Vigilance Needed in the Fight Against Skin Disease -- An Interview with Author Jill Kargman

Vigilance Needed in the Fight Against Skin Disease -- An Interview with Author Jill Kargman

07.06.11 | By

Jill KargmanPhRMA recently released its report on the nearly 300 new medicines now being developed to help fight skin diseases. The report looks at new medicines now in late-stage clinical trials or currently before the FDA for final approval for patient use. Like all PhRMA new medicines in development reports, the news here should give hope to patients battling a variety of skin disorders and build better understanding of the problems of skin disorders as well as awareness of the scientific and medical challenges confronting those researching and developing new medicines.

Following-up on the report's release, I had a chance to chat with author Jill Kargman. Jill is well known for her often humorous but always on-target tales of life among New York City's ultra rich and ultra ambitious. Jill is also a survivor of a life-threatening, stage 2 melanoma, a harrowing story that she explores with both humor and directness in her latest book of essays and observations: Sometimes I Feel Like a Nut.

Here's some of what Jill had to say:

First, how are you doing today?

JK: Great. It's a year out and I've had my lungs scanned and I am totally clean. But I'm in a high risk category, so I still go in every quarter to get checked because the cancer cells I had have a tendency to migrate to the lungs. And that's the challenge. I'm not a smoker nor do I spend time uncovered in the sun. But I'm at risk for skin and lung cancer.

Fortunately, there are more skin treatments available today, but it is still terrifying when you're the one at risk.

How did you find out that you had a potentially deadly melanoma?

JK: Vanity saved my life. It's a story I call "Tumor Humor" in Sometimes I Feel Like a Nut.

I'd been seeing the same dermatologist - one of the best in the city - regularly for 24 years. During a check-up a couple of years ago I told him I had mole on my thigh for a couple of years that bled periodically. I was pregnant at the time, and he told me it was nothing to worry about and that I was being overly cautious.

After my baby was born, I returned for another visit, and told him that the mole was still bleeding. He said it was in a high traffic area and was probably being irritated by clothing and stockings.

And here's where the vanity comes in. The next time I went because after the baby, I was in my mid-30's and wanted to try Botox to smooth out some lines around my eyes and nose. He told me that he didn't do Botox, that it was poison and that I should find some "scumbag" dermatologist to do that for me. And, when I mentioned the mole again, he again dismissed it.

Now, I'm not a drama queen or a hypochondriac. The fact that he wasn't worried mattered, but the mole was still bleeding periodically.

So, anyway, I ended up going to a great woman dermatologist for my Botox treatment. After I got "toxed-up" and was about to be on my way, I showed her the mole. She said it looked fine but because it was bleeding she wanted to take it off. And she did right then.

A couple of days later, I was walking my son in his stroller, its pouring rain, and I get this call from the doctor. The doctor, not the nurse. You know, usually it is the nurse or a recording of the nurse that calls. I thought this can't be good.

The doctor told me that the pathology report had come back, she had called the lab twice to confirm the results. She said I had a fast advancing melanoma and had to get to Sloan Kettering right away. Needless to say, I was shocked. Fortunately, my mother knew a lot of people at Sloan Kettering and helped me get in. They were worried that the melanoma was migrating to the lymph nodes and was at stage 2 or 3 level. I was under the knife in 72 hours. I had to have 16 injections in my groin area - that was widely unpleasant as you might imagine. The whole experience was harrowing.

After the surgery - I have a nine inch scar on my thigh now -- they told me that my lymph nodes were clean but that I was very lucky. It was a very quick-spreading cancer cell and if I hadn't acted, I would have been dead in three years.

What was the hardest part?

JK: I had to get this full body scan. It would take 70 minutes and I had to lie perfectly still in this coffin-like box to do the scan. I was freaking out. I was breathing heavily, panicky and sure I couldn't do it. They gave me a sedative to help and I was still freaking out. I just didn't know how I was going to get through it. But then something changed.

While I was waiting for the medication to kick-in, they brought in a little 8 year old girl who was waiting for the same procedure. It made me think about how brave and calm she seemed to be. It also made me think that I'd rather it be me going through this than one of my kids. And that gave me the strength to get through it. From then on, I never complained.

Before all of this, how aware were you of melanoma?

JK: I was aware but of the typical warning signs, this particular mole didn't look like the ones you had to be worried about. You can get melanomas in place that you don't see or that are not exposed to the sun. Bob Marley, for example, died of melanoma on his foot.

So I knew about the perils of melanoma. I had body scans all the time and through the years I've had 30 moles removed. My back is like a mine field, a 1/2 inch scar is better to have then leave it and have worse things happen.

How important are check-ups and early prevention?

JK: Very. There's been an extreme rise in exposure to the sun. It can happen at any age. But it's important to talk to your doctor and dermatologist even if you're like me - someone who doesn't expose themselves to a lot of sun. What I had was a-typical. It didn't look like the pictures you see of melanomas nor did it fit the usual warning signs. As I said, I'm not a drama queen or a hypochondriac. I was diagnosed because it was a persistent problem and I kept asking my doctors until someone took a look and did something.

You're now working with the Melanoma Research Alliance, how hard is it to get people to pay attention to the problem?

JK: It is hard and sometimes it feels like it's falling on deaf ears. A lot of people love the sun. I abstain completely, big hat, don't even play sports in the sun, doctors recommend no exposure from 10am-2pm. But we just have to keep reminding people that body checks are important.

Also, research into melanoma new treatments is critical.

What do you say to those who think it can't happen to them?

JK: I say: look at me. I don't have it in my family. Statistically there are all kinds of flukes. People assume that some lifeguard in Sydney can get it. But me? I'm Casper the ghost, exhumed from a grave, but I got it. There are all kinds of melanoma that don't have to do with the sun and can get dangerous quickly if you don't catch it.

Finally, if you could talk to researchers working on new treatments for melanoma and other skin disorders, what would you want them to know?

JK: I'd want them to know how important what they're doing is. I know, for example, that they're working on a vaccine. I'd love to see that happen. How great would that be if my kids could be vaccinated? Or, I could be vaccinated so I don't get it again?

I'd also want them to work in ways to help stage 4 sufferers and find ways to shrink those tumors. There have already been huge breakthroughs and we are on the cusp but there is still a lot of work to be done.

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