they have little tan freckles in it. And sometimes
[43:41] Speaker 2: they'll start to get the sol the keratosis.
[43:44] Speaker 1: So what other things should they be doing? In terms
[43:46] Speaker 1: of tips for prevention.
[43:49] Speaker 2: I think, you know, if they're going to be outdoors,
[43:50] Speaker 2: let's say they enjoy surfing, golfing, whatever I'd say to them,
[43:55] Speaker 2: try and cover as much as you can. You can
[43:56] Speaker 2: now get sleeves, you can get surfing hats where rashy.
[44:00] Speaker 2: You know, it doesn't matter if you look if you
[44:02] Speaker 2: think you look stupid. If you're a good surfer, people
[44:04] Speaker 2: look at your style. They won't look and say what
[44:05] Speaker 2: are you wearing.
[44:07] Speaker 1: The motorage and out, well, you right the wave, that's correct,
[44:10] Speaker 1: unless you unless you're bloody hopeless, and then they might
[44:12] Speaker 1: look at what you're wearing. And in terms of sunscreen,
[44:15] Speaker 1: you know, we hear at SPF fifty and fifty plus
[44:18] Speaker 1: and then then then you hear about something he says.
[44:20] Speaker 1: Someone will say, well, hang on, but that particular shungcreen
[44:23] Speaker 1: has got something else in it that you shouldn't be
[44:25] Speaker 1: putting on your skin. For me, I find extraordinarily confusing.
[44:28] Speaker 1: I don't know. There's some people say, why zen ping zinc,
[44:31] Speaker 1: go back to the old days, But you can't even
[44:33] Speaker 1: get the stuff off. I mean, if you put on once,
[44:35] Speaker 1: it's going to be there for a week, especially with
[44:37] Speaker 1: some of the nose as big as mine, that's probably good. Yeah,
[44:40] Speaker 1: So what would you say, so in terms.
[44:43] Speaker 2: Of my general pays, I mean, if you when you
[44:45] Speaker 2: have to use a sunscreen, so you can use clothing
[44:47] Speaker 2: to protect on much of your body, so you don't
[44:49] Speaker 2: put sunscreen all over your body. Okay. So I think
[44:52] Speaker 2: you know, even when you have sunscreen on, it gives
[44:54] Speaker 2: you good protection for maybe forty five minutes to an
[44:57] Speaker 2: hour in the summer. It does not give you good
[45:00] Speaker 2: protection for ten hours if you're out there, because there's
[45:03] Speaker 2: a I call the law of diminishing returns. You know,
[45:06] Speaker 2: if the sunscreen blocks are ninety nine percent of your light,
[45:09] Speaker 2: you're getting one percent coming through your skin. If I
[45:11] Speaker 2: said to you, look, I'm going to give you one
[45:13] Speaker 2: percent of a dollar one sent you said, that's really generous.
[45:15] Speaker 2: If I give you one percent of a million dollars,
[45:17] Speaker 2: you'll say, oh, I'm interested now. So the quantum of
[45:19] Speaker 2: light changes, right, and then I would always say to you,
[45:24] Speaker 2: use a fifty plus sunscreen. So the laws regarding SPF
[45:28] Speaker 2: varies from country to country. In this country, in order
[45:31] Speaker 2: for the sunscreen to meet the fifty plus requirement. It
[45:34] Speaker 2: has to have a minimum of a seventeen or eighteen
[45:37] Speaker 2: rating for UVA protection. Anything lower in that it doesn't
[45:41] Speaker 2: necessarily have to have any UVA protection. And as you
[45:43] Speaker 2: may remember, I was talking about UVA as a longer
[45:45] Speaker 2: wave length light hitting the pigment cells. So that's why
[45:48] Speaker 2: I think having the fifty plus is important to protect
[45:51] Speaker 2: against the pigment.
[45:52] Speaker 1: And what about the little kids?
[45:54] Speaker 2: It looks the same clothing as much as possible. There
[45:56] Speaker 2: are toddler sunscreens that are rated safe by the government.
[45:59] Speaker 1: And training in sunscreens? Are they generally speaking? Would you
[46:05] Speaker 1: say they are as effective as anything you can get overseas?
[46:07] Speaker 2: Absolutely? You know so, and laws often people say, look,
[46:10] Speaker 2: I got an SPF one hundred in America, but that
[46:13] Speaker 2: SPF one hundred maybe against UVB light, it's not necessarily
[46:16] Speaker 2: against UV A light. And you'll find some of the
[46:18] Speaker 2: sports sunscreens here in Australia they're rated at over one
[46:21] Speaker 2: hundred SPF as well, but they're not allowed to market
[46:24] Speaker 2: it as such.
[46:25] Speaker 1: Okay, can I just want to move Maybe is slightly different.
[46:29] Speaker 1: Now let's talk about well, first and foremost, what's the
[46:35] Speaker 1: difference is difference between you and a plastic surgeon.
[46:38] Speaker 2: So there's a there's a there's a big difference. So
[46:41] Speaker 2: I mean as a dermatologist, you know part of my
[46:46] Speaker 2: I guess dermatologists may be beaurely medical based, so they're
[46:50] Speaker 2: looking at skin diseases rather than skin cancer. There are
[46:53] Speaker 2: some more surgical dermatologists that do treat a lot of
[46:55] Speaker 2: skin cancer. There are cosmetic dermatologists that do a lot
[46:58] Speaker 2: of beauty treatments. So there will be the three main groups.
[47:01] Speaker 2: And then you do also or you also have pediatric dermatologists.
[47:03] Speaker 2: They treat diseases that we see in the skin that
[47:06] Speaker 2: are in children. A plastic surgeon. Again, they would vary.
[47:11] Speaker 2: There are plastic surgeons that are more interested in doing
[47:13] Speaker 2: cosmetic stuff like facelifts and that sort of thing. There
[47:15] Speaker 2: are plastic surgeons that are more reconstructive surgeons, so if
[47:18] Speaker 2: you've had to have major surgery from an accent, they're
[47:20] Speaker 2: helping to reconstruct that. And then there are plastic surgeons
[47:23] Speaker 2: that will do skin cancer work. So if you have
[47:25] Speaker 2: a skin cancer in your ear or your nose and
[47:28] Speaker 2: has to be cut out, there's a piece of tissue missing,
[47:30] Speaker 2: how do they replace that piece of tissue so that
[47:33] Speaker 2: you look fairly normal, so you don't look disfigured. Now,
[47:37] Speaker 2: when dermatologists first started, they didn't really get trained and
[47:40] Speaker 2: proper surgery. But you know, from when I started dermatology,
[47:45] Speaker 2: there was a push because there's just so much skin
[47:47] Speaker 2: cancer work and not everyone can can afford to go
[47:49] Speaker 2: and see a plastic surgeon, and so we started to
[47:51] Speaker 2: do more and more surgical procedures. So this is your
[47:55] Speaker 2: surgery and bond junction. Yeah, yeah, so I do. I do.
[47:59] Speaker 2: I do surgery on all parts of the body. Face
[48:02] Speaker 2: knows all that sort of stuff. But I know what
[48:04] Speaker 2: I can do and what sort of result I can
[48:05] Speaker 2: give a patient. If the patient is happy for that
[48:08] Speaker 2: to go ahead, then I go and do it. If
[48:11] Speaker 2: it's a young person, I'll say look for whatever reason,
[48:14] Speaker 2: I think the plastic surgeon you'll feel better and more
[48:15] Speaker 2: comfortable with That's what I'm going to send you to.
[48:17] Speaker 2: I don't need to do everything that I see.
[48:19] Speaker 1: So you can diagnose it.
[48:20] Speaker 2: I can diagnose, so to me, it's always you know,
[48:23] Speaker 2: if you make the correct diagnosis, then the correct treatment
[48:25] Speaker 2: will follow.
[48:27] Speaker 1: If I then go on to an aesthetic dermatology, if
[48:32] Speaker 1: I good call it that when if someone does something,
[48:39] Speaker 1: for example, what do they call it? Laser treatment? Laser laser?
[48:44] Speaker 1: Does the laser treatment apart from well maybe you could
[48:48] Speaker 1: tell me, does it does make your skin better? It
[48:51] Speaker 1: doesn't work.
[48:52] Speaker 2: Yes, lasers do work. Yeah, but you know again, it's
[48:55] Speaker 2: like you're choosing a tool and using that tool to
[48:57] Speaker 2: treat what you've diagnosed, what the patient wants. So there
[49:00] Speaker 2: are many different types of lasers. There are lasers to
[49:03] Speaker 2: treat broken blood vessel. So you know, one of the
[49:05] Speaker 2: things that in a sun damaged skin, particularly in people
[49:08] Speaker 2: that are fair skin, you start to notice that have
[49:10] Speaker 2: lots of little red lines on their faces.
[49:11] Speaker 1: I got some here and you pointed out something here
[49:14] Speaker 1: last I said, you might have there's like a purple
[49:17] Speaker 1: thing or a blue thing.
[49:18] Speaker 2: H get rid of it?
[49:19] Speaker 1: Is that what laser surgery would get rid of.
[49:21] Speaker 2: So yes, lasers vasculates and get rid of that, right,
[49:24] Speaker 2: It sort of seals the vessel. But you know, people
[49:27] Speaker 2: have to understand the reason why they develop those vessels,
[49:30] Speaker 2: and that basically is from sun exposure. You know, for
[49:33] Speaker 2: anything that you know when you exercise and your face
[49:35] Speaker 2: goes more red, you have spicy food or alcohol your
[49:37] Speaker 2: face knows more red. Those vessels are getting stretched, so
[49:41] Speaker 2: over time some will always come back. But that's vascular laser.
[49:44] Speaker 2: And then you have lasers that are designed to treat pigments.
[49:47] Speaker 2: So let's say you had a brown or brown marks
[49:49] Speaker 2: or dirty marks on your face. You didn't like that,
[49:51] Speaker 2: there are lasers that are designed for that. There are
[49:54] Speaker 2: lasers that are designed for hair removal. So people that
[49:57] Speaker 2: don't want hair, or girls that don't want hear on
[49:58] Speaker 2: their arm pits or their legs, they'll spend the money
[50:01] Speaker 2: and get that done. If you've got scars, you know,
[50:03] Speaker 2: scars from acne, scars from surgery, you can use what's
[50:07] Speaker 2: called fractionated laser to help blend the scar.
[50:10] Speaker 1: So do any of these things that make your skin younger?
[50:15] Speaker 2: Well, yes, particularly, I guess if you have brown marks
[50:19] Speaker 2: and red marks on your face, evening out the skin
[50:22] Speaker 2: color will make you look clearer. It makes your skin
[50:25] Speaker 2: look younger. It's like if you were to look at
[50:26] Speaker 2: your look at the inside of your forearm, all right,
[50:29] Speaker 2: the inside of your forearm, the skin's much more one
[50:32] Speaker 2: colored and it will feel smoother to you than the
[50:35] Speaker 2: exposed side. So if we were to give you that
[50:38] Speaker 2: on the exposed side, it would take years off your.
[50:42] Speaker 1: Look younger, But is your skin actually younger? Is probably might.
[50:45] Speaker 2: Post So if you were to do what's called ablative laser,
[50:49] Speaker 2: so when people actually burn the skin, that stimulates collagen production.
[50:52] Speaker 2: So there are some lasers that break the skin. There
[50:55] Speaker 2: are also lasers that don't break the skin and they
[50:57] Speaker 2: stimulate more collagen. So yes, if you're to cut a
[50:59] Speaker 2: piece of skin out and look at it, the treated
[51:01] Speaker 2: skin is more youthful.
[51:03] Speaker 1: So can you just talk about the collagen for a moment?
[51:06] Speaker 1: And you know you can buy products in shops that
[51:09] Speaker 1: says collagen peptides, which is a powder and you just
[51:13] Speaker 1: put water with it. How does collagen fit into the
[51:17] Speaker 1: program here? Because is collagen about the bodybuilders use it?
[51:21] Speaker 1: Or is it just for skin repair? What's to do
[51:23] Speaker 1: with collagen?
[51:24] Speaker 2: Well, I don't think you can swallow it or eat
[51:27] Speaker 2: it to help the collagen your skin. Wow, you know
[51:30] Speaker 2: it's note by available. Yeah, your gut would just break
[51:33] Speaker 2: it down right all right. It might use the nutrients
[51:35] Speaker 2: or something else, but ultimately the skin cells make the
[51:39] Speaker 2: collagen right all right. And there are different types of
[51:41] Speaker 2: collagen and over time some of the collagen degrades, and
[51:45] Speaker 2: so it's like the trauma, all right, of the burn
[51:49] Speaker 2: stimulates to collagen to be produced. The factor is the cell.
[51:52] Speaker 2: The cells say, hey, we've got to make new collagen.
[51:55] Speaker 2: And so you can't eat it, you can't put it
[51:57] Speaker 2: on your skin, you can't, you can't apply it top
[51:59] Speaker 2: you can't topically. You can inject it. Okay, So that's fillers, okay,
[52:03] Speaker 2: but they're not you know, the current fillers that we
[52:05] Speaker 2: use are all mostly what are called haloratic acid fillers.
[52:08] Speaker 2: They're not collagen.
[52:09] Speaker 1: They're not collagen. But how would someone get you gave
[52:13] Speaker 1: one example, but how would someone get more collagen into
[52:16] Speaker 1: their skin? Like, is there's some way to do that?
[52:18] Speaker 2: Irritated Irritated irritation stimulates collagen production.
[52:22] Speaker 1: And what is that process? Is your body fighting back?
[52:24] Speaker 1: What is it?
[52:25] Speaker 2: Like? I don't know why it does, but that's what
[52:30] Speaker 2: people observe. So any sort of you know, even if
[52:32] Speaker 2: you have a superficial burn, so it's almost like you know,
[52:35] Speaker 2: if you burnt your skin, when that scab comes off,
[52:37] Speaker 2: the new skin looks much healthier than the skin that
[52:40] Speaker 2: was there previously.
[52:42] Speaker 1: So therefore, some of these treatments like laser sounds like
[52:47] Speaker 1: it's pretty hot. It sounds like it's burning. It's a
[52:50] Speaker 1: burning process. So maybe these things do stimulate the production
[52:54] Speaker 1: of more collagen in your skin. Yes, therefore making your skin.
[53:00] Speaker 1: It obviously doesn't go back in time, so you can't
[53:04] Speaker 1: your skin. Yeah, it just creates more things that would
[53:06] Speaker 1: be normally there. If you're a younger person, yes, so
[53:09] Speaker 1: you are getting the younger person effect. Yes, your skin
[53:12] Speaker 1: has got younger, but you've got the younger person effect.
[53:14] Speaker 1: So because you know, I watch all these Hollywood stares
[53:17] Speaker 1: and I think, my god, they look like they someone
[53:21] Speaker 1: look younger now thirty years than they did thirty years ago,
[53:24] Speaker 1: And I think, what are you doing? I mean it's
[53:26] Speaker 1: maybe the lights are good and the makeup is good,
[53:28] Speaker 1: but still, like I can say, there are no lines.
[53:31] Speaker 1: They've got no lines on their face. They know, like me, like,
[53:33] Speaker 1: you know, like they look awesome. How do they do that?
[53:38] Speaker 2: Well, it's probably a combination of things. It's not just
[53:40] Speaker 2: one thing that they're doing. So, you know, it depends
[53:43] Speaker 2: on what their age is, whether or not they've had
[53:44] Speaker 2: a face lift. Okay, So I often say, if you
[53:48] Speaker 2: want to look at someone closely, that they think, oh gee,
[53:50] Speaker 2: they look really good for their age. Have a look
[53:52] Speaker 2: at their neck. Okay, the neck is probably the most
[53:54] Speaker 2: difficult place to improve. There are treatments of that now too,
[53:57] Speaker 2: but it's hard to improve it. You can if you
[53:59] Speaker 2: look at them the neck or the deck colored tage
[54:01] Speaker 2: of a female, then you'll sort of often see it.
[54:03] Speaker 2: It's much more sun damage because they then had the
[54:05] Speaker 2: same protection there. And then there's there's usually a combination
[54:08] Speaker 2: of botox okay, just to smooth out the skin, fillers
[54:13] Speaker 2: all right, the plump up the skin, and various other
[54:16] Speaker 2: lasers all to get rid of freckles. You know, one
[54:20] Speaker 2: of my again using analogy, Morgan Freeman, has a lot
[54:22] Speaker 2: of little brown dots on his face. At one stage
[54:24] Speaker 2: he's had those zapped off, so the skin now looks
[54:27] Speaker 2: much clearer.
[54:28] Speaker 1: And you we think by laser, yeah, by laser.
[54:31] Speaker 2: Yeah yeah. And so I mean we do we do that.
[54:33] Speaker 2: I mean I do that to patients. Yeah yeah.
[54:35] Speaker 1: You have that process in your in your business.
[54:37] Speaker 2: For patients that want to have it done.
[54:38] Speaker 1: Yeah yeah, yeah. Yeah. So there's I don't know if
[54:41] Speaker 1: you follow this guy, if you ever watched him, is
[54:43] Speaker 1: a guy called Brian Johnson.
[54:44] Speaker 2: Oh, I think I think he's the see the fellow
[54:47] Speaker 2: that's also had stem cells injected his son or something
[54:50] Speaker 2: like that.
[54:50] Speaker 1: Yeah, yeah, and he's he's had sort of transfused, taken
[54:54] Speaker 1: blood from his son and put in his own system.
[54:57] Speaker 1: And and he in turn actually put blood into his
[55:00] Speaker 1: own father, Bryan put it into his own fel which
[55:02] Speaker 1: is interesting. But the guy, when I look at his skin,
[55:06] Speaker 1: like he's hasn't got a freckle on his old body
[55:08] Speaker 1: because he always got a shirt off. There's a new
[55:10] Speaker 1: series on Netflix with him in it. His skin looks
[55:12] Speaker 1: like basically perfect, like it's nearly translucent. To me. It
[55:18] Speaker 1: looks like like I can see through it, nelly. And
[55:21] Speaker 1: his face is like perfect, like like he's eighteen in
[55:26] Speaker 1: he's like mid forties. And I wonder myself, what does
[55:30] Speaker 1: someone like that do? I mean, he's sure he only
[55:32] Speaker 1: eats once a day, and he only eats in a
[55:34] Speaker 1: certain time of day, but he's only doing that for
[55:37] Speaker 1: a few years, as me doing that his whole life,
[55:40] Speaker 1: he restricts his amount of unlight, et cetera. If you
[55:44] Speaker 1: respeculate what sort of things would someone like that be
[55:48] Speaker 1: doing to get himself in such a perfect such a
[55:50] Speaker 1: perfect condition. Is he eating something like, you know, is
[55:53] Speaker 1: fish all really good for us? You know, all those
[55:55] Speaker 1: sorts of things.
[55:57] Speaker 2: I don't think that any supplement that's been proven to
[55:59] Speaker 2: be really helped for the for the skin. I mean,
[56:02] Speaker 2: the only supplement that our routinely would tell patients to
[56:04] Speaker 2: take is nicotinamide. So there's some studies that's just so
[56:07] Speaker 2: nicotinamide reduces the incidents of development a solu kerotosis and
[56:11] Speaker 2: skin cancer. But I suspect that he's having some sort
[56:14] Speaker 2: of laser work done.
[56:15] Speaker 1: Yeah, and you know, is that dangerous.
[56:18] Speaker 2: It depends on what sort of laser he's having done.
[56:22] Speaker 2: But I'd suspect that initially you probably had more more
[56:25] Speaker 2: invasive laser procedure and it's done a much simpler maintenance.
[56:30] Speaker 1: And how what role is drinking lots of water play.
[56:35] Speaker 1: I think it's good to hydrate your skin, but I
[56:37] Speaker 1: think that's probably it hydrate your skin, or hydrate yourself,
[56:40] Speaker 1: hydrate the whole body. Yeah, So you can't hydrate your
[56:42] Speaker 1: skin though, can you.
[56:43] Speaker 2: Well, you're you're always losing water through your skin, So
[56:48] Speaker 2: you know, even if you're sitting here it's cool, there's
[56:51] Speaker 2: a degree of water loss through your skin. So if
[56:53] Speaker 2: you're not if you're not drinking water, eventually that's going
[56:55] Speaker 2: to dry.
[56:56] Speaker 1: Yeah. So but the hydration of your skin though, is
[56:58] Speaker 1: through through water into there's no way you can hydrate
[57:03] Speaker 1: skin from the outside there.
[57:05] Speaker 2: Well, yes you can. I mean basically if you put
[57:07] Speaker 2: on a moisturizing cream. What that moisturizing cream is partly
[57:10] Speaker 2: to clog the sweat paws so that the moisture that's
[57:14] Speaker 2: coming out of your sweat paws is then going to
[57:15] Speaker 2: hydrate the skin.
[57:16] Speaker 1: Yes, okay, So is that the sort of like the
[57:21] Speaker 1: theory of the premise behind face creams.
[57:23] Speaker 2: So most face creams that's what they do. There are
[57:27] Speaker 2: some other face creams that work by lifting away some
[57:29] Speaker 2: of the dead layer of the skin. So there's a
[57:31] Speaker 2: dead layer of skin, and so you're then revealing the
[57:33] Speaker 2: next lave skin which is more hydrated that looks plumper.
[57:36] Speaker 2: So there's those two variants to moisturizing.
[57:39] Speaker 1: Because I remember many years ago, not that many ago,
[57:41] Speaker 1: maybe fifteen years ago, you could go in some pharmacies
[57:44] Speaker 1: they sold a vitamin C which is sort of an
[57:49] Speaker 1: as an acidic base, and you could apply this vitamin
[57:52] Speaker 1: CEED to your skin and everyone's raving on about saying
[57:54] Speaker 1: it's the grest thing.
[57:55] Speaker 2: You know.
[57:56] Speaker 1: Ever, probably what it was doing because it was acid based.
[58:01] Speaker 1: Votums is an acid base chemical. It's probably burning the
[58:05] Speaker 1: top layer of your skin, peeling off a good skin,
[58:07] Speaker 1: and and you know allegedly therefore it's probably stimulating. You know,
[58:12] Speaker 1: the iritates enough, yes, if it irritates enough so so
[58:18] Speaker 1: that that's interesting what you say about hydration though, if
[58:21] Speaker 1: I could just look at skin care, not not about cancer,
[58:25] Speaker 1: but skin care, what is a good regime like I mean,
[58:31] Speaker 1: or just wash your faces sunlight? So I mean, what
[58:33] Speaker 1: is it?
[58:35] Speaker 2: Well, the skin wasn't designed to be washed every day, and.
[58:38] Speaker 1: I always have an alkali alkaline alkalini impl apply to.
[58:42] Speaker 2: It, right, and so you know, unfortunately, you know, we
[58:45] Speaker 2: see lots of x mem in this country because it's
[58:48] Speaker 2: always said, you know, cleanliness is next to godliness. So
[58:50] Speaker 2: people shower every day, people have long showers. When you're young,
[58:54] Speaker 2: it probably doesn't matter for the majority of us because
[58:56] Speaker 2: we have enough oil in our skin. But as we
[58:57] Speaker 2: get older, you find a lot of people and up
[59:00] Speaker 2: with dry skin problems. The don't understand why their skin
[59:02] Speaker 2: is so fragile. Because it's dry. And so you know,
[59:06] Speaker 2: I think a good regime is not spending too long
[59:08] Speaker 2: in a shower, not having it too hot, just using
[59:11] Speaker 2: the ark lines soap for the areas that you need
[59:13] Speaker 2: to for personal hygiene, and then if your skin is
[59:17] Speaker 2: starting to get a bit dry, started applying a bit
[59:19] Speaker 2: of moisturizer to it.
[59:21] Speaker 1: So like in terms of our faces, in terms of
[59:24] Speaker 1: managing ourselves, unless would be fair to say, unless you're
[59:27] Speaker 1: sort of working in a grimy environment in down hole,
[59:30] Speaker 1: you probably don't need to wash your faces soap every day.
[59:32] Speaker 2: No, you can just just warm waters.
[59:33] Speaker 1: Fine, Yeah, and then does that then result and you're
[59:38] Speaker 1: getting perhaps blackheads or spots, and so if.
[59:41] Speaker 2: You're getting black heads and so on, that means your
[59:43] Speaker 2: skins quite early and the oil is not coming out,
[59:46] Speaker 2: then you probably need to use a cleanser that gently
[59:49] Speaker 2: peels the skin. You want to unclog those paws.
[59:52] Speaker 1: So can I just ask you about something about young
[59:54] Speaker 1: men who get let's call it acting but just like
[59:58] Speaker 1: active skinned in terms of you know, pimples and bumps.
[1:00:04] Speaker 1: Just so we understand this, and I know I've always
[1:00:09] Speaker 1: wondered this surely is not because you too much chocolate
[1:00:12] Speaker 1: and pizzai shit like that. I mean, has it got
[1:00:14] Speaker 1: something to do with testosterone or has it got something
[1:00:18] Speaker 1: you know, with your if you're in puberty, how does
[1:00:22] Speaker 1: it all work?
[1:00:23] Speaker 2: The main thing is testosterone. So you know, you don't
[1:00:25] Speaker 2: see acne before puberty hits. And with puity, you got
[1:00:28] Speaker 2: a surge of testosterone, and that testosterone level keeps going
[1:00:31] Speaker 2: up into your twenties before it starts to go down.
[1:00:33] Speaker 2: And testosterone is what stimulates oil production.
[1:00:36] Speaker 1: And what happens then is that get clogged or something.
[1:00:38] Speaker 2: So if you've got all this oil coming out and
[1:00:40] Speaker 2: it can't get out of the poor because the oil
[1:00:42] Speaker 2: is produced a couple of millimeters below the surface of
[1:00:45] Speaker 2: the skin, where it's a bit warmer, it's more liquid there.
[1:00:47] Speaker 2: It just gets to the surface of the skin's a
[1:00:48] Speaker 2: bit cooler, so like butter, it starts a set and
[1:00:51] Speaker 2: that's how the white head develops. When the skin separates
[1:00:54] Speaker 2: on the top, then it becomes a black head. And
[1:00:56] Speaker 2: then because it's like a stagnant pond of oil, eventually
[1:00:59] Speaker 2: it might get in and then you've got your red pimple.
[1:01:01] Speaker 1: Ah, So it all starts through with testosterone.
[1:01:05] Speaker 2: Yeah, so you know if you if you read about
[1:01:08] Speaker 2: uh and then Egypt when they had unux so units
[1:01:11] Speaker 2: were all carstrated and they all had beautiful skin because
[1:01:14] Speaker 2: their testosterone never came to the fore.
[1:01:16] Speaker 1: Because they didn't produce test uster testosterone or there's you
[1:01:19] Speaker 1: can produce testosteron without testes. Yes, it's not the same.
[1:01:22] Speaker 1: So not much, not much. Your dream of land produces
[1:01:24] Speaker 1: a little bit, just enough to live, but not not much.
[1:01:27] Speaker 1: And that makes sense. Yeah, that makes a lot of sense.
[1:01:30] Speaker 1: So if I could just just turn a little bit
[1:01:34] Speaker 1: now back to the whole longevity discussion, you know, no
[1:01:38] Speaker 1: longevity discussion, because I'm sick of the bloody word, Like
[1:01:41] Speaker 1: I don't even know what it means. It's an elusive word,
[1:01:44] Speaker 1: you know, because sooner or later, Mother Nature's going to
[1:01:46] Speaker 1: get you one way or the other, and you're going
[1:01:49] Speaker 1: to go down. And you're either only go down from
[1:01:51] Speaker 1: hard problems or cancer or some sort of metabolic disease
[1:01:54] Speaker 1: or a brain brain disorder, all of which will you know,
[1:01:57] Speaker 1: finish your days off. But if I go to cancer,
[1:02:01] Speaker 1: and in particular skin cancer, what you being a dermatologist,
[1:02:06] Speaker 1: and I know you're very aware of your health and
[1:02:09] Speaker 1: your own longevity because as both you and I were
[1:02:12] Speaker 1: similar sort of ages, we start to think of, you know,
[1:02:15] Speaker 1: we've had this discussion a few times when we pull
[1:02:17] Speaker 1: the plug and in terms of work and take advantage
[1:02:20] Speaker 1: of whatever's left. What do you think about at your
[1:02:24] Speaker 1: age now relative to skin cancer and your Asian genetics?
[1:02:30] Speaker 1: So both parents Asian, yes, yeah, Asian genetics on both sides,
[1:02:34] Speaker 1: so you would have a certain type of risk factor
[1:02:40] Speaker 1: associated with you. What do you think about how you
[1:02:43] Speaker 1: live your life from now on relative to sunlight and
[1:02:47] Speaker 1: just make sure you don't get a skin cancer.
[1:02:49] Speaker 2: So I mean, genetically my risk of getting a skin
[1:02:52] Speaker 2: cancer is pretty small, but I sort of think of
[1:02:58] Speaker 2: the sun exposure is gradually aging my skin, so you're
[1:03:02] Speaker 2: losing elasticity, you'll see, Like you know, my mother went
[1:03:08] Speaker 2: before she passed, her skin was getting thin, so easy bruising,
[1:03:11] Speaker 2: and it's always going to be bruising on the exposed sites.
[1:03:14] Speaker 2: So to me is the further longer I live, I
[1:03:18] Speaker 2: want to keep my skin in good order. So it's
[1:03:19] Speaker 2: not a source of annoyance, you know, if you I
[1:03:24] Speaker 2: mean I play golf, if my skin got thinner looking
[1:03:27] Speaker 2: for golf ball, I scratched my arm on a twig
[1:03:30] Speaker 2: and it starts to bleed, that would be annoying. And
[1:03:33] Speaker 2: then if that, if that's happening on your legs, then
[1:03:36] Speaker 2: any break in your skin does run the risk of
[1:03:38] Speaker 2: pick up an infection.
[1:03:39] Speaker 1: So is that a thing? Is though as we get older,
[1:03:41] Speaker 1: the skin is like thinner, absolutely, And because I remember
[1:03:46] Speaker 1: my dad used to get bruising cuts really quite easily
[1:03:49] Speaker 1: and when he's ninety eighty nine, is that that's just
[1:03:55] Speaker 1: normal process?
[1:03:56] Speaker 2: Well, you know it's again that aging paint. Yeah, you
[1:04:00] Speaker 2: know analogy. Your skin's getting thinner and thinner, so that
[1:04:02] Speaker 2: paint is cracking and splitting. So you know, one of
[1:04:05] Speaker 2: the things is if you put moisturizer on it, there's
[1:04:07] Speaker 2: a bit more give and take there, but the skin
[1:04:10] Speaker 2: is still thinner. So I mean, if I often will
[1:04:12] Speaker 2: do a demonstration to my patience where I sort of
[1:04:15] Speaker 2: generally squeeze the back of their hand and see how
[1:04:17] Speaker 2: easy to srinkle their hand. I squeeze the exposed forum
[1:04:20] Speaker 2: again you see wrinkles, and you squeeze the inside of
[1:04:23] Speaker 2: the arm and you'll find that they're much fewer wrinkles.
[1:04:25] Speaker 2: But as people age, they will still have some of that. Yeah,
[1:04:28] Speaker 2: you can't stop thinning of the skin.
[1:04:30] Speaker 1: So because that's very interesting, there's nothing. It doesn't matter
[1:04:34] Speaker 1: how much water we drink, how much olive oil will take.
[1:04:36] Speaker 1: I mean, I've got great keep talking about olive oil,
[1:04:39] Speaker 1: does that do anything?
[1:04:41] Speaker 2: I wish there was a dart that you could have
[1:04:43] Speaker 2: that would increase the amount of oil in your skin.
[1:04:45] Speaker 2: That would help take a lot of kids that get
[1:04:47] Speaker 2: bad exma. It would help elderly people as the skin
[1:04:49] Speaker 2: gets thinner. But I'm not aware of it.
[1:04:51] Speaker 1: So the amount of oil that and or moisture that
[1:04:55] Speaker 1: your skin produces is probably really genetics.
[1:04:57] Speaker 2: Yes, at the end of the day, Yes, it is
[1:04:59] Speaker 2: what It's what you were lucky to be born with.
[1:05:01] Speaker 2: So you know, often I will say to patients that've
[1:05:03] Speaker 2: got bad acne, You'll say, you might hate it because
[1:05:05] Speaker 2: you've got such an older skin, got all this problem.
[1:05:07] Speaker 2: But guess what, when you get order, your skin is
[1:05:09] Speaker 2: not going to get dry. You're not going to have
[1:05:10] Speaker 2: you know, it's like a bit of your own natural sunscreen.
[1:05:12] Speaker 2: You'll like it then, but at the moment you can't
[1:05:15] Speaker 2: see that.
[1:05:16] Speaker 1: Suck it up. So just to finalize that this whole thing,
[1:05:20] Speaker 1: and they're having to really appreciate your time. What would
[1:05:24] Speaker 1: you be of one bit of advice or a couple
[1:05:26] Speaker 1: of bits of advice would you give to the every
[1:05:28] Speaker 1: day Aussie who's out there living their best life, going
[1:05:33] Speaker 1: to the beach, hang out in the sun. Maybe drinking
[1:05:37] Speaker 1: too much or drinking a lot too much is a
[1:05:41] Speaker 1: bit hard to examine. Eating shit food and then having
[1:05:46] Speaker 1: some good food, exercising but not exercising enough, sleeping but
[1:05:50] Speaker 1: not maybe sometimes not having enough sleep. But would you
[1:05:52] Speaker 1: say to them in relation to their skin and their
[1:05:54] Speaker 1: propensity to get unwell as a result of their skin,
[1:05:58] Speaker 1: not just look old, but just get well well.
[1:06:00] Speaker 2: I mean, I think, I think all those things that
[1:06:02] Speaker 2: you said are important. They need to exercise, they need
[1:06:05] Speaker 2: to eat properly, they need to sleep right. All those
[1:06:07] Speaker 2: things have a role to play in your skin. So
[1:06:09] Speaker 2: there's research that shows if you have poor sleep, your
[1:06:13] Speaker 2: immune system doesn't work so well. If your immune system
[1:06:15] Speaker 2: doesn't work so well, it increases your risk of skin cancer.
[1:06:18] Speaker 2: Are really okay, well at risk of any cancer?
[1:06:20] Speaker 1: Yeah?
[1:06:21] Speaker 2: Yeah, yeah, okay. You know it's like a form of
[1:06:23] Speaker 2: imminent suppression. So all those patients that we put on
[1:06:25] Speaker 2: drugs because they've got certain arthritis or their transplant patients,
[1:06:28] Speaker 2: they get more skin cancer.
[1:06:30] Speaker 1: It's is that right, because you put on any flammatory
[1:06:34] Speaker 1: medications that helps them not reject the organ.
[1:06:36] Speaker 2: Yeah. Yeah, so we see that.
[1:06:38] Speaker 1: We see that all the time because they're immuneus are
[1:06:40] Speaker 1: pressent drugs because if you didn't put them on those immunes,
[1:06:44] Speaker 1: supressed drugs, their immune system would be our nuts in
[1:06:46] Speaker 1: the beginning, aches and pains and all sorts of problems.
[1:06:48] Speaker 1: So you suppress immune system. But that has another result, Yes,
[1:06:52] Speaker 1: it causes other problems, potentially other problems.
[1:06:55] Speaker 2: And then there are you know, blood disorders, so some
[1:06:58] Speaker 2: types of leukemia that people live with, Okay, that affects
[1:07:01] Speaker 2: part of the immune system, so they also get increased
[1:07:03] Speaker 2: skin cancer. So it's you know, so to me, it's
[1:07:07] Speaker 2: always trying to make sure that your immune system is
[1:07:09] Speaker 2: working properly and part of that sufficient rest, you know,
[1:07:12] Speaker 2: sufficient appropriate food. Otherwise you are literally increasing your risk,
[1:07:18] Speaker 2: you know. And with one thing that people can do
[1:07:20] Speaker 2: in this country is at least have a check of
[1:07:22] Speaker 2: their skin. Have someone look at your back just to
[1:07:24] Speaker 2: look for things that are odd, you know, get it checked.
[1:07:27] Speaker 2: I mean, skin cancer at the earliest stage is so
[1:07:30] Speaker 2: easily curable?
[1:07:31] Speaker 1: Is that right?
[1:07:31] Speaker 2: Right? If you get them early, it's a scar and
[1:07:34] Speaker 2: you get to live. I mean, it's I mean, I
[1:07:36] Speaker 2: think you know, as I was saying to you, I've
[1:07:37] Speaker 2: had you know, ten or eleven melanomers this year, and
[1:07:40] Speaker 2: you know one of them, you know, one of those
[1:07:43] Speaker 2: young boy who I think he was only sixteen. You know,
[1:07:46] Speaker 2: I had a melanimous back. So he's got a big
[1:07:48] Speaker 2: sky on his back now from me cutting big piece
[1:07:50] Speaker 2: out and you see it? How many? How many?
[1:07:53] Speaker 1: How many? How often a year? Do you just wanted
[1:07:55] Speaker 1: me to get checked? So I'm coming to see I'm
[1:07:57] Speaker 1: actually due to have a check up with you, but
[1:07:59] Speaker 1: I probably come once or twice a year. But how
[1:08:01] Speaker 1: from does an average person need to go?
[1:08:04] Speaker 2: I think if I mean, I think you know. Parents
[1:08:06] Speaker 2: will also ask me when when do I bring my
[1:08:07] Speaker 2: children for a check I'll say, look, when they're in
[1:08:09] Speaker 2: their late teens, when they're not listening to you, they're
[1:08:11] Speaker 2: in charge of their own health. Just get a baseline,
[1:08:14] Speaker 2: the baseline, you know, the dermatologists or the person that
[1:08:16] Speaker 2: knows what they're looking at, should give you an idea
[1:08:18] Speaker 2: of how much damage there is, what sort of moles
[1:08:20] Speaker 2: they have and how from they need to be checked.
[1:08:22] Speaker 2: If there's nothing unusual, I'll say, do you come back
[1:08:24] Speaker 2: in three or five years. There's no need for a
[1:08:26] Speaker 2: yearly check. But then you see people that have unusual
[1:08:30] Speaker 2: moles or they've had history of already having had skin cancers.
[1:08:33] Speaker 2: They can vary from you know, three months to six
[1:08:35] Speaker 2: months or twelve months. You know, I'd demand many many
[1:08:39] Speaker 2: years ago. He said, Look, how often do I need
[1:08:41] Speaker 2: to come back? If I really was to pick up
[1:08:42] Speaker 2: everything earlier, I said, you're going to be here every month.
[1:08:45] Speaker 2: You know, he's one of the only patients I ever
[1:08:48] Speaker 2: diagnosed a breast cancer with so breast cancer with the male.
[1:08:51] Speaker 1: But yeah, is breast cancer for a man or woman?
[1:08:54] Speaker 1: Is that?
[1:08:54] Speaker 2: Is it a dematological There's a type of breast cancer
[1:08:58] Speaker 2: which is called patastic that it manifests in the skin
[1:09:02] Speaker 2: around the around the nipple.
[1:09:03] Speaker 1: Really and is it just for mental for men and women?
[1:09:05] Speaker 2: Men and women?
[1:09:06] Speaker 1: Wow? Is it a genetic sort.
[1:09:08] Speaker 2: Of Again, I'm sure there's a genetic component to it.
[1:09:11] Speaker 1: Yeah, So as we get older, have say someone's over
[1:09:15] Speaker 1: sixty or even over fifty, perhaps they're the cadence of
[1:09:18] Speaker 1: their checkups because getting a baseline is really important, you know.
[1:09:22] Speaker 1: So you know there was a baseline, you go and
[1:09:24] Speaker 1: get a check up, and perhaps you know the doctor
[1:09:26] Speaker 1: you see who's looked at everything and like that, he
[1:09:28] Speaker 1: notices there's something there, something there, and no big dealer
[1:09:31] Speaker 1: writes a note about it the next So what's the
[1:09:34] Speaker 1: cadence look like over fifties? Once a year?
[1:09:36] Speaker 2: So I think again, it depends on what they have,
[1:09:39] Speaker 2: you know. So to me, it's like as you get older,
[1:09:41] Speaker 2: the number of things that are added on to the
[1:09:43] Speaker 2: medical train increase. You know, for a man, it's getting
[1:09:46] Speaker 2: your PSA checked, you know, colonoscopy, cardiologists, those are probably
[1:09:51] Speaker 2: the three biggest along with the skin.
[1:09:54] Speaker 1: Yes, so you because I know I come in at
[1:09:57] Speaker 1: least once a year, sometimes twice a year. I think
[1:10:00] Speaker 1: that there's a for people who are listening. And I
[1:10:02] Speaker 1: think there's actually a comfort process as well for the patient.
[1:10:06] Speaker 1: It's not necessarily for the doctor to tell you. It's
[1:10:08] Speaker 1: what makes you feel comfortable. Comfortable if you're a patient
[1:10:10] Speaker 1: as well, because and it's important to keep going back
[1:10:13] Speaker 1: to the same person.
[1:10:15] Speaker 2: I think, well, coming in getting checked like a bit
[1:10:18] Speaker 2: of insurance. You don't really want me to find anything,
[1:10:21] Speaker 2: But if I find something, it's early. I think if
[1:10:23] Speaker 2: you have confidence in the person you're seeing, you should
[1:10:25] Speaker 2: keep seeing them. But if you don't, if you don't
[1:10:27] Speaker 2: really like it, you don't get along with the person.
[1:10:29] Speaker 2: I'd find somebody else. I think it's important to have
[1:10:31] Speaker 2: a good you know, a good patient doctor relationship.
[1:10:33] Speaker 1: What am I going to do when you retire?
[1:10:35] Speaker 2: There will always be someone else?
[1:10:36] Speaker 1: Hopefully I will live longer than it takes for you
[1:10:39] Speaker 1: to retire, Like I'm serious, or what am I going
[1:10:43] Speaker 1: to do? Like you've got to start getting an assistant
[1:10:45] Speaker 1: and someone early.
[1:10:47] Speaker 2: So, like you know, there's there's a dermatologists that might practice,
[1:10:50] Speaker 2: and virtually all of them have trained with me. And
[1:10:54] Speaker 2: I wouldn't have been working there if I didn't think
[1:10:56] Speaker 2: that they were good at what they do.
[1:10:58] Speaker 1: So no one's indispensable now, no one's in dispensable less
[1:11:01] Speaker 1: for sure. But you know, I've become used to seeing
[1:11:04] Speaker 1: the one person all the time. So and I will
[1:11:07] Speaker 1: be coming to see you very soon, doctor Date Wong.
[1:11:09] Speaker 1: Thanks very much, mate, thank you for having me

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