FOOT
MELANOMA, PODIATRIST BELLMORE PODIATRIST LONG ISLAND
HOUSE CALLS BELLMORE LONG ISLAND DR CHASKIN PODIATRIST 516 783-1101
THIS MAY BE A PODIATRIST THAT
SEES A POTENTIAL FOOT MELANOMA AND REFERS THEIR PATIENT TO A CANCER
SPECIALIST THAT DIAGNOSES AND TREATS MELANOMAS Opinions of Dr. Chaskin
Podiatrist BELLMORE LONG ISLAND 516 783-1101
click the link below: BELLMORE PODIATRIST
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I highly respect Dr. Bryan C
Markinson who was one of my teachers back in the early 1980's and he
taught me that "the podiatrist may be the first clinician in the
diagnosis and biopsy of suspicious lesions that may be cancerous,
including melanoma. The ongoing management of this should be
hospital-based as a team of specialists must be involved to completely
remove the lesion, perform the pre-operative evaluations, and manage
the post-operative chemotherapy, if required. One such podiatrist who
regularly and seamlessly as possible assembles such teams is Dr. Bryan
C. Markinson, Chief of Podiatric Medicine and Surgery at the Mount
Sinai School of Medicine in New York City."
Opinions of Dr. Chaskin Podiatrist (516) 783-1101
BELLMORE NY 11710
Whenever I see a suspicious foot lesion, I explain
to the patient the risks and benefits of not
having a foot biopsy. Also I explain the risks and benefits of having a foot biopsy. One of the risks of
not having a foot biopsy of a foot melanoma is death. I believe that there is a problem that
exists when a patient refuses to give consent for a foot biopsy of a potential foot melanoma.
I feel the best course of action is that I want to do what is best for the patient. That is I refer the
patient to ask their medical doctor to see a dermatologist for a second opinion or to get a
second opinion from another podiatrist. If the patient refuses this I believe this is a potential problem.
If a malignant melanoma were to be involved , if possible I would probably refer the patient to an oncologist
that specializes in foot melanomas. I believe that malignant foot melanoma is a team approach. I was
taught by some of my teachers that the podiatrist could be the first
one
to see a suspicious skin lesion, take a foot biopsy, send that foot
biopsy to a dermatopathologist. If a malignant foot melanoma is
present, the choices are as follows: to treat it myself without any
help, to treat it with help with another podiatrist, to send the
patient to a dermatologist or to send that patient to an
oncologist that specializes in foot melanomas.
If a patient is homebound and refuses to go to the hospital, rather than not do anything
at all, why not treat such a problem myself if no one else is
willing to do a house call for this patient? These
are all difficult questions to answer. What if an ischemic foot has a chronic foot ulcer in need of
a biopsy to rule out malignant foot melanoma, and the
patient is homebound and refuses to leave her house to go to the hospital to see a vascular surgeon
so that he can give vascular clearance to allow the patient to have a surgical debridement of
an infected foot ulcer. How does a podiatrist obtain that specimen to send to a dermatopathologist. What about
the use of posterior tibial nerve blocks to improve such blood flow to allow for a home
debridement of such an ulcer? After the debridement of the ulcer, such a specimen can be
sent to a dermatopathologist. If a patient sees malignant melanoma on a pathology report
by a dermatopathologist, they will probably be more likely to accept hospitalization for treatment
of a foot melanoma.
disclaimer: Even with a posterior tibial nerve block, if there is a
debridement of a foot ulcer in an ischemic foot there is a
potential for a patient losing their foot or worse and this should be
fully decribed to the patient and documented before any other treatment
is done. In this day and age, I feel that all patients with PVD and
foot ulcers should understand the importance of seeing a vascular
doctor. If a patient is in a hospital that does not have a team of
specialists that is involved to completely remove the lesion, perform
the pre-operative
evaluations, and manage the post-operative chemotherapy if required,
why not tell your patient that such hospitals do exist? The patient has
the right to choose to transfer to such a hospital.
I have to ask every
podiatrist and other health care professional the following question:
If there is a suspicious foot lesion why not biopsy it? What if your foot skin
has an area that changed color, shape or size? How do you know that this is not
a malignant foot melanoma. Sometimes people die from a malignant
foot melanoma. I also have to ask
one more question. Isn't
it important a podiatric specimen to be seen by
a dermatopathologist?
