Skin Cancer Spotlight: Cutaneous Squamous Cell Carcinoma: Early Detection & Prevention

Squamous cell carcinoma is the skin cancer most people shrug off until it stops playing by the rules. From the AOCD meeting in Orlando, I sit down with board-certified dermatologist and Mohs surgeon Dr. Carlos Gomez Mead to talk about why cutaneous squamous cell carcinoma can be far more dangerous than its reputation and why, on a population level, it can lead to more deaths than melanoma.

We dig into what actually makes a squamous cell carcinoma “high risk” in real life: rapid growth, pain with pressure that can hint at perineural invasion, and high risk head and neck locations where lymphatic spread is a real concern. We also talk candidly about the shortcomings of common staging systems (NCCN, AJCC, and BWH) and why clinical judgment still matters when cancer behavior is unpredictable.

Then we get practical about gene expression profiling for squamous cell carcinoma, including DecisionDx-SCC (a 40-gene test run on the original biopsy tissue). Dr. Gomez Mead breaks down results in plain language: low, medium, and high risk, and how those categories can change what we do next, from imaging surveillance and oncology collaboration to when adjuvant radiation therapy may actually help. We also spend time on immunosuppressed patients, especially transplant recipients, and why proactive planning can be lifesaving.

If you care about skin cancer prevention, early detection, and smarter personalized treatment, hit subscribe, share this with a friend, and leave a review so more people can find the show.

Transcript

Painful Tumors And Hidden Nerves

SPEAKER_02 0:00

I like to use uh what's called neuropathic symptoms, which is I push on it and it really hurts. That might be an indication of perineural invasion, which often, when we go in to do surgery, we see that encompassed nerve with the tumor often. I kind of try to cater it towards high-risk patient, high-risk cancer. And do I want, is that result going to change anything that I do? Which is the really the million-dollar question, right? Particularly heart transplant patients, in my experience, seem to be just get the brunt of this. But kidney transplants are relatively common. I like to call the immune system like police force. It's like the internal police force of your body. And cancer is like the bad guy.

SPEAKER_03 0:39

Welcome to Dermot Trotter, Don't Swear About Skin Care, where host Dr. Shannon C. Trotter, a board-certified dermatologist, sits down with fellow dermatologists and skincare experts to separate fact from fiction and simplify skincare. Let's get started.

Live From AOCD With Dr. Gomez Mead

SPEAKER_00 0:58

Welcome to the Dermit Trotter Don't Swear About Skin Care podcast. We're coming at you live from the AOCD meeting, the American Osteopathic College of Dermatology here in Orlando, Florida. And I've got a special episode too for you today that we're going to talk a little bit about skin cancer and advances we've made with Dr. Carlos Gomez Mead, who's on the podcast. Welcome, Carlos. It's great to have you.

SPEAKER_02 1:18

Thank you, Shannon. Thank you. No, it's my honor and privilege to be here with you. Um and uh this has been such an amazing meeting. I mean, we really, I love how talking about how we gave this whole thing a facelift, pun intended, and uh and how we really, you know, dug deep to to create a whole new product uh with our AOCD meeting. It took 52 weeks, full weeks of meetings, and uh much of which you were on um throughout the year. And uh we really are so pumped and excited about uh the fruits of our labor here at this meeting. So it's been fantastic. So thank you for having me.

SPEAKER_00 1:56

Of course. For those of you that don't know, Carlos, an amazing dermatologist, board-certified derm, and he's also a MOS surgeon. So you get the double take with him as well. He founded Quarterstone Dermatology in Tulsa, Oklahoma in 2024, and he loves educating on skin cancer, which is why I have you on the show today. Because I wanted to talk more about squamous cell carcinoma, kind of the skin cancer that gets ignored a little bit. And a lot of people don't even know what it is. Do you mind kind of setting the scene for us a little bit and talk a little bit about squame?

Why Squamous Cell Deserves Attention

SPEAKER_02 2:24

Sure. So squamous cell carcinoma, you're right, doesn't really get a lot of hype, you know. And I talk about how melanoma gets all the hype, right? And so a lot of our patients, whenever you tell them they have skin cancer, the first thing that they think of is melanoma. And they often get confused with the more common ones, which are basal cell carcinoma, squamocell carcinoma. Uh, more people actually, not many people know this, not even dermatologists know this interesting statistic. More people will actually die from squam cell carcinoma than melanomas throughout the year. Now, it sounds shocking at first, but when you think about it and realize that there's many more cases of squamocarcinoma, that it makes sense that more people will actually die from these high risk. We see them weekly, sometimes day, actually daily in our practice, as most surgeons. Uh, I practice uh in Tulsa, Oklahoma, like you said. And uh myself and Dr. Elena Meyer, uh, my my partner there in the practice, um you know, that's this is our bread and butter, right? And so we treat so many of these, and many of these are they grow rapidly. Um, they're aggressive right off the bat, and the the risk of metastasis and recurrence is significantly higher than, for example, basic cell carcinoma. So um, so yeah, it doesn't get its due respect. It's something that we learn uh throughout our practice, and having done this for you know over 12, 13 years now and treated thousands and thousands and thousands upon thousands of these, um, that yeah, you have to respect spam cell carcinomas. Um, and so they they should get more hype and more publicity than they really should, than they really receive.

SPEAKER_00 3:58

Well, hopefully that will be the end result of our conversation today, because you know, people just kind of brush it off, right? You know, it's the second most common type of skin cancer be like, oh, you can just cure me with surgery, which the vast majority, you know, we do. And we have other treatment modalities as well. And you talked about really the mortality piece, like how many people actually die from it. I bet people are shocked to hear that. Yep. And it is a numbers game on some level, like you said, but I think what it really does is highlight the need then that we need to pay more attention. And how do we find these more aggressive cutaneous squamous cell carcinomas? So there's something out there to kind of help us with that a little bit. There's now what we call gene expression profiling that's available. So it's gonna be just explain what is that, because a lot of people might be scratching their heads and not have heard of it before. And then how are we using it for cutaneous squamous cell carcinoma?

Staging Limits And The Need For Help

SPEAKER_02 4:44

Yeah. So um squamocal carcinoma um, again, is I often like to describe all cancers, uh, but particularly squim cell carcinomas, um, as a squirrel on the side of the road, right? And uh so you don't know what that squirrel's gonna do. It's either gonna run onto the road, yeah. You don't know. So you're driving along your neighborhood, you see a squirrel come up to the edge of the curb, and you really don't know what it's gonna do. So uh it might go backwards, it might run right in front of your car, it might uh jump up. You know, you really don't. So it's it's it's a very erratic cancer. It's sometimes even, I like to give it personalities here, these cancers personalities. It's sometimes temperamental, you know. So you might treat it with uh certain modality and it erupts, you know. I'm sure you've seen that in your career, or they recur for no particular reason, even with uh, you know, clear margins, right? And so it's a very uh interesting cancer that has so much clinical behavior that we need help, right? And so what's the help that we uh need? Well, we need help determining which one of these can come back uh after treatment, which one of these can metastasize, right? More importantly, be life-threatening. So um if you look at the numbers, you look at the statistics, overall risk of squem cell carcinoma metastasis is about 6%. So that includes all of them, the high risk and the low risk, right? Well, and then we we look at our second tools, which are our staging systems that we clinically have. We have NCCN staging systems, uh, we have uh Brigham and Women's uh BWH, which is my personal favorite that we use in our practice, um, and um uh AJCC, right? And so these are our staging systems that we use. The problem with them is they're really bad. They're really bad because they encompass all squam cell carcinomas, uh, a whole risk of uh populations that were included in the studies. And there's really they boil it down to like four criteria, like depth more than six millimeters, bone invasion, perineural invasion, and those that are greater than two centimeters, right? Overall. And so not all squam cell carcinomas fall into those, what they're calling high risk. There's many of these that don't fit into that criteria that we've seen metastasize, right? So we need help. And so that's where I think um the GEP testing kind of came into play uh through Castle Biosciences. They said, look, we have we have a gap here that we need to fill. How can we help predict? So they came up with 40 genes. I was one of the earlier adopters of this test because I was seeing so many high-risk GMC carcinomas and seeing all their different varieties of behavior that I said, yeah, anything you can throw at me that I can use to help treat my patients, I'm all in, right? And so um, so as I started using it, I started finding ways to cater towards that personal patient's risk, as opposed to saying, well, you've got about a 18% chance. Now I can say it's gonna be six, it's gonna be 20%. And when you combine the staging systems, let's say BWH, uh with your CASEL uh result, uh the GEP testing result, you actually become a better provider in general. So you combine those forces and you have a much more specific number that you can relay to the patients and their families of what their really true risk is of recurrence metastasis. And now it even includes the potential benefit from adjuvant radiation after their treatment, right? And so there's three really, really valuable components uh to GEP testing, but it's just an extra tool in the toolbox. And when it comes to fighting cancers, I often tell my patients we have to get one step ahead. Right. Right. And so you can't be, you have to be proactive, not reactive, right? So with cancers, um, if you don't address things before they happen, then you're gonna be chasing your tail, right? And so um any tool that we can use to predict that something's going to happen is uh is gonna be life-saving, really.

SPEAKER_00 8:33

So I'm gonna back up a little bit for some of our listeners that probably even heard of this test. When you mentioned this, I'm gonna have you go through kind of the test, kind of what happens with it, like how it works a little bit, if you don't mind explaining, because you're probably wondering, well, ooh, I had a squamous cell diagnosed. Yeah, I don't know if my doctor ran that test. So it's gonna have you walk us through, you know, how's that test ran and then what what are the different categories of results that potentially a patient could fall into.

SPEAKER_02 8:57

Yeah.

SPEAKER_00 8:58

And before I even do that, actually, let me back up one more time. When is the test really indicated? Because, you know, as you and I talked about, we could have biopsy like two and three squamous cell carcinomas on one patient, right? And then times that, times how many patients you see. The just the sheer number is outstanding. So, one, let's talk about who would you consider to be eligible for the test?

SPEAKER_02 9:19

Right.

SPEAKER_00 9:19

And then two, let's talk about then what would the results actually be?

SPEAKER_02 9:23

So uh, you know, these tests and tools are not for all squamous cell personalness. So it's up to the provider to determine what you think is a high risk behavior, right? And so I have my own criteria that I like to share with others. Uh one of the things I found to be high risk for my patients is rapid growth, right? And so um if a patient comes in and what's rapid, that's so you know vague, right?

SPEAKER_00 9:49

Right, two weeks, three weeks. Yeah, exactly.

SPEAKER_02 9:51

I usually say if your skin cancer doubled in the twos, doubled in size in two weeks.

SPEAKER_00 9:56

Okay, I like that.

SPEAKER_02 9:57

Uh I that's my personal criteria. That's fast, you know, that's really fast. If a patient uses anywhere along that lingo, that's a high-risk squame cell carcinoma. Um, I like to use uh what's called neuropathic symptoms, which is I push on it and it really hurts. That might be an indication of perineural invasion, which often when we go in to do surgery, we see that encompassed nerve with the tumor often. Um, that's a high-risk feature for me. Um, when I have something that's large in a high-risk area, I like to call, I'm gonna coin this phrase, I call it uh, I like to speak a lot about it. I call it my cereal bowl zone, right?

SPEAKER_00 10:31

I love cereals, so this is it with me.

SPEAKER_02 10:33

So if you get your cereal bowl and you put it on your ear, I call that my cereal bowl zone, right? I love it. I don't know why it's a cereal bowl, by the way. It could be a frisbee or whatever.

SPEAKER_00 10:41

Side note, what's your favorite cereal as a kid?

SPEAKER_02 10:44

Gotta pick one. You know, I uh I'd probably go. It's funny, I grew up with the most bland cereals, probably the one with the rooster, the corn flicks.

SPEAKER_00 10:54

Cool pimples for me, all the way in. Pope pimples. All right, we'll go back. All right, go back.

SPEAKER_02 10:58

But uh so um, so I call that my cereal bulzone. Why? Because the lymphatic drainage in in and around this area is very superficial. So um it doesn't take much for a skin cancer to get picked up by a lymph node in this area. In fact, sometimes we do most surgery, we run into lymph nodes and this they're that shallow, you know. Um, and so that lymphatic spread is very real in that zone. Um, and so these are all kind of features, but I I've ordered it for things outside of my high-risk zone that I still think is gonna be a high risk. But to answer your question, I don't order it on all squem success carcinomas. If we did that, it would be millions, right? Um, so I kind of try to cater it towards high-risk patient, high-risk cancer. And do I want, is that result going to change anything that I do, which is the really the million-dollar question, right? Um, and again, is this gonna change my proactive status on imaging, um, et cetera? So um the three results that you can get, first of all, to order the tests, it's extremely easy. You can do it via portal, which is my personal favorite. I actually order it myself. Um, you know, a lot of patients have like administrators or office admin order it for them or send a fax. You know, you could do that. I do it myself. It takes me about 30 seconds to do it. Um, and it's really easy. And your local representative, I'm sure, can set you up with a portal. You go in, you enter the patient information and information about the cancer and the pathology.

SPEAKER_00 12:28

You're using the biopsy, right? That you did. Okay.

Who Should Get GEP Testing

SPEAKER_02 12:31

So they will test the original biopsy tissue. So that's something that patients really like. They're like, well, if you're gonna order tests, does that mean you're gonna have to draw my blood or re-biopsy this thing? And I'm like, no, I just go on my computer and I order it, and there we go, we get a result. Um, and so they'll actually originally they'll test the original biopsy tissue. Um, and you can go back as far as a three-year-old biopsy. Let's say, you know, someone listening now or watching now has this patient in mind that they had a high-risk squam cell carcinoma on their scalp, for example, or maybe a family member. You're like, can I still test that? If it's been within three years, you can actually go back and test that tissue. That tissue will remain in the lab where it was uh where it was processed. Um, and then you're gonna get your result. And the result uh comes back as one of three. I like to simplify things, uh, Shannon. I'm I'm I'm a very um, you know, it makes it easier on me for understanding, but I like to call them low, medium, high. Oh, love. Right. So too many people get caught up in the interpretation. And a lot of physicians and providers have gotten deterred from ordering it because they say, Carlos, I don't really like ordering this because I have no idea what that result means, right? And I go, if you just go low, medium, high, I think a five-year-old, you know, can interpret that.

SPEAKER_00 13:44

Patients probably love that too. That makes sense to them, yeah.

SPEAKER_02 13:47

So the low is what's called a class one, and that puts it at the overall general squamous cell carcinoma risk of about six percent uh risk of metastasis, which is fine. That's the best one. Um if it gets bumped up, it's called a 2A, a class 2A, and that puts it at roughly about a 20% chance of metastasizing or recurring, right? Of coming back. Um, and if you get the worst one, which is a class to be the most aggressive, which I've had, I can probably count on one hand how many of those I've had in my career, um, results of, um, that's a greater than 50% chance of metastasizing and recurring, which is imagine if someone had breast cancer, you said you have a greater than 50% chance of coming back. That's horrible news. I mean, that's a very aggressive cancer. And so luckily those are extremely rare, but I have seen those. Um, what do we do with those? Well, again, these things move the needle, right? So, class ones in general, if they did not have nerve invasion when I went in and do and did surgery, and there's really no other reason for me to uh go forth with any other testing, imaging, et cetera, I say surgery is appropriate. We got clear margins, but we're still gonna watch you really closely. Um, if it gets bumped up to the 2A, that's when we start dancing around with medical oncology, imaging, um, extra surveillance. Because it again, it puts it at roughly at least a 20% chance. Again, if you marry it with the Brigham and Women staging, it actually becomes much more specific. But let's just simplify and say it's about 20%. Two out of 10 of those are gonna metastasize or recur. Um, and then if you get the 2B, then generally speaking, that's when not only the imaging surveillance, but the post-operative adjuvant radiation comes into play as well. We're gonna throw the kitchen sink at this thing because we have a very, very high risk chance that they this thing is trying to kill you.

SPEAKER_00 15:39

So it sounds like then it really helps you figure out, okay, for this patient, you can really personalize their care.

SPEAKER_02 15:44

Right.

SPEAKER_00 15:45

Yeah. So you you can based on their risk, you can change it. Now, if if it's in conflict, do you feel like with maybe what current staging suggests, you kind of let that tumor biology, the test, help direct you further. Is that how you utilize it?

SPEAKER_02 15:57

Yeah, and and usually, yeah, you're right. There's often uh conflict, right? So you have a let's say a BWHT1, which is the lowest risk, and you get uh a class 2A, let's say a 20% chance. So now you have the staging uh systems that told you it was not any problem, and then the castle result that told you that it's a problem, right? So what do you do? Again, if you kind of synchronize those and put them together, then you kind of get a more specific number. But and you don't put all your eggs in one basket. You know, again, these are things that are meant to use like puzzle pieces, um, and it's meant to form a puzzle, right? So your clinical judgment, your surgical experience that you had when removing that cancer, and in addition to that, the staging system and the uh gene expression profile testing, right? So um, you put all these things together and they and they make a puzzle uh for you, but um you don't put all your eggs in one basket. I mean, I think too many people, too many physicians I know um have that pitfall. They go, well, it came back because of class one. I think we're done here. You know, and I go, Oh, wait a second, like did it have nerve invasion? Tell me about the patient. Are they immune compromised? Right. You know, all these factors, right? So medicine, as I often like to say, is never one plus one equals two. I mean, it you know, they teach you in medical school right off the bat, they're like, you're never gonna see textbook cases ever.

SPEAKER_00 17:15

Yeah, no, it doesn't tend to happen.

SPEAKER_02 17:16

Ever. The human body and human physiology, especially cancer related, is so unpredictable sometimes that we need all the help we can get.

SPEAKER_00 17:24

Well, and it sounds like, you know, I think tumor biology in general for cancer has been phenomenal, right? People are familiar with it for breast cancer, oncotype DX. So it's exciting to have it for skin cancer. And you mentioned, you know, who would be eligible for the test, people that are considered high risk. You comment a little bit about, you know, pain that you look at, neurological involved or symptoms, you know, rapidly growing, location size. I know we get talked about, but what if there's, you know, patients listening, they're like, I wonder if I should have had this test, or maybe they just had one come back and they're wondering are there other features, you know, maybe in their clinical history or exam that you would be more worried about that they could have a more aggressive cutaneous swim cell carcinoma?

Low Medium High And What Changes

SPEAKER_02 18:04

Yeah, I mean, I think uh a patient can talk to their physician to see if maybe they had a squem cell carcinoma and maybe it did have some high risk features, they can talk to their physician if it's worthy of ordering the test. Um you ask you mentioned uh a cancer that came back. And then unfortunately, when a skin cancer, squem cell carcinoma has recurred, and this goes for their melanoma test too, by the way, um, you can't order it at that point. Any volori kind of excludes it. Why? Because you have your answer. You don't have to order a test to tell you the risk of it coming back, it came back, you know. So again, it goes back to us as physicians being advocates for our patients and saying, we're going to be proactive with this and we're not gonna wait for it to happen. So uh if you have a high-risk squamcarcinoma and you feel like you would have some value from these results, then you you can order the test and get your answers uh uh right away. You know, it takes about two weeks to get the results in my experience. Once they get the tissue in the lab, it's like 48 hours or something like that. But um, but from the moment you order on the computer about two weeks later, you're gonna get the results. So it's always easier to have those questions answered early on than to wait for something bad to happen and then you can't order it anymore. You live, it'll literally get kicked out. The recurred, sorry, you can't order anymore. Now you can't even have that question answered anymore.

SPEAKER_00 19:23

Yeah, which is tough. And I think too, and patients might be wondering if if they're high risk, you know, other things to think of, you know, are transplant patients, right? Or some of the patients out there carry a diagnosis of you know CLL or if they have HIV, you know, things that patients might be wondering, am I at risk or high risk, you know, cutaneous feminist carcinoma, that they should be curious, you know, maybe this test would benefit them. Because it was checked and those patients are validated, the test in those patients. And I think often we're looking at, you know, under the microscope features, often, especially if you look at our different systems. That's what they really focus on, you know, how deep it is, is their perineural involvement. But us looking at the clinical, you know, is really important. As you mentioned, the rapidly growing that's important for you, location or size, people have had chronic burns or wounds, you know, what else is considered high risk? And I think it is crazy because it is across the board, right? And with the different definitions of high risk. But I think for patients that fit those populations, they should know that, yeah, this might be a test that benefits them potentially. So we can really figure out how do we treat them. Have you ever had? I mean, I've experienced it when I first got out and I worked out how to say at the James. I my first death in one of my clinics was actually a heart transplant patient who died from metastatic squamous cell carcinoma. Have you experienced this in your practice with patients?

SPEAKER_02 20:37

Yeah, of course. I mean, we all in the world of cutaneous oncology, we have so many transplant patients. They are so high risk, particularly heart transplant patients, in my experience, seem to be just get the brunt of this. But kidney transplants are are relatively common. Uh, their immune suppression obviously is medication involved to keep the uh the reactivation of their immune system attacking the organ that they receive, right? And so they are so immune compromised. I like to, I like to consider, again, simplification of things. I like to call the immune system like police force. It's like the internal police force of your body. And cancer is like the bad guys, right? And so if you have bad guys with no or little police force, they're gonna go rampant. They're gonna do whatever they want, right? And so that's essentially what immune compromise situation is, is a whole bunch of bad guys with nobody to police them, right? And so they they go a little wild. And so not only skin cancers, those are very common, but other internal malignancies as well. Um, whereas those with normal immune systems can keep cancers in check, you know, a little bit easier. So um, yeah, I've had many, many, many transplant patients, but all sorts of uh varieties of immune compromised patients. Those are sometimes the most challenging patients. You you do everything you can and and they keep coming, you know. And that's when you start talking to their transplant surgeons, their primary care physicians. Is there anything they could do to kind of Modify their medications a little bit. We've had to do that on a few patients and they do better, you know, but it's kind of such a fine line between organ rejection, very important, and uh and cancer, also very important. Right. So uh that's where, you know, experience I think matters, uh, and watching patients closely and supervision and surveillance, cadences, uh, these are all things that that are all part of, again, the big picture and puzzle that we put together with cancer patients.

Radiation Decisions And A Life Saved

SPEAKER_00 22:28

So if I recap a little bit, you know, have to have a high-risk cutaneous quemic cell carcinoma, can meet all the kind of different features, and there's even some we didn't talk about, but your provider, your doctor can look and see, okay, yes, if you meet one of these, this is a good, you know, potential run for the test. Right. Test gets ran, you get your I like your low, medium, high risk, and it's answering that question of risk of metastasis or spread. I wanted to go in a little deeper on the second question that you mentioned that can help us answer, and it's the radiation piece, right? And what I wanted to kind of touch upon is like, why would we want to know who responds to radiation? Because a lot of people are like, oh, radiation maybe no big deal. But I think too, you and I know, you know, it can be a little bit more involved, and there's cost and other factors. Like, why is this test so important to help us decide who should get radiation?

SPEAKER_02 23:13

Yeah, so some of our colleagues, you know, uh who see this on a on a regular basis did a study to see what potential adjuvant radiation, ART, um post-operatively would would benefit some of these scrim cell crush numbers and some that do not. And um in my practice, in my experience, uh there is uh a small percentage of people that will actually benefit from post-operative adjuvant radiation. A lot of that is determined on the day of surgery. Um, so we we see things like nerve invasion. That's a classic for post-operative adjuvant radiation within the cancer guidelines. Um and umor, you know, growing around very, very important structures, anatomical structures. I've dug deep into necks, you know, around these lymphatic structures, big vascular structures, chasing squem cell carcinomas. Um, these are things that tell me that if I, even though I've got clear margins, there is a chance that these cancer cells do have some rogue friends going on in there too. So post suffarative adjuvant radiation might be indicated in something like that. Um, and you want to keep it tailored towards every patient. The the result, the GP result, includes that component to it. So with a class one, for example, it'll say there's no discernible benefit from adjuvant radiation. Um, but again, that's not all eggs in one basket kind of thing. You still have to make a clinical judgment. And uh with a 2A with the middle one, uh, it says potential uh benefit from adjuvant radiation. And um, and then with the 2B, it's like, yeah, you probably should. And which which I do, you know, and those few that I've seen, again, we we recommend post-operative vague radiation on those patients because we know the risk is very high and we don't want to wait for something bad to happen.

SPEAKER_00 25:03

So well, as we kind of wrap up, I wanted to have you offer there was a experience from a patient, you know, that you know, that really thought the test was valuable. You're like, wow, this was a game changer, really changed what I was gonna do for this patient. Do you have an example or an example? Oh, so many explain.

SPEAKER_02 25:18

Yeah.

SPEAKER_00 25:19

Short though, here.

SPEAKER_02 25:20

Yeah, this uh this test has been uh so valuable for me. But uh in general, just to give one off the top of my head, uh, a patient that uh we did surgery on, had high risk, ran the GEP tests, uh, was a 2A, uh, so the about 20-ish percent chance of metastasis and recurrence. We went ahead and sent them for imaging radiation, uh imaging surveillance. So CAT scan head and neck. Um and we do that about twice a year, is is what's recommended for a few years, you know, it can be maybe two or three years. Um, because this that's what the study shows, is it'll it'll happen within three years based on the study. So um, so when we did that, we were actually able to locate that initial change. We had that baseline imaging to go by, and then we actually saw a jump in the size of the lymphatic uh nodes. Even though everything was fine clinically on the surface, there was some activity going on inside, and we were able to catch that, save that patient's life. Um, but that's just one of many examples of how valuable it is to be proactive with this, and this allows us to do that and to again get one step ahead of cancers, these very high-risk cancers, and uh and save as many lives as possible. That's what we signed up for, right? Exactly.

Key Takeaways And Final CTA

SPEAKER_00 26:36

And I think you really just show what the value is of gene expression profiling and specifically, you know, with the decision DX SEC or 40 GV tests. So thank you so much, Carlos, for coming on the podcast and running through that. I think a lot of people are re-educated now on really, you know, squamous cell carcinoma. We can't neglect it, needs to be highlighted. So thank you for putting it in the spotlight today.

SPEAKER_02 26:55

Yeah, thank you very much, and appreciate it.

SPEAKER_00 26:57

And stay tuned for the next episode of Dermot Trotter. Don't swear about skincare.

SPEAKER_03 27:02

Thanks for listening to Dermotrotter. For more about skincare, visit dermittrotter.com. Don't forget to subscribe, leave a review, and share this podcast with anyone who needs a little skincare sanity. Until next time, stay skin smart.