Anatomical Pathologists make diagnoses of skin cancer  – much of their work involves analysing biopsies for melanoma and determining suitable treatment.

We spoke to three anatomical pathologists to get their insights on skin cancer and sun safety.

Dr Penny Yarrow

As an Anatomical Pathologist and a mother of two, Dr Penny Yarrow has spent many years teaching the value of Slip, Slop, Slap.

“With kids, I think it’s crucial to set good examples at a young age. I have a daughter and a son who have been taught to wear hats and sunscreen since they were toddlers. They are both very wary of sun burn as a result.”

Throughout her career, Penny has diagnosed thousands of skin cancers and melanomas in people of all ages.

”Skin cancer isn’t just a threat to older adults, it is a multi-generational health issue, affecting grandparents, parents and even teenagers. Much of the sun damage to our skin that causes skin cancers in later life occurs during our teenage years so it’s essential that we teach our kids to be sun smart throughout childhood and adolescence.”

Dr Nick Musgrave

Nick Musgrave has experienced skin cancer both in the lab and in his personal life.

”I’ve had more skin cancers than the average Anatomical Pathologist! Being fair skinned and growing up in Queensland has its consequences and it’s taught me that prevention is critical.”

Nick is a strong advocate for skin checks, particularly for those with a genetic predisposition to skin cancer.

”Anyone with lots of freckles and moles or with a family history of skin cancer should get a professional skin check once per year. In Queensland, 2 out of 3 people will have skin cancer before the age of 70 so it’s important to be aware of your risk.”

While the statistics are concerning, Nick is encouraged by advances in pathology which have helped improve treatment of melanoma.

“Thanks to BRAF mutation testing, we can identify a patient’s genetic blueprint and guide targeted therapy for melanoma.

Genetic testing has had a dramatic improvement on the prognosis for patients who have melanoma that’s already spread. With advances in genetic testing, the hope is that melanoma will become more of a chronic disease than a fatal one.”

Dr David Clift

When David Clift was growing up in the 1950s, people had less knowledge of sun safety.

“It was very common for people to get plenty of sunburns, peeling and even blistering burns so it is no surprise that melanoma rates have doubled in the last 20 years and we are seeing 80% of all melanomas on 50+ year old Australians, who grew up not using sunscreen”, he says.

David has noticed that a greater public awareness of skin cancer has helped to improve patient outcomes.

“During the summer months in the lab, we see a much larger volume of skin cancer cases. People are showing more skin and noticing new moles that were never there before. Rather than ignoring it, they’re going to their doctor and getting treatment early and that can save their life.”

A keen sailor, David is always careful to protect himself on the water.

”Skin cancer is very common on the neck and ears so I always wear a hat with a legionnaire scarf to protect those areas.”

The post How do anatomical pathologists protect themselves in the sun? first appeared on Know Pathology Know Healthcare.

We spoke to Pathology Awareness Australia ambassador, Dr Penny Yarrow (pictured left) to find out about some of her recent, unusual diagnoses.

“We recently had a case of leprosy which is quite unusual. The patient had been living in Tasmania for about 18 months but was a refugee from the middle east. Although the patient had been seeing a doctor for a little while leprosy wasn’t suspected, the doctor was really kicking themselves when we came back with the diagnosis.”

Leprosy is rare in Australia. It is a chronic bacterial infection caused by Mycobacterium leprae and affects the nervous systems of the body. Contrary to popular belief, leprosy is curable and is not highly contagious, but can be passed on by close and frequent contact with an infected person and may cause nerve damage if not treated.

The most common symptom is skin lesions. The case that Dr Yarrow found was detected in a skin biopsy taken by the patient’s doctor.

Dr Yarrow told us of another unusual case also detected via a skin sample. The patient was also a refugee but was a more recent arrival. The sample was taken from the patient’s lip and the diagnosis was leishmaniasis.

The condition is caused by Leishmania parasites. It can cause painful skin sores and ulcers leaving lifelong scars. If left untreated it can spread to the organs and may be fatal.

Both diagnoses required the skill of an anatomical pathologist examining the samples under a microscope looking for particular features, then applying additional chemical stains to highlight the bacterial and parasitic organisms.

“These cases are a great example of anatomical pathology, microbiology and the patients’ doctors working together. With good communication, a good history and sending the right tissue to the pathology lab to be tested we were able to make those diagnoses. In both cases knowing that the patients were recently arrived refugees was a crucial clue.

This was so important for the patients to get the right treatment and also to prevent any spread of disease.”

Dr Yarrow also recently found an unexpected tumour. She was sent an appendix for examination, which is standard practice when someone has had their appendix removed, and found a carcinoid tumour less than two centimetres in diameter.

“Whenever an appendix is removed it is examined by a pathologist to check for anything of concern, they can contain pinworms and other organisms as well as tumours.

This patient had acute appendicitis but there was no suspicion of a tumour. Tumours in the appendix are not uncommon but he was lucky we caught it early. He probably won’t need further treatment as there were no worrying features to the tumour. Fortunately, the cancer hadn’t spread to the fat around the appendix, if that happens it can spread further and be fatal. It was a lucky escape.”

The post A dangerous parasite, a hidden tumour and leprosy….pathology in Tasmania first appeared on Know Pathology Know Healthcare.