Sunday, 16 April 2017

Skin Cancer: Scleroderma Raynaud's, Autoimmune Rare Disease - Nicola Whitehill

Skin Cancer 
Scleroderma, Raynaud's, Autoimmune Rare Disease. 

#SclerodermaFreeWorld  #RaynaudsFreeWorld  

 
  


A few weeks ago, I attended my local hospital to have a skin biopsy on the red lump which had developed on my forehead, over the course of the last three years. To have lived with a diffuse scleroderma diagnosis for nineteen years, and to have not had to have a skin biopsy, I know, is very lucky. 


I wrote about this experience, here

I wrote more about the involvement of the skin in a scleroderma diagnosis, here

Being a long term diffuse scleroderma patient, I have, reluctantly, become resigned to the fact that, my daily reality is to manage my symptoms to an optimum level, in the hope to get through the day, with as much ease as possible. 

I detailed more about this, here

Due to a diffuse scleroderma diagnosis bringing along a multitude of medical symptoms, crossing over into differing medical specialities, I try to prioritise and minimise my medical appointments, otherwise I would be attending a medical appointment every day! 

I detailed my annual check-up tests, here

And so, after procrastinating for three years, I finally ‘braved up’ and had the biopsy. 

The results of which, after ten days, concluded that an ‘Actinic Keratosis’ was the source of my red lump. 

I am scheduled to return to the skin clinic for treatment on this, the week before Christmas. 


 





Actinic Keratosis is caused by sun damage and could develop into any kind of skin cancer, including a squamous cell carcinoma. 

I also have a patch of Bowen’s disease on my left leg, which is thought to have been caused by sun damage, also. 

I have cream to apply on the area – another task to add to the daily list for symptom control.

In 2012, a scientific medical paper entitled ‘Systemic sclerosis (scleroderma) and cancer risk: systematic review and meta-analysis of observational studies’ concluded:  

‘There is an increased risk on the association 
between scleroderma and cancer’. 

The results showed, 
 
‘The association is fairly specific, since lung cancer and, to lesser extent, haematopoietic cancers were significantly increased in scleroderma patients, while breast cancer, although suggested by previous epidemiological investigations, was not associated with scleroderma.’

The study highlighted several difficulties with its design, including the use of immunotherapies, as well as, information on scleroderma subtype and organ-specific involvements, could not be considered. 

A further difficulty included, 

 ‘The time relationship between clinical onset of scleroderma and diagnosis of malignancy, a crucial issue to understand possible underlying mechanisms, has not always been reported, and several investigations also included cancer cases ascertained within the first year after the diagnosis of scleroderma, which were more likely to be concomitant than subsequent diseases, leading to potential overestimate of summary risk. 

However, the sensitivity analyses excluding the latter studies showed significant, albeit slightly lower, increased risks for all and specific cancer sites explored, anyway.... 

The implications of this study are 2-fold. 

First, active surveillance of scleroderma patients for early detection of cancer is advisable and, with regard to the lung, specific guidelines would be welcomed to define modalities and timing of the screening with the benefit of a periodic CT scan of the lung, outweighing the risk posed by radiation. 

Secondly, alkylating agent should be used judiciously since they may predispose to cancer patients with an already fragile genome. Cyclophosphamide has been linked to increased risk of malignancy in patients with RA and systemic vasculitis.’ 

To read the full article, Click here


On a personal note, although I am trying to not have a heavy heart due to another Christmas time being sabotaged by another Scleroderma ‘Added Extra’, I take huge comfort in knowing that Dr Tiberiu Bontea, my skincare medical team, are experts in their field. With plans to becoming a national skin centre of excellence in fruition, as featured in my local paper last week.

Living the dream, scleroderma style.



An edited version of this article was published here, in my Column with Scleroderma News. 
November 2016.  



  

Scleroderma Family Day 2020

25th Anniversary Meeting

The Atrium, Royal Free Hospital, London, NW3 2QG

Chair: Professor Chris Denton

PROVISIONAL PROGRAMME


09.30 – 10.00           Registration and Coffee

10.00 – 10.20           Welcome                                                   Dame Carol Black
                                                                Prof Chris Denton & David Abraham

10.20 – 10.40           What is a Biopsy?                                    Dr Kristina Clark

10.40 – 11.05           Dental aspects of Scleroderma            Prof Stephen Porter

11.05 – 11.25           Gastrointestinal problems –                       Dr Fiza Ahmed
shedding new light on old problems 

11.25 – 11.50           Pulmonary hypertension and the heart Dr Gerry Coghlan

11.50 – 12.15           Scleroderma cohort studies –                  Dr Francesco 
                                 ‘Learning from our patients’                     del Galdo

12.15 – 14.15           LUNCH BREAK – see below  

14.15 – 14.45           25 years of progress –                          Prof Chris Denton
from ‘black box’ to ‘positive trials’

14.45 – 15.15           International speaker –                            Dr Madelon Vonk
                                 Scleroderma Management in Netherlands

15.30                        Raffle


Lunchtime Discussions Groups / Demonstrations include:

Clinical Trials                                                                  Rachel Ochiel and team
National Institute of Health Research                            Christine Menzies
Drug Information / monitoring                                        Pharmacy
Massage                                                                         Keith Hunt MBE
Pulmonary Hypertension Education / nursing            Sally Reddecliffe/Adele Dawson
Rheumatology Laboratory                                          Research Laboratory Staff
Scleroderma Education / Nursing                          Louise Parker/ Joseph Cainap
Thermography                                                                Dr Kevin Howell
SRUK                                                                             Ollie Scott
Sjogren’s syndrome                                                       British Sjogren’s Society 


To Read My Articles:  

Gift in My Will, Click here 

Planning for the Future, Click here  

 


Rare Disease Day:   

Rare Disease Day 2020:  

  

Listen to my interview with John Smeeton, (Silver Fox), from the Royal Free Radio, here  


 

Raise awareness and donate to medical research, order your #SclerodermaFreeWorld #RaynaudsFreeWorld tshirt  here   


 
Rare Disease Day 2020: NIHR 'Research gives hope to Rare Disease patients', Click here  

  


 
Rare Disease Day 2019: Leaving a Legacy Gift, Click here       



Rare Disease Day 2019: 11am 97.4RockFM headlines, NO CURE, Click here  

Rare Disease Day 2018 – Research, Taking Part in Clinical Trials. Scleroderma, Raynaud's, Autoimmune Rare Disease, Click here     

2017 Rare Disease Day Medical Research  


2016 Rare Disease Day Patient Voice   

2016 Rare Disease UK Parliamentary Reception       

  

Rare Disease Day is a fantastic opportunity for the entire rare disease community to shine a spotlight on their reality, combining as one unified voice. Where, at least one commonality presides –  
Medical Research
provides the brightest light,
for the illumination of 
the rare disease patients’ plight.


To read about medical research at the scleroderma unit, Click here   

Although rare disease patients are few in number, eg. 2.5 million scleroderma patients worldwide, (the World Scleroderma Foundation), the commonalities and golden hallmark for each rare disease patient are the same overall. 

For optimum patient care, 3 hallmarks preside:







supported by a medicaldream team’ 
(expert specialist as the clinical lead).

INVESTMENT in MEDICAL RESEARCH is CRUCIAL.   


To read my articles:  

Celebrating 20 years of being a patient at the Scleroderma Unit, Click here

2019 New Challenges, Click here
 
NIHR Video: 'My Experience of Clinical Trials', Click here 

If we only had more RESEARCH investment for Scleroderma, Raynaud's, Autoimmune Rare Disease, Click here   

The Importance of Medical Research and Awareness to the Scleroderma, Raynaud's, Autoimmune Rare Disease patient, Click here  

2018 Scleroderma Awareness Raising and Medical Research, Click here    


SCLERODERMA:

Importance of an early diagnosis, Click here   
    
Taking Part in Clinical Research Trials, Click here     

The Importance of a Multi Disciplinary Medical ‘Dream Team’, Click here    

Expert Specialist Centres, Click here      
  
My Skin is Cured from Scleroderma, Click here   
    
UK Guidelines for Managing and Treating Scleroderma, Click here        

Fatigue, Click here         

Mobility, Click here      

Diet and nutrition, Click here      


Raynaud's- How to Diagnose, Click here        

'All you need to know', 2016 Awareness Video, Click here    

Global Patient Profiles 2018 Video, Click here    


Unmet Medical Needs, Click here     




Calcinosis Video, Click here    


The scleroderma tooth fairy, Click here     


Skin Cancer and scleroderma, Click here   

 

Sept 2017

Prof Chris Denton and I, Sept 2017

June 2019



This year, 2020, I am celebrating 22 years of being a patient at the Scleroderma Unit, The Royal Free Hospital - a world leading expert specialist, research centre.  

Read more, here.    

I am eternally grateful to the global scleroderma trail blazers Dame Prof Black and Prof Chris Denton, whose commitment and dedication to unlocking the scleroderma enigma, is nothing other than, superhuman. Along with the Raynaud's world trail blazer, Dr Kevin Howell.  

I am truly humbled and inspired by their work ethic and commitment to their patients.  

I am wholly appreciative for Prof Denton’s continued medical expertise and support, especially during my barrister qualifying years, 1997 - 2004. 
 
1st March 2004, I qualified as a self employed practising barrister. Further to having been told in 1997, by my original diagnosing doctor, that I was looking at a 15month prognosis. 
 


  

Chat Magazine May 2019

I very much hope to utilise my professional skills and qualifications along with my patient experience, to help achieve the #SclerodermaFreeWorld dream, hoping to improve understanding and best practice, in the meantime. Read more, here    


  

World Scleroderma Day 2018, Click here  

World Scleroderma Day 2017, 29th June, Click here    

World Scleroderma Day 2016, 29th June. Origins of the date, Click here   

World Scleroderma Day 2015, 29th June.  


James Carver, myself, Prof Chris Denton

I had the pleasure of being a presenter and part of the European co-hort who gave a presentation at the European Parliament, Brussels, in honour of World Scleroderma Day 2015.  

I am immensely grateful to James Carver, former MEP, for organizing this event in memory of his late wife Carmen, who sadly passed from Scleroderma.  

To view the presentation, Click here 

Raynaud's

October:  
Raynaud's, Click here  
 
To view the UK treatment guidelines for Raynaud’s Phenomenon, Click here   

To view the EULAR treatment guidelines, Click here   

To view Thermograph Video, Click here    

To view Thermograph image, Click here    

   
My Raynaud’s reality, Click here     


The global Raynaud's trailblazer - Dr Howell and I, Sept 2017

To view Nailfold Capillaroscopy equipment (used to identify possible blood vessel damage), Click here   

Invisible Disability Awareness Video, Click here

To read My ‘Invisible Disability’ experience, Click here   

50 Shades of Blue, Click here



 

For latest updates follow / subscribe:  

@SclerodermaRF 

@RaynaudsRf 

Twitter, Instagram, Blogger, YouTube, Facebook Page:

#SclerodermaFreeWorld           #RaynaudsFreeWorld    #Research  



Please DONATE to help fund medical research at The Scleroderma Unit,The Royal Free Hospital, London.  


Alternatively, to make a direct donation to fund medical research via the Royal Free Charity, Scleroderma Unit, Click here    
 


100% of your monies will be used for medical research purposes only. NO wages or admin costs. Thank You. 

  

  
Last Update: Feb 2020.       


Skin Cancer 
Scleroderma, Raynaud's, Autoimmune Rare Disease. 

#SclerodermaFreeWorld  #RaynaudsFreeWorld  












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