Posted Saturday, March 20, 2004 by arjuna




Published in the Asbury Park Press 3/19/04


Toms River dermatologist urges people to have strange spots checked

By MARGARET F. BONAFIDE
STAFF WRITER

TOMS RIVER -- Waiting too long to check on a changing mole may have been
a serious mistake for a former sun enthusiast whose melanoma spread
before he sought treatment.


PETER ACKERMAN photo

Everett McAllister (right), with his fiance, Alison DiGiorgio, and his
9-year-old daughter, Danielle, is being treated for melanoma, which has
spread to his lymph nodes.

Everett McAllister, 43, of Red Bank Avenue in the Bayville section of
Berkeley said he waited more than a year to see a doctor after the mole
on his neck began changing colors. By the time he had surgery to remove
it, cancer had spread to his lymph nodes, which also were surgically
removed. Now, doctors are trying to determine the best way to continue
treating him.

McAllister worked outdoors installing fences and doing power washing.

"This is from the sun," he said. "The doctor said it could be from a
sunburn from 20 years ago."

McAllister's "small mole" had darkened to blackish in color. It began
itching a year before he went to see Dr. Rami Geffner at Accredited
Dermatology in Toms River.

Now, two operations later, McAllister, a volunteer firefighter for the
past 10 years, researches on the Internet for information on cancer
treatments while he worries that the disease may come back.

At Accredited Dermatology, office manager Jerry Schlitzer is a busy man
managing the patients who visit the staff at all 12 locations of
Accredited Dermatology, among them several in Ocean and Monmouth
counties. Geffner's partner in business is his wife, Dr. Patricia Tager,
also a dermatologist.

"Everybody is a product of the '60s, and it catches up to you,"
Schlitzer said of people who spend a lot of time in the sun.

Yesterday, Geffner removed a growth from the nose of Janet
Shallcross-Siecke, 68, of the Lanoka Harbor section of Lacey. As a
child, Shallcross-Siecke's family spent summers in the sun. She has
basal cell carcinoma and had surgery yesterday.

"Back when I was young, they said the sun was good for you,"
Shallcross-Siecke said. "It was a good source for vitamin D."

There are other members of her family who have the same type of skin cancer.

"If you have something (on your skin), and it's not healing, get it
checked," she said. "Don't wait."

On Lucille Peters' left cheek is a small patch of irregular shaped
discoloration.

Peters, also of Lacey, had basal cell cancer removed from her cheek
yesterday. She has been a patient of Geffner for the past 15 years.

Geffner used a circular incision around the growth, called the "Mohs"
procedure, to remove the suspected cancerous material. He cauterized the
blood vessels to minimize the bleeding.

"If you catch melanoma early, there is a 100 percent cure rate," Geffner
said.

Skin cancer "can look like a blemish on the skin," he said.


TIM MC CARTHY photo

Everett McAllister's dermatologist, Dr. Rami Geffner of Accredited
Dermatology in Toms River, cauterizes Patrice Cloos' incision after
removing a cancerous growth.

If the suspect mark is bigger than the thickness of about 10 pieces of
paper, the rate at which the cancer cells can grow is much faster, he said.

There are three types of skin cancer, Basal cell carcinoma, Squamous
cell carcinoma and and malignant melanoma. Basal cell carcinoma is most
common. It grows slowly and rarely spreads.

"Basal cell won't kill you," Geffner said.

Squamous cell carcinoma, which growns slowly, can be fatal if left
untreated.

Patrice Cloos, 43, of Toms River had a mole near the base of her left
ear and went to see the doctor. Her mother had metastatic cancer and
died several years ago. Cloos, of Irish descent, is a fair-skinned
blonde who vacationed at the Jersey Shore as a child.

"We would suck up as much sun as we could," she said of her
sun-worshipping days.

Her mole became noticeable on March 7, and she went to her primary
doctor, who refered her to Geffner's office. The bump was removed and
found to be cancerous, and within two weeks, the growth returned.
Geffner removed it again yesterday.

Cloos worries about her 15-year-old daughter's desire to lie in the sun
or its artificial equivalent, the tanning bed.

Geffner said the need to be tanned is causing patients to come in younger.

People with a history of skin cancer in their family are predisposed,
Geffner said. He has one 8-year-old patient with a precancerous growth.

Larry Wager, 83, of Whiting in Manchester has had several cancerous
growths removed from his legs by Geffner. He also blames the sun.

"I spent many years on Jones Beach (Long Island) when I was young,"
Wager said.

For Angel Morrison, Geffner's head surgical nursing supervisor, working
in the busy office is a pleasure.

"I was born to do this," she said of caring for patients. "It is my
calling."

Morrison works with all the doctors in the practice including Dr.
Prabhas Trivedi, a dermatologist. Trivedi remembers McAllister's diagnosis.

"We want to tell patients to come in early as possible," Trivedi said.
Breaking bad news to patients such as McAllister requires "compassion
and some hand-holding. We need to get them to the next surgery as soon
as possible. Most of all, they cannot delay."