Is there a cure for keloids?

DEAR DR. ROACH: Is there a cure for keloids? My husband is 56 and has several keloids on his body, but there is one on his chest that has gotten considerably larger over the years and causes the most problems. He has experienced pain and discomfort, and it also bleeds at times. My husband would prefer not to have surgery. He was born with a keloid on his ear. At a very young age it was operated on, and it returned larger in size. He has tried numerous types of remedies, but none has prevented the keloid from growing or bleeding. — J.B.

A keloid (from a Greek word meaning “tumor-like”) is a complication of scar tissue. In some people, when the skin heals from a cut or a burn, the healing cells keep growing, creating a variably sized, disfiguring, sometimes painful lesion called a keloid.

The best treatment in people who are predisposed to keloids is to avoid them by avoiding any unnecessary surgery (including ear and other body piercings). Once a keloid has formed, there are several possible treatments. Unfortunately, the longer a keloid has been there, the harder it is to treat.

I have seen great results from silicone gel sheeting. This is particularly effective when used immediately after surgery, but may have some effectiveness on your husband’s chest keloid. Another potentially effective treatment is injection of steroids, which help flatten and shrink keloids up to 75 percent of the time.

DEAR DR. ROACH: I wonder if the PSA reading 0.2 cited in the second-last paragraph of the Oct. 17, 2014, answer to B.D.’s query should, in fact, read 2.0? — L.B.

Thank you for reading closely, but I did mean 0.2. After successful prostate cancer surgery, there should be no normal prostate tissue left, and since PSA levels in people without cancer roughly correlate to amount of prostate, the level should be zero, or very nearly so.

A level above 0.2 — which would be a very low level for a man who hasn’t had surgery — is, in a man who had surgery, very likely indicative of recurrence of prostate cancer. It is mandatory to confirm this with a second PSA test. After radiation treatment for prostate cancer, PSA levels fall slowly for 18 months or so. In some men, the PSA levels rise transiently and then fall (called a “bounce”), but it is impossible to tell when the levels are first rising whether this is a bounce or recurrent cancer.

When the PSA does rise after surgery, indicating recurrence of cancer, it does not necessarily mean that the cancer will be aggressive. In general, the longer the PSA stays low, the slower it rises and the less-aggressive the cancer was pathologically before surgery all predict a more indolent, slow-growing cancer on recurrence.

Keith Roach, M.D. To Your Good Health