Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Kelli (00:00):
Whether you're sipping on
your favorite coffee or tuning
in during your daily task,welcome to the podcast designed
to fit into your busy schedule.
Get ready for a quick, easylisten that aims to educate,
energize and empower your life.
Tara (00:11):
I'm your co-host, Kelli,
owner and publisher of the
Northeast Ohio Women's JournalDigital Magazine, where we
engage and create meaningfulconnections with our readers, to
local businesses andorganizations and I'm your
co-host Tara, partner of the WJCreative Studio, where we design
content experience for ourclients' audience, while
conducting a symphony ofcollaborations as a community
(00:33):
influencer.
You'll hear from guests whichwill bring you authentic and
powerful voices that make the WJmore than just a magazine.
Let's dive into their journeysand discover knowledge that
extends beyond the confines ofour publication.
Hello listeners, this is Tara,partner and Chief Ideation
Officer at WJ Creative Studioyour co-host.
Kelli (00:56):
And this is Kelli, a
publisher of the Women's Journal
Digital Magazine and also yourco-host.
Thank you for being part of theWJ community.
Joining us today is Dr JorgeGarcia.
He is more a dermatologist thanboard-certified and Mohs
surgeon.
He is a passionate skin expertwith a unique journey from
biomedical engineering tomedicine.
After earning a master's degreein biomedical engineering, he
(01:20):
then commissioned with the USNavy.
Graduating from Penn StateMedical School, his career then
took an exciting turn when hebecame a US Navy flight surgeon,
then deployed with the Marinesaround the world, earning a
prestigious Surgeon's GeneralAward.
Dr Garcia later specialized indermatology at UH Case Medical
(01:41):
Center, followed by advancedtraining in Mohs surgery and
aesthetic dermatology at HarvardMedical School.
In 2008, he stepped into therole of director of Mohs surgery
at the University Hospitals,where his research on laser skin
treatments was published.
Not one to stop advancing orlearning.
He also earned a MBA from CaseWestern Reserve University and
(02:03):
founded Apex Skin DermatologyCenter in 2011.
As a fellow of multipledermatologic associations, dr
Garcia is dedicated totransforming lives through
healthy skin, bringing hisextensive expertise, warmth and
a touch of storytelling to everyconversation.
Well, what a story, dr Garcia.
I'm sure you have plenty ofthem.
(02:24):
So thank you so much forjoining us here today, excited
to have you here today.
Dr. Garcia (02:28):
Thank you so much
for having me.
It's a pleasure being here withyou today.
Kelli (02:32):
So can you tell us what
inspired you to start ApexScan,
with such an extensive journeyof all going all different ways,
ways.
Dr. Garcia (02:42):
Well, you know, back
when, back in 2011, I was
working at an academicinstitution, very happy, had a
great career, great job, greatteam.
But I, you know, I wasn't 100%happy and I would see in the I
was seeing the frustrations ofmy patients having to wait a
long time to see me or or a verylong time in the waiting room
to get seen.
(03:03):
So I decided to try to changethe model and thought, hey, you
know what we can do this better.
I want to have, at least in myown little world.
I want to change it so that thepatients have rapid access to a
dermatologist and really haverapid access to skin cancer
treatment.
Nobody wants to be, you know,with a cancer on their face for
(03:25):
months and once you have that Cword, you know that that's hard
and people want to get thattreated.
So that's kind of what inspiredme to start Apex and really
with the mission of rapid access, same-day appointments.
And you know we've done thatvery successfully over the last
several years.
We're in our 14th year now andwe have 15 locations and really
(03:48):
delivering on that promise.
And you know, I think this yearwe treated our one millionth
patient at Apex overall, whichis awesome.
I remember my first days when Iwas seeing a handful of
patients right so it's been areally good journey, right so
it's been a really good journey.
But that that was myinspiration really to try to,
you know, create a betterpatient experience from the
(04:10):
dermatology side and have accessto us.
Kelli (04:12):
So important in the
medical field, I think, these
days, and I think patientsreally appreciate it too.
Tara (04:17):
Yeah, and congratulations
on the growth.
This is such a great time tohave this conversation.
With Skin Cancer AwarenessMonth coming up, we couldn't
have timed it any better.
So, dr Garcia, can you explaina little bit about the different
types of skin cancer mostcommonly diagnosed in
dermatology?
Dr. Garcia (04:34):
Yes, so in general
in our practice we see mainly
three main common types.
There are a lot of other ones,but the main ones are called
basal cell carcinoma.
That's the most common type ofcancer in humans.
Squamous cell is a second typewhich also can be a little bit
more aggressive than basal cell,and obviously the one that
everybody's heard about ismelanoma, which can be very
(05:01):
aggressive and can be deadly ifyou don't treat it right.
So those are the main cancersthat we treat in our in our
practice and, like I said, everyyou know statistics out there.
One in five Americans willdevelop a skin cancer within
their lifetime.
So it's very prevalent and youknow we we have, you know that's
what we do every day at ApexJust do skin checks and diagnose
skin cancer.
Kelli (05:20):
I think almost every day
you can talk to somebody and
they know someone or they've youknow, they themselves or they
you know someone in their familyhas said oh yeah, they, you
know they had skin cancer, andmy mother actually.
So it is definitely moreprevalent.
But thank goodness, if youcatch it early, it's definitely
positive.
Tara (05:38):
So yeah, those numbers are
always shocking to me.
So what types are the mostcommon?
Dr. Garcia (05:48):
Yes, basal cell is
the most common, so one in five
people will have basal cell,probably in their lifetime.
I always tell people that thereare some, some risk factors for
skin cancer, right Like youknow.
For example, if you're veryfair skin or if you have a
family member that had melanoma,sometimes this cancer can go in
families.
If you have an occupation thatyou know you're outdoor a lot,
(06:08):
you know, or if you have a hobbythat you're outdoor a lot, a
lot of my patients are boatersor people that are gardening
outside or skiers.
So you know, obviously, ifyou've done indoor tanning or a
lot of indoor tanning in yourlifetime, that also creates a
risk factor for developing skincancer.
(06:30):
But I would say it's very commonand I encourage people,
especially as we go into May,the Skin Cancer Awareness Month,
to be smart and do a skincancer screening with your
dermatologist or come to one ofour offices and get screened.
We always have in May some freeskin cancer screenings for our
patients, so that's a reallygood opportunity for you to.
If you have a spot that youdon't like or something that's
changing or something you know,don't just blow it off.
(06:52):
It could be something that'saggressive and I highly
encourage people to get theirskin checked and be proactive on
their health Such importantinformation?
Tara (06:59):
Would you say there is a
certain age or gender that maybe
is a higher risk of developingskin cancer?
Dr. Garcia (07:09):
You know.
I would say that most of ourpatients are, you know, older
than 30 years old, although wedo have a lot of younger
population coming in now becauseof the increased use of tanning
beds.
But I would say, you know, ifyou're over 30, you have a lot
of sun exposure in your life, ifyou're really light skin, you
(07:29):
know you have a lot of frecklesor moles you have, you know you
could be at risk of developingprecancerous or skin cancer.
Also, if you're a patient thathave had, for whatever reason, a
transplant, you know, let's sayyou have a kidney transplant or
an organ transplant thosepatients are also very much at
(07:50):
risk of developing skin cancerbecause of the immunosuppressant
medications they take.
And that doesn't have to bejust a transplant.
It could be if you have lupusor any other disease that
requires you to take animmunosuppressant medication
that lowers your immune system.
You know, obviously thosepatients are at risk of
developing skin cancer down theline.
(08:10):
I've never heard that.
I haven't either.
Yeah, you develop a lot of skinlesions and we got to check
those.
So we encourage those patientsto kind of wear sunscreen and
also be proactive with seeingtheir dermatologist frequently.
Tara (08:23):
Are there special
considerations for people with
maybe darker skin tones when itcomes to skin cancer?
Dr. Garcia (08:30):
Yeah, you know,
that's a really good question
because a lot of the peopleAfrican-Caribbean, you know
background they think that youknow, hey, you know I have a
little bit more color in my skinso I'm really kind of immune to
skin cancer and that's a bigmyth out there.
You know, we, in fact we see alot of people with you know
Hispanic population like me andyou know African-American folks
(08:52):
with would have moles andoftentimes what happens is that
the darker skin types willdevelop skin cancers, not
necessarily in sun exposed areas, but the opposite, like they'll
have it in sun covered areas orthey have it in the palms or
soles or they have, you know, afreckle in, you know, inside
their mouth or in the nail.
(09:12):
For example, bob Marley, hedied of melanoma of the nail,
you know, and he thought it wasa soccer injury.
Tara (09:19):
You, know, I've always
heard that.
I always wondered if that wastrue, dr Garcia.
Dr. Garcia (09:22):
So yeah, I've always
heard that kind of's, that myth
, and people think that theycan't get skin cancer, then they
just don't go to the doctoruntil it's too late.
So we found that the darkerskin and the ethnic skin cancers
(09:54):
are more advanced when we getdiagnosed.
Because of that, because theykind of waited too long, so
something that could have beenchecked a year or two before and
got it taken care of, now it'smore advanced and you require
more aggressive treatment, whichis sad.
Tara (10:09):
Apexkin, you guys have had
fantastic articles in the
Women's Journal about signs andsymptoms.
Can you explain a little bitmore about what people should
look for if they notice asuspicious spot or a mole?
Sure?
Dr. Garcia (10:23):
Yes.
So there's a really goodmnemonic that we use in
dermatology called ABCDE, ofmelanoma, and A is for asymmetry
.
So if you have a mole that'snot symmetrical or you know,
then you cut it in half and it'snot the same half in the other
side.
B is border.
If you have a mole that's nothave jagged borders or edges or
(10:47):
it's not smooth, that's anotherkind of check in the box.
C is for color.
So if you have something thathas various color or something
that's you know darker, grayishor black, these for diameter.
So anything that's you knowabout the size of a pencil
eraser should be evaluated.
You know we don't like molesthat are that big.
E is for evolving.
(11:08):
So anything that's changingeither in size or reducing in
size or getting painful orbleeding or crusting, anything
that's changing in your body,that's another sign that we
should look into, you know.
Obviously another sign orsymptom that I tell people is,
you know, sometimes basal cells,squamous cells.
They look like little warts orthey look like little pimples.
(11:30):
I always tell people listen, ifyou have a pimple, you'll have
a pimple.
The pimple will go away in amonth or so.
You have a pimple in the sameplace for five months and
doesn't go away.
That's not normal.
So you know, basal celloftentimes looks like a bump or
a pimple.
So pay attention to thosethings because if you, you know
pimples obviously not allpimples are cancer.
(11:51):
But you know, we hear thatstory all the time.
We're like oh yeah, I thoughtthis was a pimple and I popped
it, but then still keep bleedingfor months.
So that's obviously not normal.
We all had pimples.
We pop them.
Tara (12:02):
Right, right, it's all
right.
Dr. Garcia (12:09):
Not sure if you're
supposed to.
That's right, you know what Imean.
Kelli (12:10):
So you know, keep it real
Wonderful.
Well, thank you so much forsharing those so interesting.
You had mentioned also thatskin cancer can develop in those
areas of the soul, the feed, orinside the mouth.
Actually, my father-in-law, hisdentist, found a spot.
Luckily there was no cancer.
But you know, how often shouldsomeone get their skin checked
(12:33):
from a dermatologist?
And it sounds like more doctorsare being trained.
Dr. Garcia (12:37):
But I would say that
you know, it would make sense
that they need to seek yourexpertise as a dermatologist
yeah, so like you, like youmentioned definitely, you know,
melanoma and other existingcancers can can develop in areas
that are not in sun exposedareas.
So the other day I took amelanoma off somebody's buttocks
and obviously that's not a sunexposed area, you know usually
(13:00):
not usually general, right.
I was asking them do you ever goto a you know, you know naked
beach or something?
But my point is that it happensright, or in the, in the solar,
your foot.
You'll asking them do you evergo to a naked beach or something
?
But my point is that it happensright, or in the soil or your
foot you'll have a mole.
So definitely that's theimportant thing about getting
checked by a dermatologist,because we in dermatology get
(13:20):
trained on doing skin checks andlooking at people's scalp.
How often do you check yourscalp?
Probably never.
You can't check your your back.
So you know, we, we, uh, werecommend once a year skin check
, uh, you know, um, to exam by adermatologist.
Um, you know, I always tellpeople on your birthday, check
(13:40):
your birthday suit.
That's a good way to kind ofremember.
Once a year you get checked.
If you've had skin cancer, thenthe guidelines are, you know,
twice a year if you've had basalcell or squamous cell, and
three times a year or every fourmonths if you've had melanoma.
So those people we really seemore frequently in our offices
because the statistics are thatprobably 50% of the population
(14:05):
that have had one skin cancer,especially basal cell or
squamous will have another onewithin five years.
So we have to really keep aneye on those people.
The good thing is that if youcheck them, if you get them
early, they're very easy totreat.
But if you wait like sometimeswe see patients that have waited
for years then things get alittle bit more aggressive and
(14:25):
it's harder to treat.
But I would say in general,once a year is a good idea and
you know, go to your localdermatology provider and if you
don't have one, definitely checkus out at Apex again.
Kelli (14:36):
I would recommend Apex.
I've had family members andbusiness associates have gone
through the process of gettingthose checks and they said it
was great, great process.
So you know you you talk about.
Everyone knows you knowpreventative measures being
sunscreen.
Is there anything in particularor something that we may not
think about in the preventativemeasures other than, like,
(14:56):
obviously, skin?
You know sunscreen.
Dr. Garcia (14:59):
Yeah, you know.
I think that you know commonsense right applies here.
Just because you've had skincancer doesn't mean you need to
be in a cave and can go out orcan enjoy life.
I mean you have to in a caveand can't go out or can't enjoy
life.
I mean you have to.
You know I would tell peoplemake sure you wear sunscreen
with spf 30 or above.
You know, avoid blisteringsunburns.
You know you can still have funand go boating, but you don't
gotta, you don't have to getthat blistering sunburn.
(15:20):
That's gonna be really hurt,painful in the next day.
Um, you know, I alwaysrecommend people that if they
don't want to wear sunscreen,then wear some protective
clothing, which is thetechnology these days.
They make really cool fabricsand it doesn't look kind of
weird.
Kelli (15:38):
They're fashionable now.
Tara (15:40):
You see more and more of
it too.
Dr. Garcia (15:42):
Right, obviously,
wear a hat for guys, for anybody
, for anybody really.
For guys that have, you know,thin hair or no hair, the scalp
is very common.
The top of the ear is a verycommon place for people to get
stuff.
So, you know, cover up you knowthose are are things that we
can do in the office that giveyou some medications that
(16:11):
sometimes, you know, preventsome of this.
But you know, in reality isthat all you gotta do is just be
vigilant to your skin and thenwe're wear sunscreen and avoid
really sunburned and then you'llbe fine.
But you know, like I said, youknow make sure you get your
visit checked once a year, justin case, because sometimes
melanoma, you know, or otherskin cancers, they're completely
(16:34):
painless.
You know they're just there andlike, if you think about it,
you have a mole in your arm thatdoesn't hurt, it's just there.
So you know, we'redermatologists, are trained to
kind of look at patterns and wecan identify some of those
atypical moles that maybe lateron will develop into melanoma.
Kelli (16:49):
So, with those annual
skin checks, what do they entail
?
Do they take long?
I mean, give us a little quickrundown of how that might go.
Dr. Garcia (16:58):
Yeah, that's a
really good question.
Some people are, you know,afraid about?
No, I don't want to go to thedoctor to get a skin check.
That's kind of invasive.
It, you know, afraid about?
No, I don't want to go to thedoctor get a skin check, that's
kind of invasive.
It's really not an invasiveexam at all.
You come into the office, wegive you a gown, you keep your
(17:19):
underwear on and then you knowit's a visual examination.
So we look at your scalp, youlook at your face, we look at
your ears, your eyelids.
You know we kind of go fromhead to toe in between your toes
.
We look at your genitalia, justbecause sometimes people have
moles or lesions down there.
But it's really non-invasiveand it's just an observation.
It's basically observation.
It's a very, you know, easy onthe patient type of thing.
(17:41):
Now, what we do in a regularexam.
Let's say there's somethingthat's atypical, let's say you
have something funny on yourback, then we can do the same
biopsy on the same day, which isreally good for the patient.
Sometimes, as you know, somemedical practices, they find
something and they can't do iton that day.
You've got to come back nextweek or two weeks later to
somewhere else.
(18:02):
In dermatology we can usually dothe biopsy on the same day and
a biopsy on the same day, whichis and the biopsy is a really
also really simple thing.
I know it sounds kind ofinvasive, but it's really like a
little scrape of the skin andyou put a little band-aid on it.
It's literally like a scratchand then we get those cells and
we check them under themicroscope to make sure that
they are to get the diagnosis.
So it's all done on the officeand it's all done, you know, as
(18:25):
an outpatient.
It's very easy on the patientand most people that have done a
skin check will tell you it'spretty easy, easy and a good
process, so if that unfortunatething may come across as being
diagnosed with skin cancer.
Kelli (18:39):
So what are some of the
options, the treatment options
that are offered at Apex?
Dr. Garcia (18:44):
So we have a lot of
different options for skin
cancer.
That's the good news.
Sometimes we are proactive andwe tell people you know there
are surgical treatments andthere are non-surgical
treatments for skin cancer.
My specialty is called MohsMicrographic Surgery.
It's the gold standard for skincancers of the head and neck or
large cancers of the trunk.
(19:05):
It's basically a procedurewhere we take a little piece of
the skin and we check it andanalyze it in our lab while
you're waiting.
It's a pretty cool procedurethat it's kind of real time
checking the margins of thecancer and that gives you 99%
cure rate and most people docome in and out within an hour,
hour and a half and they're done.
It's very good and very easyand, like I said, it's 99%
(19:26):
curative, which is awesome.
There are other things that wecan do.
Let's say you're a patient thatdoesn't want to do surgery, or
a patient that you know is not asurgical candidate, or you know
they don't want to deal withyou know surgery.
Then we do other ways, likefreezing.
We call those destructionmethods.
Other ways like freezing wecall those destruction methods.
(19:47):
The disadvantage of thosemethods is that nobody's
checking the margins, so you'renot checking the deep edge or
the lateral, we're justdestroying the cells locally and
the cure rates for those are alittle lower.
But some people maybe you havegrandma in the office she's 93
years old, she doesn't reallywant to do surgery.
You can do some of the lesseraggressive treatments.
But I would say if you're ayoung person, you know, get the
(20:08):
best treatment.
You know it's all covered byinsurance and, like I said, you
know if something's on my face.
That's what I want.
I want somebody that knows whatthey're doing and you know,
checks the margin and the 99%.
You're out the door the office,you're cancer free which is
super, super powerful for me.
(20:28):
That's why I love my job.
So there's a lot of treatmentsfor skin cancer and that's our
job to go over the treatmentsthat are available, and we
discuss that with the patientduring the consultation.
Tara (20:36):
And Dr Garcia, myself, my
family, like we're patients, we
go to the Medina office andevery step of the way you guys
put the patient at total ease,which is just, you know, peace
of mind.
So, you and your team, you guysare so active in the community.
What kind of things do you haveplanned coming up to raise
awareness and support for skincancer?
Dr. Garcia (20:59):
Listen, our team at
Apex really does a terrific job
in the community.
We're kind of grassroots andwe'll go into that communities
and really support patienteducation.
We do a lot of free skin cancerscreenings in communities,
either in senior centers or incompanies or in just local
events.
We are sponsoring 5K runs inthe summer in support of
(21:24):
melanoma.
We help raise a lot of moneyfor Melanoma Research Foundation
.
That's one of our biggestevents.
We do that every year in August.
We also partner with localcompanies to provide education
in terms of exactly what we'retalking about now showing people
(21:45):
what to look for in your skin.
You know we give those lecturesand almost all the time there's
one or two people that comeafter the lecture and say, hey,
listen, doc, what do I think ofthis spot here in my hand?
And oftentimes they saw thepicture and they have a skin
cancer.
So those are ways that arereally good for us to kind of
just get the word out for peopleand to kind of check their skin
(22:08):
.
And you know, obviously we havea ton of social media and
information in our website andyou know we do a lot of.
You know a lot of that.
You know every month we have adifferent blog about different
things, not just skin cancer.
But you know, at Apex we doeverything skin right.
So if you have acne or warts orif you have psoriasis I think
that that's also part of what wedo I always tell people we do a
(22:34):
360 kind of you know coveragefor the patient.
So you know whether you haveyou know.
I know we talk a lot about skincancer today, but if you have
anything in dermatology, we'rethe person to go because we, you
know, we're this skinspecialist and we can probably
get you clear skin.
Kelli (22:47):
I think, kind of for our
listeners.
I was actually going to ask ifyou could share what sets Apex
Skin apart in the field ofdermatology, but I think you
kind of hit a little bit on that.
I think at that moment thatit's that approach, that it's.
You know, it's beyond the skincare or, I'm sorry, it's beyond
the skin cancer, it's the skincare and all the other things
(23:07):
that you have going on.
So what sets you apart, do youfeel?
Dr. Garcia (23:11):
Yeah, we have really
a lot of things integrated in
our group.
We have our own pathology lab,which really cuts down on the
time of biopsy diagnosis.
Sometimes when you get a skinbiopsy you got to wait two,
three weeks to get the results.
We have the in-house pathologylab, which helps us kind of get
results out within two, threedays, which is awesome for the
patient.
We also have a really activeclinical trials department which
(23:34):
is really, you know, second tonone in the area.
We're basically, you know,providing our patients that
qualify for the studies the mostadvanced medical treatments
that are coming out for, notjust for skin cancer but for
atopic dermatitis or eczema orpsoriasis or vitiligo.
So we are, you know, you'rebasically partnering with these
(23:56):
companies, pharmaceuticalcompanies that have new products
in the market and we are one oftheir main centers for these
clinical trials.
And it's been very rewardingbecause a lot of these people
that we're treating has reallyadvanced disease or have really
rare diseases and there's not alot of research going on for
those cases and we're nowbringing those medications to
(24:18):
them and it's really rewardingto be able to help somebody
clear their skin.
And, honestly, another big thingthat sets us apart is our staff
.
I mean we have terrificproviders, tons of experience in
skin cancer surgery anddermatology.
Our you know, our aestheticline is superb.
We, you know, we have thelatest advance.
(24:41):
We haven't talked aestheticsbut we have the latest advances
for fine lines and wrinkles andbody contouring.
So we really do it all at Apexand it's a testament to really
the team that we have.
We're not a perfectorganization but you know, I try
to lead a culture that's really, you know, strong and try to
put, you know, our core valuesup front and center and I feel
(25:02):
that we're doing a really goodjob in the community, you know,
letting people know that we arethe rock stars of Durham.
Tara (25:09):
I love that and you can
honestly feel that when you walk
in your office, Dr Garcia, youpick up on that.
You guys, you put your patientsfirst.
Kelli (25:15):
Yeah, and Tara and I,
when we came to your open house
headquarters and we got to takea look at the facility, let
alone the research and that justwhole lab, just was so
impressive.
Yes, you've done an amazing jobhere in Northeast Ohio, so thank
you so much for your time andhelping us educate our listeners
(25:40):
and Apex you can find them onso many social platforms as well
as I encourage you to check outtheir website.
It's so informative.
You can set appointments onthere as well as check out all
their 15 locations, so you wouldgo to apexskincom.
So thank you so much forjoining us, Dr.
Garcia.
Tara (25:58):
Thank you for being here
today.
Thank you so much for your time.
Kelli (26:04):
We've enjoyed it and it's
definitely a very timely,
timely topic for the AwarenessMonth coming up.
So thank you listeners, forjoining us.
Next time you can hear moreinsights from local businesses,
community leaders andinfluencers, connecting with the
voices and stories that makethe WJ more than just a magazine
.
Till next time, we hope youenjoyed this episode of the WJ
(26:30):
Beyond the Magazine.
If you haven't already,subscribe to ensure you never
miss an insightful conversation.
Tara (26:35):
For a deeper dive into the
enriching content we discuss.
Visit our websitewomens-journalcom to explore the
Women's Journal digitalmagazine that complements the
podcast.
Kelli (26:47):
If you'd like to be
social, follow us on Facebook,
linkedin and Instagram forupdates behind the scene content
and announcements aboutupcoming episodes.
Thank you for being a part ofour community.
Your loyalty means the world tous.
Follow, subscribe and visit ourwebsite.
Until next time, stay empowered, stay curious and keep the
(27:07):
thirst for knowledge alive.