Dear Dr. Garner,
My brother was told he had melanoma last year.
He was lucky to have found it on a routine physical, and it had not spread.
My question to you is, if I should be taking any special precaution?
What should I be looking for?  What does a melanoma look like?  Is it too late to avoid the sun?  Both of us loved the sun growing up in Florida.
Our family is really shaken up at this time. We read your column every week and look forward to your answer.
Fearing Melanoma in Midwood

Dear Fearing,

I am very happy that you have given us the chance to discuss this most dreaded disease.

Before discussing the topic, I would like to thank my good friend and colleague Dr. Emil Baccash for organizing the very successful health fair at The Church of the Virgin Mary in Park Slope.

It was a great success, and we even got in a live Ask the Doctor segment with Drs. Baccash, Mascatello, Schwartzman and Korngut.

It was nice to meet so many of our viewers in person.

I am already looking forward to next year’s fair.  Please let me know if any other parishes would like a live Ask the Doctor segment.

Melanoma is the most serious type of skin cancer and also the least common.

Having a close family member with melanoma puts the rest of the family at increased risk.  The good news is that 90% of those diagnosed with melanoma will survive.  It is never too late to practice safe sun techniques.

Exposure to ultraviolet rays, from the sun or tanning salons along with gene mutations are the leading causes for this disease.

It is important to limit sun exposure and avoid tanning lamps to help reduce the odds of developing melanoma.

The best way to treat it successfully is to diagnose it an early stage.

I would like to explain what a melanoma looks like, and what you can do as an aid to your doctor to detect it at an early stage.
Melanoma often develops in a benign mole.

A benign mole has a smooth border around it, and a color that is pretty much uniform, usually black or brown.

Melanomas are most common on the backs of men and on the legs of women.  Benign moles in general are so common that most people have about 20 of them on their skin.   Benign moles are usually smaller than a quarter of an inch.

To help detect a cancerous mole, I recommend using the ABC’s.

Let me explain what the warning signs are:
A – The ‘A’ stands for ‘A’symmetrical shape. If you were to cut the mole in half, each half should look like the other.
B –    The ‘B’order of the mole should be smooth. If it is irregular, it should set off alarms.
C –    If the mole ‘C’hanges color, it must be looked at carefully.
D –    ‘D’iameter. If it gets bigger than a quarter of an inch, this may indicate a problem.
E –    ‘E’volving. This is a mole that changes shape or appearance, as well as develops symptoms such as itchiness or bleeding.

There is a type of melanoma known as a hidden melanoma.

These usually occur in dark skin individuals and are found in unusual places.

Examples of the unusual locations are:
• Under the nail of hands or feet.
• In your mouth — your dentist will look for this.
• In the eye — should be checked for at yearly eye doctor appointment.
• In the vagina or digestive tract.

Melanoma often spread like wildfire, and I cannot stress enough the importance of early discovery.
There are new treatments including chemotherapy, radiation, as well as immunotherapy. In immunotherapy, the patient receives medicine that makes his or her cancer killing cells work better.
There has been great success with immunotherapy, and those with melanoma should be evaluated at a major cancer center.

I would like you to remember to look at your moles at least once a month.  This way you will be able to pick up changes.

Those at high risk should be aware of their need to avoid the sun and tanning salons.

The high risk group includes those with:
• Fair skin
• Family history of melanoma
• Over  50 years old
• Living close to the equator
• At least one major sunburn as a child
• Excessive exposure to the sun
With summer upon us, it is a good time to take stock of this dreaded disease.

I hope this helps you better understand melanomas, the importance of early detection and safe sun exposure.
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Dr. Garner is a Fidelis Care provider, who is affiliated with New York Methodist Hospital, Park Slope.  He also is the host of “Ask the Doctor” seen locally on The NET, Ch. 97, Time Warner and Ch. 30, Cablevision.