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Michael Millman was all set to move to Reno from the Bay Area when he noticed a pimple-like growth on his forehead, and he decided to get biopsied "just in case." It was July 2020, less than six months into the COVID-19 pandemic, when Michael got the call that the biopsy came back cancerous. He was in shock. Still living in the Bay Area at the time, he immediately scheduled to have the basal cell carcinoma removed in August. After the removal, he thought he was in the clear, but a few months later, Michael noticed that his lymph nodes felt weird, and he even cut himself shaving because of some persistent swelling in the area. Given his recent history of skin cancer, Michael immediately scheduled an appointment with a specialist in the Bay Area. "I met with an ear, nose and throat doctor who suggested a fine needle biopsy of my lymph nodes, tongue and an MRI, both with and without contrast," Michael said. "I remember feeling dreadful and that I couldn't believe this was happening yet again." A Hard Decision Michael's squamous cell carcinoma, determined by the pathology report to be significantly influenced by the HPV virus, had metastasized to his lymph nodes on both sides of his neck, and his doctor said it could be stage four cancer. He remembers feeling like he was in quicksand, unsure if he should follow through with his move to Reno, or stay in the Bay Area for treatment. By now, it was early December 2020, and hospitals in the Bay Area and across the world were at limited capacity due to COVID-19. But, in what Michael describes as a positive twist of fate, the San Francisco ear, nose and throat provider he had seen about his biopsy results mentioned that he knew many providers in the oncology department at Renown, including Abhinand Peddada, MD. The San Francisco provider called Dr. Peddada's office with a referral, and Michael even remembers that Renown called him to hear more about his diagnosis before he even got the chance to call them "To be honest, I was feeling shut out in the Bay Area, and Dr. Peddada said he could help me expedite the treatment process," Michael said. "I finally felt a sense of relief." And so began Michael's 7-week chemoradiation cancer treatment program at Renown.

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We talked to Heidi Nicol, licensed aesthetician with Renown Dermatology, Laser and Skin Care, to learn about the 7 best morning skincare tips that will provide all-day protection. “Your skin uses the nighttime hours to repair itself, secreting oils and toxins in the process,” says Heidi Nicol, a licensed aesthetician with Renown Dermatology, Laser and Skin Care. “Cleansing your skin in the morning is very important. It removes these oils and toxins and any nighttime products you use that are not suitable for daytime use — such as retinol and exfoliating acids.” Nicol’s process includes choosing the right products for your skin type, using them in the proper order and applying them correctly. Steps to Perfect Your Morning Routine Step 1: Cleanser. Use a cleanser tailored to your skin type. Many lines of products produce unique formulas for your specific skin, including dry skin, oily skin, and a combination of the two. Be sure to rinse, rinse, and rinse again! Step 2: Toner. After cleansing, you should apply a toner quickly. This is like a big drink of water for the skin and helps trap moisture into your skin and prevent evaporation. Step 3: Serum. Choose a serum that addresses your skin’s needs. If you use more than one type of serum, alternate them instead of layering. Nicol recommends using a Vitamin C serum, an antioxidant serum, and hydrating serums. Step 4: Moisturizer. Select a daily moisturizer that fits your skin type. Step 5: Eye Cream. “A good eye cream is refreshing and can help the delicate skin around the eyes,” says Nicol. Step 6: Sunscreen. This is the most essential step when it comes to protecting your face. Some sunscreens come tinted, which can replace foundation. “Do not forget to also apply to the neck, chest, and hands,” says Nicol. “It is important to reapply every few hours when you are out in the sun.” Step 7: Makeup. After you’ve completed the above steps, proceed with your make- up routine. This is a crucial step for protecting your skin. Many aestheticians recommend wearing makeup every day.

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Colorectal cancer is the number two cancer killer in Nevada, only second to lung cancer, yet it is also one of the most preventable. Still, in 2020, 20.7% of Nevadans said they had never been screened for this deadly disease, according to the Nevada Cancer Coalition. At the start of the COVID-19 pandemic, unfortunately many healthcare services were halted, including colorectal cancer screenings. Those delays in screenings can lead to delays in diagnoses of colorectal cancer, resulting in poorer outcomes. Per the American Cancer Society, if colorectal cancer can be found early the relative 5-year survival rate is approximately 90%. Screening is key, and it is important to engage in preventative care. Even if you have no personal or family history of colorectal cancer, ask your doctor about colorectal risk factors and when to start screening, and if you’re up to date on your screenings, talk to loved ones and make sure they are too. According to the American Cancer Society, most colorectal cancer cases are found in those without a family history. This month let us help raise awareness for colorectal cancer and the importance of routine, life-saving screenings. To learn more, we spoke to Renown Health oncology nurse Christina Alsop, APRN. What is Colorectal Cancer Colorectal cancer is a disease in which the cells in the colon or rectum grow out of control. It usually forms from precancerous polyps, or abnormal growths, in the colon or rectum, which can become malignant without presenting any symptoms. How do Screenings Work Screening tests like stool tests, colonoscopies and others can detect these precancerous polyps, so they can be removed by a physician before turning into cancer. Screening tests can also find colorectal cancer early, resulting in better treatment outcomes. As of 2021, the U.S. Preventative Services Task Force recommends adults begin colorectal cancer screenings beginning at age 45, through 75. Screening methods include a blood stool test, which needs to take place every year or a colonoscopy, which takes place every 5-10 years. Healthy Habits Can Help Stave Off Risk Routine screenings are the only way to determine colorectal health, yet some healthy habits may reduce your risk for colorectal cancer. These factors include maintaining a healthy weight, being physically active, eating a diet rich in fresh fruits, vegetables and whole grains, limiting alcohol intake and not smoking.

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Austin was five years old when he was diagnosed with leukemia. A fever and pale looking skin prompted his mom, Brenda, to bring him into his primary care physician in Carson City. After doing some blood work, the fight to beat Austin's cancer began. The initial shock of learning your child has cancer is traumatic and can feel like a whirlwind. Then the questions begin – will my child survive, what happens next, how will we tell his siblings, will we have to travel out of state for quality care? The list of questions feel endless. While grappling with the news, Brenda brought Austin to Renown Children’s Hospital for an additional check-up. This weeklong hospitalization started with a series of tests to confirm Austin’s diagnosis and ultimately it led to treatment for the leukemia. Dr. Jacob Zucker, a pediatric oncologist at Renown Children's Hospital, was with Austin every step of the way, even meeting him in the parking garage on his first day of treatment. Brenda is eternally grateful that Dr. Zucker was on staff at Renown Children's Hospital, which allowed them to keep Austin's care in Reno. The alternative was to travel out of state for care. "Dr. Zucker was the best thing to ever happen to our family. I consider him a part of our family now," said Brenda. "His kindness and knowledge gave us faith in him." Treatment for Childhood Leukemia Austin’s treatment was broken into a number of stages with the first eight months of therapy being the hardest. He would receive almost weekly therapy at Renown Children’s Infusion Center as well as frequent spinal taps with chemotherapy. After eight months, and for the next three years, Austin would receive a maintenance phase therapy. This meant oral chemotherapy every day, IV chemotherapy once a month, spinal chemotherapy every three months and steroids for the first five days of every month. After more than four years of fighting cancer, Austin, now 10, is free of any disease. Currently, he has blood work every two months to ensure he is on the right track. Seeking Advice from Children’s Oncology Groups Throughout Austin's treatment, Brenda regularly sought advice from Children's Oncology Group (COG) members. COG is the world’s largest organization devoted exclusively to childhood cancer. Renown Children's was not a member of COG at the time of Austin's treatment -- with the closest facilities located in the Bay Area and Salt Lake City – but it is /now. “When faced with pediatric cancer, the last thing parents should worry about is traveling great lengths to receive the best in cancer care," said Larry Duncan, Vice President of Pediatrics and Surgery and Administrator at Renown Children's Hospital. "We are proud to now offer the most advanced childhood cancer treatment options here at Renown, close to home and convenient for area patients and their families.” This membership allows Renown to enroll our youngest patients – just like Austin – in the latest clinical trials, including groundbreaking treatments, studies to understand these diseases better and in addition, this program will focus on supportive care and survivorship. "The COG allows Renown providers to access treatment plans that were not available to non-COG hospitals when Austin was receiving treatment," said Brenda. "It comforts me to know that not only can children receive cancer treatment right at home, but their parents can now elect for them to participate in trials and plans that are at the forefront of cancer treatment today." How You Can Help Make a Difference Renown Health is focused on being the destination for all your family’s health and healthcare needs. As a not-for-profit health system, Renown relies heavily on community funding. If you are interested in supporting Renown Health, and kids like Austin, please consider giving to Renown Health Foundation. Donations are accepted through the following ways: Make a gift at www.renown.org/give Call Renown Health Foundation at 775-982-5545 Mail a check to Renown Health Foundation, 1155 Mill St., 02, Reno, NV 89502

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