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.

As a result, the whole family was very cautious about our sun exposure this summer.

Is this necessary? Should we be taking special precautions?

If we were to develop melanoma, what symptoms should we look for?

Thank you for your help.

Fearing Melanoma in Midwood

 

Dear Fearing,

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. 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 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 ABCs.

Let me explain the warning signs:

A – The ‘A’ stands for an asymmetric shape. If you were to cut the mole in half, each half should look like the other.

B –       The ‘B’ stands for border. The border of the mole should be smooth. If it is irregular, it should set off alarms.

C –       The ‘C’ stands for changes. If the mole changes color, it must be looked at carefully.

D –       The ‘D’ stands for diameter. If it gets bigger than a quarter of an inch, this may indicate a problem.

E – The ‘E’ stands for evolving. This is a mole that changes shape and appearance as well as develops symptoms such as itchiness or bleeding.

There is also a type of melanoma known as a hidden melanoma. These usually occur in dark-skinned 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. Eyes should be checked during an annual eye doctor appointment.
• In the vagina or digestive tract.

Melanoma often spreads like wildfire, and I cannot stress enough the importance of early discovery.

Treatments include chemotherapy and 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 notice 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.
• Increased age (over 50).
• Living close to the equator.
• Excessive exposure to the sun.
• At least one major sunburn as a youngster.

With summer past us, it is a good time to take stock of the condition of your skin. I hope this helps readers better understand melanomas and the importance of being safe in the sun.

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Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET-TV, Tuesdays at 8 p.m. on Time Warner Channel 97 and Cablevision Channel 30.