Â鶹ѧÉú¾«Æ·°æ

Scot: Hey, Mitch, John, simple question. Do you take steps to protect yourself whenever you're out in the sun? Do you do anything? John?

Dr. Smith: I'm 50-50. I should do more because I am about as albino as they come, but I'm about 50-50.

Scot: All right. How about you, Mitch? You seem like a guy that probably does.

Mitch: Well, I didn't used to, but these days I got myself a little daily moisturizer. I do it because I get dry skin anyway. I just got one with SPF. That's all I do. I know I should probably do more, but yeah, I just . . .

Scot: You know what? I'm kind of 50-50 too. Sometimes I'm pretty good, sometimes I'm not good. And it's funny, because I know that I should be better, but yet I still don't necessarily take all the steps that I need to take. And that's what we wanted to talk about today.

I think most guys know that the sun can be really dangerous, and skin cancer is a cancer you don't want to get, but yet we still don't necessarily take the steps that we should to protect ourselves. And that's what we're going to talk about today.

This is "Who Cares About Men's Health," with inspiration, information, and a different interpretation of men's health. My name is Scot. I bring the BS. The MD to my BS, Dr. John Smith.

Dr. Smith: Good afternoon.

Scot: Producer Mitch is a "he cares about his health" convert.

Mitch: Hey, there.

Scot: And we've got Dr. Dekker Deacon. He's a dermatologist. He's also a skin cancer expert at Huntsman Cancer Institute, and he's going to probably tell us how bad skin cancer is and hopefully give us some insights as to what we could do to make sure we're more than 50-50. How are you, Dr. Deacon?

Dr. Deacon: I'm doing well. Thanks for having me.

Scot: Also, , he's a professor in the Department of Communication at University of Utah, and he's got an interesting relationship with skin cancer. Jake, thanks for being on the show.

Prof. Jensen: It's my pleasure to be here.

Scot: All right. So we want to hear real stories. So, first of all, let's just get right into it. Jake, you're the reason we're here. You got hit with melanoma when you were 19 years old. What happened?

Prof. Jensen: I was a lifeguard working in Montana. I had just graduated from high school. I was in between my freshman and sophomore years of college. And it was right at the end of the summer, having spent the whole summer out in the sun, lifeguarding at a little small-town pool.

I was doing morning swim lessons with a 5-year-old who had been sick for a little while, so she had missed the normal swim lessons for the season. Her mom had asked if I would do private lessons, and I said yes.

After I got done with the first lesson, her mom, who happened to be the county health nurse, her name is Sue Good, she walked up to me and she said, "Hey, has anyone ever told you that you have a really strange mole in the center of your back?"

Scot: Wow.

Prof. Jensen: I said, "No, no one has ever told me that." I walked into the lifeguard house, I asked the other lifeguards, I said, "Have any of you noticed that I have a strange mole on the center of my back?" And they all go, "Oh, yeah, you do. You have a really strange mole." And I thought, "Well, thanks for telling me."

Scot: Yeah. No kidding. Did she indicate she thought it could be skin cancer at that point?

Prof. Jensen: Yeah, in hindsight, she's a county health nurse. And she still is to this day, by the way. She's been the county health nurse for that county for many decades. She'd had maybe a couple weeks' worth of training over her career in melanoma identification because it's something that county health nurses pick up a little bit along the way, and she just thought it looked strange.

It did look strange. She wouldn't have articulated it in this way at that time, but it kind of violated ugly duckling sign. It didn't look like any other mole on my body. I mean, what really made it stand out is it just was clearly something very different. It broke the pattern on my back.

And she's, of course, sitting there watching me teach her daughter to swim, and so she can't help but notice the mole on my back, right?

Scot: Right. The whole time thinking, "Oh, this poor guy. He could have skin cancer." Probably distracted the whole time.

Prof. Jensen: Right.

Scot: So after she told you that, how long did it take until you actually went to the doctor? I mean, being a young guy, did you go right away or did you wait?

Prof. Jensen: Yeah, it's interesting, because I think at that time, I was very much a person that was a waiter, if you will. I would wait. If I found something, it would be months before I moved.

But the thing that made me go a little faster in this case, I think I went in about a week later, is because this would have been the first week of August and I was due back at college in Moorhead, Minnesota, by the third week of August. And so I sort of had to get moving on it, right?

So about a week later, I went in and had it removed and didn't think much about it. But then right before I was getting ready to head to Minnesota, the surgeon . . . This was just a general surgeon who removed the mole. We didn't have a dermatologist in eastern Montana at that time. He called me on the phone and said, "Hey, that came back. It was melanoma. I need you to come back really quick. I want to cut some more off of you."

And so I quickly drove back to Sidney the very next day after that and he took a lot more skin off the second time, and then said, "When are you coming back from college?" And I said, "Well, I might be back around October." He said, "Come see me again in October." And that was sort of how this thing started.

So maybe from the moment she found it until the second time he removed skin was probably a span of around 12 to 13 days, somewhere in there.

Mitch: Wow.

Dr. Smith: When you said you're a waiter and then you got in within 12 days, that doesn't seem like much of a waiter to me. I mean, I think you did the right thing.

Mitch: And I guess the other question that I had is how did you feel when you got that diagnosis? I mean, it's one thing to have someone say, "Hey, you've got a weird mole you should probably . . ." or whatever. I mean, was it scary? What was your understanding of the condition, etc.?

Prof. Jensen: When he told me, I didn't know what melanoma was. I turned and I told my mom, I said, "Hey, the doctor called me and said I have a melanoma." And she gasped, and she said, "A melanoma?" That was the first sense that I had. Because he had been very calm when he told me, right? That was the first sense that I had that there was something perhaps more significant about this than I first realized.

Then most of the people that were my age, if I said, "Oh, yeah, that mole came back, it was a melanoma," they didn't know what it was either. And so my own peer group wasn't really all that concerned about it.

Eventually, we all figured out it was cancer, and then it was a little bit heavy to think, "Wow, we have some cancer." And all of the lifeguards immediately went in and got mole checked then. I think their parents did that as much as anything.

And honestly, it took me years to really figure out the experience I had been in. And now I look back on it and realize I was very, very lucky that Sue caught that, because had she not caught it . . . I was about to go to Minnesota and Minnesota is cold and the winters are long and it probably wouldn't have been seen again until the next summer at the earliest. So hat tip to Sue. She caught it so early.

And again, I think if I had had just infinite runway in front of me, it probably would have been three, four, or five months at a minimum before I really did anything. It was just this desire to take care of it before I got to college for some reason, and that I trusted Sue a lot. The county health nurse has a lot of credibility. So when she tells you to do something in a small town like that, you take it pretty seriously. So I think Sue's credibility weighed really, really heavily.

Scot: Not to fear monger here, Dekker, but what would happen if somebody ignored a melanoma? When does it start to become a bigger issue? It moves pretty quickly, doesn't it? That's my understanding.

Dr. Deacon: It can be quite variable. When you catch it early, so a Stage 0 or Stage I, and do an excision in a relatively timely manner, the rate . . . The five-year recurrence rate is one of the metrics we use. So how likely is it to come back within the next five years? It's less than 1%. It's actually less than 0.1%.

So when you catch it early, that's when it's treatable with a local surgery. Once it's on the move, once it's gone to lymph nodes or particularly other parts of the body, once it's metastasized, that's where it's a whole different ballgame. And that's why it's so important to catch these early.

Scot: At the top of the show, we didn't ask Jake or Dekker what their steps are to protect themselves. First of all, Jakob, do you think this experience . . . Tell us about the Jakob before and the Jakob after getting diagnosed with a melanoma. Did anything change in your behavior?

Prof. Jensen: Yeah, it did. I was the person who burned until I peeled every summer growing up in the '80s and the '90s. To be honest, I did that because our feeling at the time was that if you burn until you peeled at the beginning of a summer, you were protected for the rest of the summer. So most of the young people I knew, we would intentionally burn to peel. And I certainly did.

But after this experience in the years that followed . . . I wish I could say I immediately corrected my behavior. I didn't immediately correct my behavior because I didn't immediately understand what I had just been through. But over a span of about three years after that, as I read more about it and I talked to people about it, it was really huge.

I would occasionally meet other people that had had melanoma, and a lot of the education about melanoma came from other patients who would then talk to me about their journey and what they did. And it started to kind of awaken in me an awareness of how my sun-safe behavior was not especially safe.

I mean, I will be the first to tell you I was the worst. I never wore sunscreen. I didn't wear sun-safe clothes and I didn't wear a sun shirt or anything. I didn't try to stay out of peak sun. Like I said, I intentionally burned until I peeled. I thought that was a sun-protective measure.

I worked as a lifeguard. I bailed bails all day long for my uncle. I spent tons of time out at Fort Peck Lake out on the lake on a boat. I never put sunscreen on once in my life.

I'm a really good case study in hindsight, that if you just willfully refuse to engage in any sun-safe behavior, you probably will eventually get skin cancer.

Scot: Yeah. Hey, it sounds like we came from similar backgrounds. I came from a ranching, rural background as well. And my dad always wore a cowboy hat with a brim on it. He always, even in the hottest of days, would have his long sleeves down. He'd have his collar up. I could never understand how . . . Here I am running around without a shirt or short sleeves, and I'm like, "How do you even do that?"

So on some level, he knew that he needed to protect himself, although I don't know that I saw that as modeling that behavior. I don't think I understood why he did it at the time.

Was there anybody in your life . . . Did you see sun protection growing up? Were there any role models using it?

Prof. Jensen: Well, that's funny that you say that. My dad was the same way. He wore a cowboy hat. He wore a button shirt that was long sleeve, even if we were out baling, right? And we would tease him about it, like, "Man, you must be roasting wearing that."

We were wearing t-shirts or tank tops or, frankly, sometimes no shirt at all, and maybe a baseball cap if we're lucky. But he was wearing that stuff. In hindsight, he was being sort of sun safe. We were being not sun safe at all. But we were teasing him because we thought about the heat, right?

So those old Western guys, that's kind of how they were. And that's an interesting thing to think about, some of that sort of experience that's there, whether it knows it or not.

There are a lot of people that kind of dress like that and it is serving a function. I don't know if they're always aware of that, but that's the function. My dad might've said, "Well, the bails make me itch so I wear a long . . ." He always had a reason why he had a long-sleeved shirt on. It changed with the task, I noticed.

Scot: Dekker, were you sun safe early on in your life? Did you have any role models?

Dr. Deacon: Yeah. So interesting, my experience in childhood was maybe 10, 15 years later than Jake's here. I remember going to the beach. I grew up in Southern California. My parents would slather sunscreen on me before we went out. I swam, I played water polo, I surfed, and sunscreen was always something that I should have been using.

I was kind of resistant to it at times. I think the cold sunscreen that got left in the car overnight, first thing in the morning I was resistant to it. But yeah, sunscreen was always a part of my childhood.

Dr. Smith: Yeah, I was going to say my growing up was very similar to Scot and Jake, where there was no sunscreen. We ran around. I mean, I grew up in suburbia of Utah, but we didn't . . . I had a little thing taken off my nose that was a pre-cancer when I was in my early 30s. I'm very light-skinned, and so it's one of those where I probably should have been smarter when I was younger and now I'm a lot more conscious of it.

My kids, unfortunately, got my complexion, so they get slathered in sunscreen a lot like Dekker, it sounds like. They're not allowed to go out back before they put sunscreen on. And we're very regimented with that because I see the beauty in it now of keeping their skin as safe as we can.

Mitch: One of the things that's interesting is that growing up . . . I mean, sunscreen wasn't the biggest thing, but I was also of the generation when I was growing up in high school in the '90s and 2000s that people would go to tanning beds. People would go to get that base tan to protect their skin, right? And they would just nuke their skin and peel and everything intentionally. It was always kind of interesting.

I didn't do that myself, but there was this kind of thing that you needed to have sun damage to somehow help your skin.

And so it wasn't until actually I got into college and someone who lived on my floor, one of my really good friends, had a pretty severe melanoma on her face that she got after years of baking herself in a tanning salon.

It was a long journey to get all of the stuff. It was on her face and there was a scar. And that's about the time I started really taking it really seriously, is seeing someone my age going through that.

Dr. Smith: Now, Dekker, is that something you see a lot? I mean, it sounds like a bunch of us have this thing . . . Other than the kid who grew up in Southern California and knew better. The rest of us all have this mindset that, "Hey, the sun is not a problem." Is that something you see in your practice quite a bit where people are like, "I didn't know it was a problem"?

Dr. Deacon: Yeah, definitely. And it is kind of a generational shift. We still have pretty significant tanning bed use. Fortunately, here in Utah, we have banned the use of tanning beds for minors. But that kind of notion of getting a base tan, getting a tan before going on vacation or before summer still exists and is something that I routinely have to counsel patients that, "No, any time your skin is darkening, that is because it is trying to protect itself because you are getting DNA damage." And so there's no real such thing as a base tan or a safe tan.

Scot: So there's a little bit of an educational thing going on, like how serious this could be, the fact that even if your skin is changing color, that's not your body protecting itself. That's your body getting damaged.

But I've also seen a statistic that only 11% of men wear long-sleeved shirts, only 14% of men regularly use sunscreen. I think there are a lot of us that do know better, but we don't do anything. So why? What's the barrier here? Information is one of them. What are some other possible barriers that keep us from doing the thing we know we need to do?

Dr. Deacon: I think part of it is inconvenience. The long sleeves are not ideal in heat. I think that long sleeves, hats, are your first line of defense, and sunscreen is really your second line of defense.

But outdoor exposure, both recreation and occupationally, are big points of UV exposure, particularly with men and in Utah. So it takes a little time, it takes a little forethought, it takes a little planning, and maybe that's stuff that men aren't quite as good at.

Scot: John, when you say you're 50-50, when you're the 50 that's not doing the right thing, why?

Dr. Smith: I mean, a lot of it is time. We put a pool in last year, and so the 50 I had it on was when I was making my kids do it. I'm a big fan of trying not to be a double-standard dad, even though I am completely double-standard dad the majority of the time. I like to tell myself I'm not. But when I make them put sunscreen on to go out into the sun, I do the same thing at that time.

The times I don't do it is if I'm, say, running to a kid's soccer game, or softball game, or something in the morning or in the afternoon where I should put sun protection on. Now, I usually have a hat on or something like that, but at the same time, my arms and my face still need additional protection.

And so those are the times where I'm probably 50-50, is when I'm running out the door and it's not in the forefront of my mind because I personally haven't made it a habit, and that's a personal problem for me.

Scot: Yeah, a habit or just even this notion that there might be certain events, like when you go to the beach and you're from California, you put sunscreen on. When you go out to the pool, you put sunscreen on. But when you go to the game, "Oh, I don't need sunscreen. That's not a sunscreen activity." Maybe there's a mind thing there. I don't know.

Jake, how about you? Are you 100%? Are you the poster child for proper sun behavior now?

Prof. Jensen: I'm probably about 75% now. I will typically wear a sun shirt, like a long-sleeve shirt, a good UV shirt. I have a lot of them. I really like sun shirts as a way to go . . .

Dr. Deacon: Agreed.

Prof. Jensen: . . . and a relatively large sun hat.

I say about 75%. It resonates with me the sort of, "Oh, my sons are playing soccer. This is happening." When I get in a hurry, sometimes I find myself going, "Whoops, I got out moving before I got my sunscreen on or before I did something." I'll usually put on a sun shirt, a sun hat, and sunscreen when I take the time to do it.

There's something called being an inclined abstainer. An inclined abstainer is a person who intends to do something, but little things get in their way. So I think most men today, when they don't engage in sun-safe behavior, they're inclined abstainers. "Oh, yeah, I probably should do it. I just forgot. I ran out of time."

Scot: "I'll catch it next time."

Prof. Jensen: Yeah. And isn't that what gets . . . I mean, for men, we are more likely to fall victim to time and forgetting. And a lot of health behavior issues we suffer from, it's nickels and dimes that add up to those dollars of punishment, right?

It's rare to encounter a man, for example, that probably is just willfully like, "No, I'm not going to do anything to protect myself." They're out there. But for most of us, I think it's, "Yeah, I know I should be doing that. My wife is always telling me that," or, "I'm always trying to make sure my kids do it. I need to model it." When we don't do it, it tends to be time and place that catches us.

Scot: Is there anything else that anybody feels that we should talk about here, or do you think we're good to start wrapping up? Is there anything in particular, Dekker, that you wanted to bring up that you think we missed, or Jake, that you think we missed?

Prof. Jensen: Yeah. For me, if we bring it full circle, then I went on in life to eventually get my PhD and become a communications scholar, and my primary research program is about designing visuals that help people identify melanoma. And so my lab has produced a lot of patient materials that teach patients ugly duckling sign, the ABCDEs. Huntsman has all of those materials, but they're now used all around the world.

So a lot of my work is focused on trying to help people identify melanoma early, and I think it was because . . . They say as a researcher, there are certain catalyst moments in life that kind of drive your work. And for me, I just kept going back to that first melanoma.

My fate may have hung in the balance based on Sue just seeing something and saying something. And had she not done both of those things, maybe my life is a very different life, and I didn't like that about it.

I loved that Sue had done that, but I wanted to have more efficacy. I wanted to be able to control my own health better than that. So that's where a lot of my work has gone.

I also just recently had melanoma. I was diagnosed again with melanoma in August of '24. Fortunately, I caught it very, very early. I was actually working in my lab the first time I saw it, working on building a mole identification task. I looked down at my right arm and I saw a very strange mole.

And I went home and I showed it to my wife, because she does my monthly skin exams on me. I strongly recommend that you have a partner help you with skin self-exams. It's much easier to examine someone else's skin than to examine your own skin. They just have a better frame of reference. It's hard to see your whole body. Your vision of your own body is not great. Their vision of you is much more traditional. They can see it.

I showed it to her and she said, "You've got to go in immediately for that." And I said, "Well, I had one that looked kind of like this that was removed maybe about two inches from here. So don't you think this is just . . ."

To me, it violated ugly duckling sign. I said, "This is not an ugly duckling. I've had this ugly duckling before." And she said, "No, I don't think so. It's glossier than that other one. There's something about that one that just looks wrong to me."

I have this rule, and it's my golden rule of melanoma identification. If anyone ever thinks something looks wrong, I go in.

I immediately, the next morning, got up and I called the Rapid Clinic. The University of Utah has this amazing service you can use called the Rapid Clinic where you can call the morning of and try to schedule a dermatology appointment that day if you have an urgent or high-risk situation.

And so I called in the very next day and got in and got it removed, and a week later, it came back, it was melanoma. But I caught it super early. That mole had just shown up. And so it's another story of catching it early.

I guess a couple of things to take from that. Have somebody assist you and trust them. If you are a person that waits . . . If somebody thinks something doesn't look right, don't challenge that. You might talk yourself right into a bad situation. It's not a hard thing to go in and get something removed. In melanoma, we don't talk about false positives. In melanoma, we just say, "Good news. It's not melanoma."

Scot: I'm glad that you brought that up because that was an aspect of the conversation we really haven't hit on. Dr. Deacon, would you like to add anything else to that as far as preventative measures that guys should do? I mean, should they schedule a Friday night with their wife to do a little skin check, if you know what I'm saying, or is that more of a Tuesday night sort of thing?

Dr. Deacon: Maybe that's a Tuesday night thing. We talked about the ABCDEs, but to spell those out, we've got the asymmetry and irregular border, multiple colors, or a diameter greater than six millimeters. All of those kind of come together to give you an ugly duckling sign.

The E, or evolving, changing over time, that's separate from the ABCDs, and that I actually think is the most important thing. I've caught a couple melanomas that I didn't even think looked that concerning clinically, but patients say, "Nope, this one is changing. I'm 100% sure it's growing." I'm like, "Okay. We'll biopsy it," and have been surprised a couple of times.

So really taking to heart not just the ugly duckling ABCDs, but that E of evolving, changing over time.

We'd always rather catch something sooner rather than later. It's much easier to treat if it's diagnosed earlier, so don't hesitate to get something evaluated if you or someone you're close to brings it up as a concern.

Scot: Great conversation. Final takeaways. John Smith, what do you think?

Dr. Smith: I think this has renewed for me to get some sunscreen for the car and just really do it the right way. I think it's inspiring.

I had a friend in med school who diagnosed himself with melanoma during our dermatology lectures, and that kind of put a little bit of the fear in me as well. And then hearing this again today, I mean, those little things that I need to do on a daily basis to make myself as healthy as I can.

Scot: Mitch?

Mitch: I know a little bit more now about the different SPFs and what I should be thinking about. But yeah, I should probably get one to throw in the car. I'll do that too.

Scot: All right. How about you, Dekker?

Dr. Deacon: I think in addition to the prevention, just knowing that melanoma and other skin cancers are one of the most preventable types of cancer out there. And so you can do something to prevent and reduce your risk of melanoma. And then just trying to do what you can. Whatever you can do, whenever you can, is better than nothing.

Scot: All right. I'm going to throw my takeaway in. So even though my dad wore a hat and long sleeves, when I go out hiking, I've gotten better. When I was younger, it was always short-sleeves and shorts. Now it's long pants and long sleeves. But I still wear a ball cap, which doesn't protect my ears and part of my face, right?

My dad actually did get some skin cancers. He'd go in periodically and have to get stuff burnt off of his face, is how he described it to me.

So what I'm going to do going forward is I do have the sunscreen in the car, but I'm going to put a floppy hat in the car, something that protects my ears. If I set out on my hike and I don't have that and I haven't sunscreened up for the other places, I'm going to hear both Dekker and Jake say, "Scot, you really should go back. You really should go back and just do it."

And I know if I do that a few times, it'll start to build in a habit and then I won't have to go back again. So that's my takeaway. I need to take it a little bit more serious. I'm about 80%, but I'd like to be 100%.

Jake, do you have any final thoughts?

Prof. Jensen: My final thought is I give a lot of talks on skin cancer education and sun-safe education. And if there are more than 100 people in the room, about a month or so later, I'll have an email or a phone message where somebody says, "Hey, I just wanted to say I attended a talk of yours and I was sitting on a mole that I needed to get in on. I went in, and sure enough, it was melanoma," or it was basal or it was another form of skin cancer. "I'm so glad I went in. I needed to be nudged. I was sitting on this thing."

And I say that to say, if people are listening to this, there are a lot of us that sometimes are sitting on an ugly-looking lesion on our body, an ugly-looking mole, and we need to be nudged to go in.

I hope you will think of this as a nudge to go in, because that is the thing you should do. You should be sun safe, you should be doing all these other things, but when you think there's a problem, go in as soon as you can.

Scot: I love it. That's a great way to end.

If you have a story or thoughts about today's episode, you can reach out to us at hello@thescoperadio.com.

I'd like to thank all of our guests today for talking very openly about skin cancer. Hopefully, you will take the nudge, and hopefully, you too will hear Jake and Dekker's voices in your head when you're perhaps not engaging in sun safety. And think about those that you love and the fact that you want to be there for them and set good examples for them.

Thanks for listening, and thanks for caring about men's health.