Healthwise Maui

Q: I love the beach and spend a lot of time in the sun. What’s the best way to protect against skin cancer?

Dr. Derrick Beech, surgical oncologist, Maui Health System: Many people wear sunscreen to protect their skin, but several studies have shown increased rates of skin cancer in people who use sunscreen. The exact reason for this association is not known, but it’s possible that people who use a lot of sunscreen are simply spending more time in the sun overall, with some of that exposure going unprotected. That’s why the very best way to protect against skin cancer is to cover your skin with UV resistant clothing, like shirts, pants, hats, etc. Use barrier protection in addition to sunscreen.

Q: What is endometriosis?

Dr. Stacy Ammerman, OB-GYN, Maui Lani Physicians & Surgeons: Endometriosis is a painful condition that affects women’s health. It occurs in about 1 in 10 women of reproductive age. With this condition, the tissue that forms the lining of the uterus (the endometrium) implants outside of the uterus. These implants can occur in the ovaries, fallopian tubes, peritoneum, outer surface of the uterus, bowel, bladder, ureters, intestines and rectum. The implants respond to changes in estrogen, and they may grow and bleed like the uterine lining does during the menstrual cycle. Surrounding tissues become swollen, inflamed and irritated. Scar tissue can also form. This bleeding and inflammation can be painful, especially before and during menstruation. If you have severe cramping or back pain with your period, heavy bleeding during periods or pain with intercourse, endometriosis may be the cause.

While there is no known cure for endometriosis, treatments can reduce discomfort and manage symptoms. In addition to pain relievers like ibuprofen, hormonal medications, including birth control pills, IUDs and injectable medications can be helpful. If the problem is really severe, surgery can be helpful. A hysterectomy to remove the uterus is a final option if childbearing is complete.

Q: My mom was just diagnosed with breast cancer. What are the most important things she needs to know to give her the best chance of fighting this?

Dr. Derrick Beech, surgical oncologist, Maui Health System: Breast cancer will occur in 1 out of 8 women during their lifetimes, and more than 200,000 women are diagnosed with breast cancer each year in the United States. Screening and early detection are important, because when breast cancer is caught early, doctors have many more options for treating it, often without having to remove the whole breast. The size of the tumor and stage of the disease will often guide treatment, so your mother’s doctor will want to discuss these factors with her, along with whether or not hormonal receptors on the tumor are present.

Treatment will probably include surgery and may or may not involve additional chemotherapy or radiation therapy as well. Your mom’s oncologist or cancer surgeon will go over the stage of the disease with her and discuss treatment options and prognosis before starting treatment. One of the most important factors for a good outcome is coordinating care, so your mom should make sure that she and all her different treatment providers (including her surgical oncologist, medical oncologist and radiation oncologist) are all in close communication.

* Physicians, providers and administrative staff who practice at Maui Health System hospitals and clinics answer questions from the public in “Healthwise Maui,” which appears on Thursdays. Maui Health System operates Maui Memorial Medical Center, Maui Memorial Medical Center Outpatient Clinic, Kula Hospital & Clinic and Lanai Community Hospital and accepts all patients. To submit a question, go to the website at mauihealthsystem.org/contact.


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