The Times West Virginian

June 6, 2007

Doctor: Take precautions in the sun

Santmyire-Rosenberger cautious after having basal cell carcinoma

By Mary Wade Burnside

FAIRMONT — Some people might consider yard work as an opportunity to get some sun, but not Dr. Beth Santmyire-Rosenberger.

“Even my husband would make fun of me,” Rosenberger said. “I work in a hat and long sleeves. He would joke, ‘Could you have any more clothes on?’”

But it’s not Rosenberger’s specialty — dermatology — that dictates her gardening wear. The Eastern Panhandle native was a resident in Washington, D.C., four years ago when at the age of 30, a suspicious bump in her hairline began to bleed spontaneously.

She already had shown the bump to specialists who told her not to worry about it, but after that incident, Rosenberger demanded a biopsy.

The diagnosis came back as a basal cell carcinoma, a typically non-life threatening condition that accounts for about 80 percent of all skin cancers.

As a dermatologist, Rosenberger had the experience of breaking the news to patients that they had a basal cell carcinoma, but now she had to deal with her own. That meant an outpatient procedure in which her hair in that area was shaved and the carcinoma removed, leaving a 4 1/2-inch — albeit faint — scar just in front of her ear.

“It was a little traumatizing,” she said.

Before, Rosenberger noted, “I would tell patients, ‘It’s not a big deal, it’s not going to spread to other parts of your body,’ but when it’s on you and you’re a girl and you’re cutting your hair, it’s a big deal.”

Since the experience, Rosenberger, who now operates Appalachian Spring Dermatology, has become a huge advocate for taking precautions in the sun, something she did not always do as a girl.

Now, when she spends time outdoors, she wears a long-sleeved shirt with a tight weave. A normal shirt can allow a lot of sunshine through the material, providing an unsatisfactory Sun Protection Factor, or SPF.

“Most cotton shirts are only 4 or 5 percent SPF,” she said.

In addition to the protective clothing, she wears a sunscreen with zinc — to keep the lotion from breaking down and wearing off quickly — every day of the year, even on wintry and gloomy days.

Even in the car, she is cautious. “I keep sunscreen in my center console. If I’m driving home and I’ve washed my hands a thousand times that day, I’ll reapply it to the back of my hands and arms.”

She has asked her husband, David Rosenberger, to get her car windows tinted with clear but protective tint. He has been even more understanding since he had his own run in with a basal cell carcinoma last fall.

He found a bump on his eyelid, which he never would have considered a concern if he did not know about his wife’s ordeal. He had the basal cell carcinoma removed by the same Washington specialist that his wife had used.

Both underwent a procedure developed by Dr. Frederic E. Mohs in which the physician continues to biopsy the excised matter until a certain margin free of disease has been achieved. That means a large carcinoma will leave even a larger hole for the surgeon to close up.

“It’s important to catch it early when it’s small,” David Rosenberger said. “The longer it goes, it’s harder to make it look good.”

Beth Rosenberger suggests that people check themselves out for suspicious bumps once a month, selecting a number they can remember such as a birthday or anniversary and using that date each time.

In addition to basal cell carcinoma — the most common and least dangerous — type of skin cancer, two other kinds exist. Squamous cell carcinomas, like basal cell carcinomas, rarely spread to other parts of the body. Melanomas, which make up about 5 percent of skin cancers, can spread, and once that happens, Rosenberger said, the disease becomes difficult to treat.

Having had a basal cell carcinoma puts Rosenberger at a higher risk for any type of skin cancer, so she continues to slather on the sunscreen and tells her patients to do the same.

“The fact of the matter is, skin cancer is the most common cancer in the United States,” she said. “It’s something to be taken seriously. You should do anything you can do to reduce your risk. It’s very easy to do.”

E-mail Mary Wade Burnside at mwburnside@timeswv.com.