Dear Dr. Bone,
Last year my gynecologist diagnosed me with the HPV virus on my Pap smear. She assured me that I did not need to worry about it because most of the time the HPV goes away. I started reading about HPV and learned that it can cause throat cancer. The last few months I have had a scratchy sore throat. I am afraid that I have HPV there and will get throat cancer. I am only 19 and am not sure what to do about it. Any advice? — K.S., Lake Worth
Sadly, at this time there is no easy way to tell if you have HPV in your throat. An otolaryngologist, otherwise known as an ENT doctor, can look carefully to see if there are any suspicious areas, but at the moment there are no real protocols for evaluating young women in your situation. My guess is that the sore throat is unrelated to your HPV. If it is, more than likely that HPV will go away, just like the kind on you other cervix. It is a good idea to get rest, eat well and exercise regularly. I would stay away for alcohol and other substances that might make your immune system weaker. Some alternative medicine options include supplementation with immune boosters like proanthocyanidins such as resveratrol and pine bark extract. Eventually there will be a way to test and treat the throat, but not at this moment.
If you write back to me in a year or two I will give you the update! Good luck.
Dear Dr. Bone,
My elderly aunt has a cancer called nodular amelanotic melanoma (AM). She is almost 90 and the tumor has metastasized to the point that we are no longer actively treating her, but working with hospice to make the most the time she has left. We have been told that this is a rare cancer and I thought you might want to share it with your readers. Instead of the regular dark mole, her cancer showed up as a lump on her back. It took a long time to make the diagnosis because a few doctors thought it was a fatty tumor or and it wasn’t until we went to a younger doctor that he wanted to biopsy it.— L.S., Wellington
Amelanotic melanoma is a form of melanoma that does not start out as a dark mole on the skin. Skin pigment that is dark is called melanin. The root of this word is Greek and means black, hence, melanoma is usually thought of as a dark, irregular mole. Amelanotic melanoma contains little melanin so it is not dark. It typically has little color or is flesh-colored, but can be dark, blue, red, or white like a scar. Because most of us are looking for dark moles, these cancers can easily be overlooked leading to a delay in diagnosis and a later stage at diagnosis. Melanomas may be found anywhere on the body, even under the fingernails, but the arms, legs and back are more common because they are exposed to the sun on a regular basis.
Treatment for melanoma includes excising the tumor and nearby lymph nodes, and then adding various immune modulators, chemotherapy, and novel radiation therapy protocols. Unfortunately, the prognosis for amelanotic melanoma is not great. Of the more than one million cases of skin cancer diagnosed each year, less than 5 percent are melanomas. Of those 50,000 cases, about 7,500 are called nodular melanomas. Of the 7,500 nodular melanomas, about 375 are amelanotic. While survival for early melanomas is more than 90 percent, once it has metastasized, only about 10 percent respond to traditional therapies.
Remembering to avoid the sun during peak hours of 10 a.m. and 3 p.m. and applying a broad spectrum sunscreen every day is helpful. I personally like the brand called LUCA. Unlike other brands which talk about their SPF, LUCA uses an approach called Critical Wavelength. It was invented by a doctor and goes on lightly without a heavy greasy feeling, but supplies protection to reduce the risk of all types of skin cancer.