Participants: Don Mackintosh (Host), Jonh Chung
Series Code: HFAL
Program Code: HFAL000215
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00:01 The following program presents principles
00:03 designed to promote good health 00:04 and is not intended to take the place of 00:06 personalized professional care. 00:09 The opinions and ideas expressed 00:10 are those of the speaker. 00:12 Viewers are encouraged to draw their own 00:14 conclusions about the information presented. 00:49 Hello, and welcome to Health for Lifetime. 00:51 I am your host Don Mackintosh, 00:52 and today we're gonna be talking about something 00:54 that strikes fear in people's hearts 00:56 and that's the word cancer, skin cancer 00:58 more specifically. And here to talk with us 01:01 about this is Dr. John Chung, 01:02 he is a dermatologist, well, actually has a 01:05 Residency in Family Medicine and then after 01:08 that he did another Residency in Dermatology, 01:11 and then he has a special training 01:12 and what's called Mohs surgery, 01:15 what it's specifically related I understand 01:16 to skin cancer. That's correct. 01:18 And you are practicing now in Dalton, Georgia, 01:21 the "Carpet Capital of the World," 01:23 and evidently there is also skin cancer 01:26 there as well, right. And people come from 01:28 the surrounding areas to see you because 01:33 you are specialist in the surgical procedure, 01:36 Mohs surgery that I think we will hear more 01:38 about a little bit later, right, 01:39 but then dealing with skin cancer. Right. 01:43 Well, welcome and the first question 01:45 that we wanna ask you as you know how 01:47 prevalent or what are the forms of skin cancer 01:51 that you see in your office? 01:52 Well, three major kinds; Basal cell carcinoma, 01:56 Squamous-cell carcinoma and Melanoma, 01:58 okay. And there are over one million cases of 02:02 skin cancers every year in United States. 02:05 So let's look at that first one more in detail, 02:07 Basal cell carcinoma. I am trying to figure 02:10 out that means the basal cell. 02:12 It's in the top of the, it's in the lower part 02:16 of the epidermis. Okay, an epidermis is that 02:21 outer layer. That's correct, and it is a most 02:26 common skin cancer in the world, 02:28 and it is caused by the harmful effects 02:31 of ultraviolet rays. So another it's being in the 02:34 sun too much, right. What's it look like? 02:37 Well, it's pearly papule or nodule with sometimes 02:41 the ulceration and with telangiectasia that 02:45 is blood vessels on top of it. 02:48 And sometimes it presents as non-healing 02:51 ulcers, sometimes it just heals and it comes back 02:54 again in the same area. 02:55 So why is it's so dangerous? 02:58 Well, it doesn't metastasize, that is 03:01 spread to the other parts of the body 03:02 but is very locally destructive. 03:06 Sometimes we end up, taking out the entire 03:10 nose because it has affected entire nose, 03:13 sometimes entire ears taken off, 03:17 lips and I had one lady who neglected 03:21 this tumor for about 5 to 7 years, 03:25 during that time it had taken over the entire 03:28 right side of her face including the ear 03:31 and the side of, part of her neck. 03:33 You have to take it all off? 03:34 Yes, and it can be very, it can be locally 03:37 very destructive. So it's not something 03:40 to mess around with that, 03:41 and how rapid does it move or does 03:43 it just depend. It usually takes several years 03:46 to do that. So if you have any question 03:49 make sure and go in and set that, right exactly. 03:52 So then what are the odds of a person once 03:58 they have been treated by you, 03:59 getting another cancer? 04:00 Well there's about 40 percent chance of 04:02 getting another basal cell carcinoma 04:04 within 5 years. 40 percent chance, 04:06 no matter how well the treatment is 04:08 or how good it is. Right, right, 04:09 it's not that, that one is coming back 04:11 but rather you are getting a new one. 04:13 What about risk of other cancers, 04:14 is there a relationship? 04:15 Absolutely, there is increase in melanoma 04:18 in this type of patient, so when you have 04:21 any skin cancer of any type, 04:23 you need to have a full body examination, 04:25 okay, at least once a year. 04:27 Okay, before talking about you know the 04:30 treatment options, what about squamous-cell 04:34 carcinoma? Well, squamous cell carcinoma 04:35 is a second most common, 04:37 and there are 250,000 cases, 04:40 new cases in the United States every year. 04:42 And out of that about 2500 people die 04:45 every year from squamous cell carcinoma 04:48 of the skin. So that's very serious too. 04:51 Yeah, because the reason why you die because 04:55 it metastasizes, it spreads, 04:58 and the way it looks it's more firm, 05:02 scaly, papule or nodule on sun exposed areas 05:10 like the top of the ears, nose, bottoms, 05:14 bottom of the lip because that's we get direct sun 05:17 and arms, backs of the hands, places like that. 05:23 So let me ask you about the ear. 05:24 My grandfather had cancer on his ear 05:27 and then they take like a little chunk out 05:29 but the squamous-cells not in the cartilage area, 05:32 its right above it. Well, it starts in the skin 05:35 but it can destroy the cartilage. 05:37 And does that spread rapidly too from there? 05:39 It can spread rapidly. Because it gets into 05:43 the blood stream or something or what? 05:44 Gets into the local lymph nodes 05:45 and there it can go, but you know it has to be, 05:51 in order to do that lot of times 05:52 the patient is immunocompromised. 05:54 Okay, so their immune system is depressed 05:57 for some reason, right, maybe diabetes, 05:59 maybe generalized infection, 06:01 maybe something else. HIV patients or sometimes 06:06 there are organ transplant patients 06:07 and they are immunosuppressive. 06:10 Taking steroids. Immunosuppressive 06:11 in that case. Okay, right, immunosuppressive, 06:12 so then we talked briefly about the basal cell, 06:17 we talked about squamous cell, 06:19 now what about melanoma? 06:21 Now that is a very, very dangerous cancer, 06:24 skin cancer. It's a most dangerous 06:27 and there are about 54,000 cases, 06:30 new cases of melanoma every year 06:32 and I will say about 8 to 10,000 people die 06:36 from that every year. So you have less 06:39 incidents than squamous cell carcinoma 06:42 but much more deaths. And how long after 06:46 someone's diagnosed with melanoma, 06:48 do they succumb to, it just depends probably? 06:51 Well it depends on the, it depends on the 06:53 depth actually, so sometimes it may 06:56 take years, sometimes months we don't 07:00 really know. What does it look like? 07:03 Well, it has, we call it ABCDs of melanoma. 07:07 A stand for asymmetry, that means when 07:10 you look at a ball and if you have to cut 07:13 it in half, one side does not look like 07:16 the other side, and the border is irregular, 07:19 it's not perfectly round. 07:22 The color, there is usually more than one color, 07:25 two or three colors, although, you know, 07:27 that's not a harder pustule because sometime 07:30 we can have just a jet black, just one 07:32 color melanoma, and D is diameter 07:36 which is 6 millimeters or greater but 07:39 I've seen melanoma size maybe even 07:43 1 or 2 millimeters so you cannot go by the size. 07:49 And what part of the body do these usually occur on? 07:51 Well, in males is a trunk and anterodorsal. 07:57 Okay. In females, the back and the legs. 08:03 So man is the back and anterodorsal, 08:07 for women back and lower legs actually, 08:10 lower part of the legs. Okay, so the trunk 08:13 for the man, the back and the lower legs 08:15 for the females. Yeah, you know, 08:17 I had an interesting case of a man 08:19 who came into my office one time with a tick, 08:21 he couldn't take the tick off. So he came on, 08:25 was on his back and it was biting a melanoma. 08:29 It was biting a melanoma. So you know, 08:32 I told him that tick was send by God, 08:35 you know. But I don't suggest that you know 08:38 you depend on ticks to find melanoma. 08:41 You needed to see dermatologist on a 08:43 regular basis. Right, now the family medicines 08:47 specialist and, do they pick up on this too. 08:51 Yes, if they are well trained. So let me ask 08:54 you this, isn't it usually true that someone 08:57 doesn't just go directly to a dermatologist 08:58 but they are referred. That's right. 09:00 So you said, normally go see your dermatologist, 09:04 you mean ask your family medicine person 09:06 to refer you. That's what we recommend? 09:10 By what age? It's just, you can start 09:13 as an infant, but usually there are melanomas 09:16 and skin cancers don't start until after puberty, 09:20 unless they have a giant something called 09:24 congenital nevus. What was that congenital nevus? 09:28 The congenital nevus which is a huge, 09:32 the larger the mole when you are born with, 09:35 born then the higher risk of melanoma. 09:39 Okay, so in those of the cases you need 09:41 to follow that much earlier. 09:43 Okay, let's talk about treatment then, 09:45 going through the various things we've talked about, 09:47 we talked first of all basal cell carcinoma. 09:51 What's the treatment for basal cell carcinoma? 09:53 Well, you know, can I go back 09:56 little bit to melanoma. 09:57 Absolutely not, you can go ahead. 09:59 Because a melanoma, I think we need to know. 10:04 Couple more things about, yes, 10:05 some more serious, lets get much as we can. 10:07 Yes you can, melanoma can also occur 10:12 in Afro-Americans as well as Asians. 10:17 okay. And they occur most commonly 10:21 on the soles. The soles of the feet? 10:23 The soles of the feet and mucous membrane, 10:25 then palms, then the nail beds. Nail beds 10:28 like inside. Right, exactly, 10:30 so those are the places that you have to 10:32 watch out for in African-Americans 10:36 and Asians. So on the soles of the feet, 10:38 palms, and the hands, nail bed where else? 10:40 And mucous membrane inside the mouth. 10:42 Inside the mouth, how are you gonna 10:44 pick up on this, better look inside. 10:46 That's why I check every single person 10:48 that I do, full bodies and I look inside 10:50 the mouth. Now also it can involve the eyes 10:53 as well. So, where in the eyes, 10:55 underneath the lids? You can, actually something, 10:58 you have to do dilation of the eye 11:01 by an ophthalmologist. And you recommend that too, 11:05 you refer people to an ophthalmologist. 11:06 Especially if they had a history of melanoma, 11:08 you know, it will be good to do that. 11:11 Okay, are we ready sitting down and talk 11:13 more about treatment for basal cell carcinoma. 11:15 No, not yet. Not yet? Because I need to tell 11:16 you about the risk factors. 11:17 Okay, risk factors for melanoma. 11:19 Right, exactly. Okay, what are those? 11:20 One is, one is, if you are fair skinned your heart 11:24 is at higher risk. So it means, 11:25 I am higher risked. 11:26 You are higher risked than me. 11:28 I am higher risked than you. 11:29 And the other thing is history of sun burns 11:32 especially as child, sun burns, study shows 11:36 that up to about age 30 at least half 11:39 the people have one sun burn a year, 11:43 and sun burn is not the tan but it is the 11:46 sun burn that leads to lot of time to 11:49 squamous cell, I mean the basal cell carcinoma 11:52 and melanoma whereas squamous cell carcinoma 11:56 is more chronic cumulative. 11:58 I see. And also if you have more than 30 moles, 12:02 if average you have about 30 moles, 12:05 if you have more than 50, if you have more than 12:08 50 moles then you are at risk. 12:11 More than 50 moles. Yes, and also if you have 12:14 atypical or something of dysplastic moles. 12:18 What's that? This we called that pre-melanoma, 12:21 if you have these types of moles that 12:22 mean you are at high risk for melanoma. 12:25 And the other important thing is 12:26 family history of melanoma. 12:29 I had a patient who came in with, 12:33 with the father and the mother both 12:35 died of melanoma, sister and brother both 12:37 died of melanoma, and one of the uncles 12:40 and aunt died of melanoma. 12:41 Wow! And when he came in I was wondering 12:46 why they all died from melanoma, 12:48 and I looked at his moles and they look, 12:52 they did not look like the ABCDs so I just took 12:57 some samples here and there and many of them 13:01 were severely dysplastic and fewer 13:04 actually melanomas. Was that right? 13:06 Then I realized at that time, 13:08 the reason why did the other people died 13:10 is because they were just. 13:13 They missed it. Right, because they look 13:15 almost normal, not completely normal 13:18 but almost normal. And then this person 13:19 make it. Oh, yeah, this person we got it early, 13:22 so family history is very important. 13:24 So from family history it maybe like this guy, 13:27 they are atypical, they don't look like a normal 13:31 melanoma and the physicians may miss them, 13:33 so, that's right, make sure and tell people, 13:35 right. I saw your physician. 13:36 That's why one of the questions, 13:37 anybody in your family with melanoma, 13:41 if they say yes, you have to be much more 13:44 ready to do biopsies even slightly abnormal 13:47 moles instead of watching them. 13:49 So are these all the risk factors you wanna 13:51 cover for melanoma? Yeah, those are the 13:54 major risk factors. The major ones, okay. 13:56 And the prognosis depends on the depth, 13:59 how deep it has gone into the skin. 14:02 It may get into bloodstream or 14:04 other things and then it could be. 14:05 So earlier the better, the earlier the diagnosis 14:07 because almost, you have almost 100 percent 14:10 cure rate with early detection and treatment 14:13 of melanomas. We are talking with 14:14 Dr. John Chung, we are talking about melanoma 14:18 right now. We're gonna come back 14:19 and we're gonna look at treatment options for 14:21 both basal cell carcinoma and squamous cell 14:25 carcinoma and the melanoma. 14:26 Join us when we come back. 14:29 Are you confused about the endless stream 14:32 of new and often contradictory health 14:34 information with companies trying 14:36 to sell new drugs and special interest groups 14:39 paying for studies that spin the fact, 14:41 where can you find a common sense approach 14:43 to health? One way is to ask for your 14:46 free copy of Dr. Arnott's 24 realistic ways 14:49 to improve your health. 14:50 Dr. Timothy Arnott and the Lifestyle Center 14:53 of America produced this helpful booklet 14:54 of 24 short practical health tips based 14:57 on scientific research and the Bible, 14:59 that will help you live longer, happier 15:01 and healthier. For example, did you know 15:04 that women who drink more water lower 15:06 the risk of heart attack? Or the 7 to 8 of sleep 15:09 a night can minimize your risk of ever 15:11 developing diabetes. Find out how to lower 15:14 your blood pressure and much more 15:16 if you're looking for help not hide them, 15:18 this booklet is for you. Just log on to 15:20 www.3abn.org, and click on free offers 15:23 or call us during regular business hours, 15:25 you'll be glad you did. 15:29 Welcome back, we are talking with 15:31 Dr. John Chung. He is a dermatologist, 15:33 he is trained in family practice, 15:34 he is also a specialist in Mohs surgery 15:37 which has to do with cancer, 15:38 isn't that right? That's correct. 15:40 And we were talking about basal cell carcinoma, 15:42 simple squamous or squamous cell carcinoma 15:44 and then the dreaded melanoma. 15:46 You were giving us the risk factors 15:48 and really letting us now not to take this lightly, 15:51 make sure and have it checked out; 15:54 even if you have any suspicion whatsoever, 15:56 right. Prevention is lot better than catch up 15:58 with melanoma. Well, talk to us about the 16:00 treatment of these very serious conditions, 16:04 basal cell carcinoma. Okay, basal cell carcinoma 16:07 you can just treat it, there are many ways 16:09 to treat basal cell carcinoma actually. 16:11 One is just simply cutting it out, 16:13 the other one is you can cure it out that 16:16 is scraping it out, okay, and the other 16:19 way is you can actually freeze it, 16:21 freeze it really hard and the other way is, 16:25 injection with something called interferon. 16:28 Interferon is like a cancer drug, isn't it? 16:30 Right, it actually promotes your own body 16:32 to come and attack this cancer cells, 16:34 okay. And also there is a new medicine out 16:37 called Aldara cream, Aldara cream. Aldara, 16:41 that also promotes your immune system 16:45 to come and fight that. That is usually used 16:48 for superficial type of basal cell carcinoma 16:51 but by far the best treatment which has a 16:53 highest cure rate is that something called 16:55 the Mohs micrographic surgery. 16:58 Now Mohs micrographic surgery can be useful 17:00 for basal cell carcinoma, squamous cell carcinoma 17:02 and melanoma. We can talk about that later. 17:07 So you look at it, you are specialist in that 17:10 and people there and your staff and you 17:12 just laser it out. Well, okay, let's go to 17:16 Mohs surgery, what that is? 17:18 Okay. You know, when you cut out a specimen 17:23 and then send it to the lab, they cut it 17:25 vertically and they look at 1, 1000th 17:28 of the margin, they are looking at 1, 1000th 17:30 of the margin and then based on that they 17:32 state that cancer is out or not, okay. 17:35 Where as in Mohs surgery you don't cut vertically, 17:38 you can cut kind of tangentially 17:41 and by the time you are done dyeing 17:43 and all that, dye with a special dyes 17:47 and cutting in certain way, you are looking 17:50 at 100 percent of the margins. 17:52 Okay, so you are not gonna miss something 17:54 that's on the side. Right, on the side 17:56 or deep size, you are looking at 100 percent 18:00 of the margins. So that's why the cure rate 18:03 of Mohs surgery is almost 100 percent, 18:07 and so especially with basal cell carcinoma, 18:10 and now squamous cell carcinoma you can treat 18:13 it with excision or just cutting it out 18:15 or sometimes you scrape it off especially 18:18 if it's early, and also you can do probably 18:21 the best treatment is Mohs micrographic 18:24 surgery which has a highest cure rate. 18:27 The other thing about Mohs micrographic surgery 18:29 is that you take out basically only the cancer 18:34 and you follow the cancer. 18:35 So you spare normal tissue and so you have 18:40 the smallest defect possible, 18:42 at the same time you have the highest cure rate. 18:45 So smaller the defect you have easier 18:49 time to close. So what's the cancer look like, 18:52 someone told me once, that the word cancer 18:53 means star fish, does it look like a star fish 18:56 in there, you have to go like tentacles this way, 18:58 that way, the other way. Some of them, 19:00 you know, some of them are just like a 19:01 round ball you can just it cut it off 19:02 but some of them have roots. 19:04 And then how do you know where to go, 19:05 you can just kind a see with your. 19:07 When you cut it, you cut the visible margin 19:10 but you can see, what you think maybe 19:12 the outline of the cancer then you take it out 19:15 and then you, we have a lab in house that's 19:20 the way you do Mohs micrographic surgery, 19:23 in house you cut it and dye it and then cut it. 19:28 They look at all these things and they see 19:29 if there is like in the middle of the cell or 19:31 something and they could figure out exactly. 19:32 Yes, we trace the cancer until it's gone. 19:37 So and it's the same treatment for melanoma 19:39 as well? Melanoma, you can do Mohs surgery. 19:42 We actually do Mohs micrographic surgery 19:44 for melanomas as well, but you can treat 19:48 it a lot of time with just regulate excision, 19:52 and those are the two major. 19:55 Usually people come to you because of the higher 19:57 success rate of the Mohs procedure, right. 20:00 How many people in United States 20:01 do that type of surgery? 20:06 Actually many, many people are doing it 20:08 who are dermatologists and some of them 20:11 are formally trained, some of them are trained 20:15 by somebody else, not but formal in a fellowship, 20:21 and so I can't tell you exactly how many people 20:23 are doing it. But the more, the better 20:27 and your estimation because it's highly 20:29 affective, exactly. So are we ready to move 20:33 on in terms of treatment, we want to talk about 20:34 maybe an underling cause like sun exposure. 20:37 Yes, let's talk about the sun. Alright, 20:39 what's good and what's bad about the sun? 20:41 Okay, well, you know, people think, 20:44 you know dermatologists say; 20:46 you know sun is absolutely bad avoided 20:48 at all cost. That is not true, you know 20:52 because sun actually has a lot of 20:55 beneficial effect. Without the sun there 20:58 will be no life in this earth. That's right, 21:00 not having green plants, not have. 21:02 Absolutely, it's absolutely vital for life. 21:04 And Florida will shut down. 21:06 Absolutely nobody will be going there, 21:08 that's right. I am probably going to move 21:10 back to Georgia. That's right. 21:11 Anyway there is photosynthesis 21:15 and also there is a, in order for your vision 21:18 to develop, you need light. Vitamin D, 21:22 all those different things. 21:23 Yes, and also exactly vitamin D synthesis. 21:26 You absolutely need although you can get it 21:30 from food supplements, Vitamin D from 21:33 ultraviolet B is very, very affective 21:37 and also sun cures pathogens and it gives you 21:43 warmth, then also helps with depression, right. 21:47 People who live in a sunny area tend to be 21:49 happier and it helps with multiple skin diseases 21:54 as well that we talked about like, 21:55 like psoriasis, even eczema, acne. 22:00 We'll talk about eczema but, eczema is a type 22:02 of dermatitis. Oh, it's the same word, yes, 22:04 alright. And acne, and there are some other 22:06 diseases. Drives them out. Right, 22:09 and now you don't like, like food you know 22:13 too much of good thing is not a good thing. 22:16 Right, right. So what are some of the 22:18 harmful effects; obviously skin cancer. 22:21 Now we talked about before is a sun burns 22:26 that are bad. Sun burns and if you have, 22:29 when you are young, you are at high risk 22:31 for melanoma. Exactly, because most of your 22:34 sun burns and sun exposure you get before 22:36 age 18, and so we have to be very careful 22:42 about and educate the parents about too much 22:47 sun exposure when they were young. 22:49 You need a sun but not too much that will 22:52 cause sun burns. You know I don't get on people 22:55 when they have a little bit of tannest, 22:57 not a big deal, but when they came out 22:59 with the burn, when they are peeling 23:01 and they are blistering that's when I, 23:03 you know kind of chastising. 23:06 And the other thing is it can cause cataract 23:10 formation. Sun exposure. Sun can, and aging, 23:16 two of the worse things for fast aging is sun, 23:20 excessive sun and also smoking. 23:24 And there are certain skin disease as well 23:28 that can be worsen by the sun like lupus 23:32 and there is something called polymorphous 23:34 light eruption, and something called 23:39 porphyria, all those things can get be worsen 23:42 by the sun. Okay, so it's a good thing, 23:44 but it can be a bad thing too, too much of it. 23:47 Absolutely and you know people ask about 23:51 tanning bed, tanning bed is not good for you. 23:54 Tanning bed actually can lead to skin cancers. 23:56 So do not go the tanning bed. 23:58 No, absolutely not. If you are operating 24:00 in tanning bed, shut it down, that's what you 24:02 would say right? Well in another words, 24:05 you are concerned about it, right, 24:06 especially the more fair skin, I mean the people 24:08 that go to those usually are fair skinned, 24:10 right. Yes, because I don't see. I don't see 24:12 many tan Amazon people going to get a tan. 24:15 So you know if you are someone like me 24:20 you know freckles and you know I have tans 24:23 and just tiny little spots all over me, 24:27 more risk for that, do you see a lot of 24:29 people like me? I do, I see a lot of, most 24:32 of the cancer surgery that we do are in Caucasians. 24:35 Okay, alright, anything else about the sun 24:40 that we need to talk about? 24:43 How about protection from the sun? 24:45 Yeah, protection, I mean wearing an over 24:47 coat to the neck. Well, it's hard to do during 24:50 summer time, okay. So you know there are 24:53 lot of good ways to protect yourself, 24:55 is one is sunscreens. And how you know 24:58 if it's good or bad? Well, higher the number 25:02 the better, but higher the number it can cause 25:06 more reactions, so what I like to do is like 25:11 15, 30 or on there will be good that is SPF 25:16 which means sun protection factor, okay, 25:19 a special number that's given, 15 to 30, 25:24 yeah 15, 30, okay. That's not necessary, you know, 25:28 the other thing is better if it's broad spectrum 25:33 that is, recovers both ultraviolet A 25:36 and ultraviolet B, okay. Now ultraviolet B 25:40 is about 60 hundred times more carcinogenic 25:46 than ultraviolet A. So you want to cover both 25:49 ultraviolet A and B, right, 15 to 30. 25:52 Right because ultraviolet A in combination of B 25:56 causes I mean exacerbates. 26:02 What about if I lay, under the umbrella 26:04 and I don't get on the sun anyways, isn't that okay? 26:07 No, about half, it takes probably twice as long 26:13 to get us sun burn because you have all these 26:17 scatter light through all the ground and also. 26:23 So it does cut it down some but it doesn't 26:26 totally protective you. No, you can get sun burn 26:28 under umbrella. What about going on 26:30 a cloudy day, just make sure there are some 26:32 clouds there, I am okay. No, about, you still get 26:36 about 70 to 80 percent of ultraviolet through that. 26:42 Only problem is it's actually is more dangerous 26:44 to go out during cloudy day because. 26:46 You don't feel it. You don't feel the heat 26:48 because that is also it's by infra red that 26:52 gives you the heat, but sun blocks infra red 26:56 and so you stay out there, you are getting 26:58 the ultraviolet the harmful ray and you, 27:01 there much longer. We get about 1 minute 27:03 left what about being in high altitudes, 27:07 still dangerous up there? Yes, higher you go 27:09 the worse it is. Because you are closer 27:11 to the sun? Right every thousand feet that 27:14 you go up, you loose about 4 percent higher 27:21 so it's totally; if you go 5000 feet it's about 27:25 20 percent more harmful. So watch out for 27:28 that sun, we've been talking with 27:29 Dr. John Chung. He is a specialist in the 27:32 Mohs type surgery. He also deals with 27:35 dermatology on a day and day out basis 27:37 there in Dalton, Georgia. We are really 27:39 thankful that you have been with us today, 27:40 and we've learned a lot in this program about 27:42 things that are very important, very serious 27:44 not to be taken lightly and you've given us 27:47 really practical counsel. I know that you are not 27:49 trying to take the place of someone's 27:50 personal physician, but if they follow 27:53 they're gonna be really benefited. 27:55 Thank so much for watching 27:56 and may God bless you. |
Revised 2014-12-17