Steer Clear of Skin Cancer

Melanoma can be treated, as a surgeon explains, but preventing it by staying safe from the sun is the best treatment of all.

Summer’s here, and the time is right for heading to the beach, the park, the golf course and the backyard pool. But all that fun in the sun can spell trouble for your skin. In fact, melanoma, the most dangerous form of skin cancer, is on the rise. Franz O. Smith, M.D., a surgeon at Saint Barnabas Medical Center who specializes in skin cancer treatment, says that melanoma is showing the largest increase of all types of cancer in men, and the second-largest increase in women. “There are about 180,000 new cases and about 9,000 deaths a year,” he says. There’s a lot written about skin cancer and skin protection each year when warm weather arrives, but people still have questions. Dr. Smith has answers:

How does one check for signs of skin cancer?

Examine your skin every month, looking for moles with the classic ABCDE signs of melanoma. “A” is for asymmetry—one side of the mole is a different shape or size than the other. “B” is for border—melanoma borders tend to be uneven instead of round. “C” stands for color—most benign moles are one shade or color, while melanomas can have different shades of brown, black or red. “D” means diameter—melanomas are usually larger than about . inch, the size of a pencil eraser. And “E” is for evolution—a mole that changes in size, shape or color, or begins bleeding or crusting over time, may signal cancer. If you see any of those signs, definitely see a doctor.

Does skin cancer run in families?

Only about 10 percent of cases have a genetic connection. The main cause is sun exposure, or exposure to ultraviolet light in a tanning bed.

Are dark-skinned individuals at risk?

It’s true that fair-skinned, blue-eyed people and those with red hair and freckles are more susceptible than others to skin cancer. But it can occur in anyone. African-Americans are prone to a particular melanoma called acral lentiginous melanoma, which starts in the palms and the soles of the feet. The most famous case of this is reggae singer Bob Marley, who died of brain cancer that developed when this skin cancer spread.

What are the best ways to prevent skin cancer?

Avoid being in the sun during its hours of peak intensity, from 10 a.m. to 3 p.m. Always use sunscreen; I recommend a full-spectrum sunscreen that blocks both UVA and UVB rays, with a minimum SPF (sun protection factor) of 30. Wear sun-blocking clothing whenever possible, including hats and sunglasses. And don’t use tanning booths. They are not safer than the sun.

What about self-tanning lotions or creams?

Those are generally safe.

What are some of the common misconceptions about skin cancer?

That it can be ignored or is invariably easy to treat. A case of melanoma may require many specialists to treat it, including surgeons, medical oncologists, radiation oncologists, immunotherapists and social workers.

Is there anything new in skin cancer treatment?

There are trials under way to study immunotherapy, in which we can take a tissue biopsy of the tumor, grow white blood cells in the tumor that attack the cancer, and give those cells back to the patient in an intravenous drip. We also are learning from trials which patients need radical surgery and which don’t, based on the genetic makeup of the particular tumor. Large trials have shown that not everyone requires the same extensive surgery or chemotherapy we offered years ago. One person’s cancer may not behave the same as another’s. Each tumor has different mechanisms for growing and spreading, and we are looking at how best to treat each tumor, with one drug over another or one surgery over another.

Have these new therapy options made a difference in outcomes?

Yes. Over the last five to 10 years, as patients have had access to many more targeted options, they have helped bring down mortality rates. Fortunately, in some cases, we can induce a complete response, meaning we eliminate the tumor, and the chances of its coming back are exceptionally low.

To learn more about The Melanoma Center at Saint Barnabas Medical Center, call 973.322.8085 or visit www.rwjbh.org/sbmccancer.