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FAQs about Skin Cancer and the Dark Side of the Sun

Drs. Alexander B. Dagum and Tara L. Huston
Drs. Alexander B. Dagum and Tara L. Huston

According to the American Cancer Society, skin cancer is the most common of all cancer types, with more than one million new cases diagnosed each year.

Here, our melanoma surgical experts, Alexander B. Dagum, MD, and Tara L. Huston, MD, discuss what can be done to help prevent skin cancer and how to detect early signs of the disease.

Q: What should people know about protecting themselves against skin cancer?

A: Skin cancer is usually the result of sun exposure and blistering sunburns that occur in childhood and also cumulative sun exposure. The most important thing we can do is to protect our children from early sun exposure, although it's never too late to reduce your own risk for skin cancer. Eliminating ongoing sun damage is very important.

The good news is that most people with skin cancer are going to be fine. The majority of skin cancers are either basal cell or squamous cell carcinomas. Only 4% of all skin cancers are melanoma, the most serious type of skin cancer.

Sun exposure is a leading cause of not only skin cancer
but also premature facial aging.

Q: Besides early sun exposure, what are some other risk factors for skin cancer?

A: Skin type has a lot to do with it. Fair skin, light hair, and light eyes are risk factors for melanoma. Sun exposure is by far the most common risk factor. The use of tanning salons is also a risk factor. Self-tanning lotions do not pose a risk.

Q: What are the symptoms of skin cancer, and what should people look for?

A: ABCDE is the key. This applies to new or changing moles. A is for asymmetry; B is for irregular borders; C is for color variation; D is for a diameter greater than 6 millimeters (about the size of a pencil eraser); and E is for evolution, or any change in a mole, including itching or bleeding. Any new lesion that bleeds or scabs and does not go away over four weeks should be brought to your physician's attention.

Q: How often should people do self-body checks for changing moles, and how often should they get clinical checkups?

A: People should be aware of their skin and look for any changing moles on a daily basis. People who don't have any history of skin cancer should have a complete skin examination annually by a physician. Those with a history of skin cancer, especially melanoma, should be evaluated at least twice a year by a dermatologist and do skin self-checks monthly. It's a lifetime of follow-up evaluations with your doctor, not just because of possible melanoma recurrence, but because of the possibility of other skin cancers as well.

When in doubt about a mole, get it checked out.

Q: How can people protect themselves against the UVA and UVB rays of the sun?

A: Plan your outdoor activities before 10:00 am and after 4:00 pm. Use a broad-spectrum sunscreen with SPF of 30 or higher, and apply over all exposed skin about ten minutes before going out, and reapply every two hours, or sooner if swimming.

There is also clothing that now has UV protection in them, including bathing suits for kids. And be sure to wear a hat to protect the scalp and ears. Sun-exposed areas such as the nose and ears are very common spots where skin cancer can develop.

Q: How is skin cancer treated?

A: If you have a lesion that you're worried about, the first step is to see your dermatologist, who will remove it if it looks suspicious. Most of the basal and squamous cell cancers are handled with local removal by a dermatologist or plastic surgeon, and that's all the treatment needed.

If there is a diagnosis of melanoma, a melanoma surgeon will become involved, and the treatment depends on the depth of the melanoma. If it's what we call a thin melanoma, which is less than one millimeter deep, the treatment is removal of some normal skin around the melanoma.

Once the melanoma is more than one millimeter deep or demonstrates concerning features on pathology exam, in addition to removing normal skin around the melanoma, we also sample the lymph node, because the deeper the melanoma, the greater the chance of lymph node involvement.

When outside, seek shade, cover up, wear a hat and
sunglasses, and use sunscreen.

Q: What distinguishes Stony Brook from other centers in treating skin cancer?

A: Stony Brook provides comprehensive, multidisciplinary care to patients with melanoma. We offer screening, surgery, and the option to participate in local and national clinical trials. In addition, we conduct basic science and translational research, and also provide community education.

While clinical trials are not for everyone and participation in them is strictly voluntary, the availability of these trials serves as a hallmark of our ability to offer leading-edge treatment. For many patients, this is the only opportunity available in Suffolk County to benefit from such studies.

Several trials are currently underway at Stony Brook. We also participate in the Multicenter Selective Lymphadenectomy Trial (MSLT 2) that is evaluating the role of lymph node surgery in melanoma, in order to determine the optimum care for patients.

Our dedicated team of pathologists, dermatologists, medical oncologists, and melanoma surgeons meets once a month to review each melanoma case, and thus ensures that our patients receive the benefits of multidisciplinary care.

For more information about skin cancer and its prevention, please visit the Centers for Disease Control and Prevention.