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Prevention & Early Diagnosis: Beating Deadly Melanoma

May 16, 2011 10:59 AM with Dr. Ross Levy

May is Melanoma Detection and Prevention Month. Dr. Ross Levy, dermatologist and surgeon, discusses the importance of being proactive when it comes to protecting your skin. Dr. Levy will answer your questions about melanoma-related issues as well as other skin-related conditions. Join us for this important discussion.

Catherine (Moderator) - 10:50 AM:
Welcome! Today’s chat: Prevention & Early Diagnosis Keys to Beating Deadly Melanoma will begin shortly. Please start submitting your questions and Dr. Ross Levy will begin answering them as soon as we get started. While you are waiting for the chat to begin, feel free to visit the Kellogg Cancer Center to obtain more information about melanoma. We will do our best to answer all of your questions, but because this is such a popular chat, the physician may not be able to answer all of your questions in the time allowed. Your understanding is greatly appreciated.

Dr. Ross Levy (NorthShore) - 11:00 AM:
Good morning and welcome to our online chat discussing melanoma and skin cancer diagnosis and prevention. This is a timely chat as some of you may know that last Monday was “Melanoma Monday”. My name is Ross Levy and I am the Associate Director of the Dermatologic Surgery Unit in the Division of Dermatology at NorthShore. I look forward to answering your questions and I will try to answer as many of them as I can during this hour. Please note that while many of the questions will apply to most people, I am not your personal doctor, and as a result the responses here follow generally accepted practices and may not be appropriate for every patient. Therefore you will want to follow-up any concerns you have with your own physician to ensure you get the best possible treatment. OK lets get started!

  Laura (Evanston, IL) - 11:01 AM:
After having Melanoma and avoiding the sun, should I be taking any extra vitamin supplements? Also, is there any blood test to detect unseen melanomas?
Dr. Ross Levy (NorthShore)
Good question Laura. You may be alluding to the recent interest in Vitamin D deficiency. Vit D can be obtained through sun exposure and diet. It is much more important for you protect yourself from the sun given your history of melanoma. Vit D can be obtained from a variety of supplements or food and you may want to discuss with your primary doctor whether supplements are in order. Currently there are no reliable blood tests to detect melanoma. The best thing you can do is stay out of the sun, use sunscreen, perform regular skin exams and see you dermatologist.

  Jack (Chicago, IL) - 11:05 AM:
I am fair skinned and have had various sunburns over the course of my life. What warning signs should I look out for? Anything besides freckles changing/moles, etc? Thank you.
Dr. Ross Levy (NorthShore)
Skin cancer will often present as a spot on your skin that is changing in some way. It may be getting darker if it is a mole (brown spot) or it may be sore that just hasn't every healed. For moles, itching or bleeding can sometimes be a sign of skin cancer. A helpful algorithm is the A, B, C, D's. A stands for assymetry (one side of the mole doesn't look like the other), B stands for irregular borders, C stands for different colors, and D stands for diameter (usually greater than a pencil eraser). However there are plenty of benign moles that are greater than a pencil eraser. You should also see a dermatologist for at least a baseline exam with your history.

  Kathy (Chicago, IL) - 11:10 AM:
How do we get thru to the younger generation about the idea that sun with protection is still a way to tan and look healthy?
Dr. Ross Levy (NorthShore)
That's a great questions Kathy and something I spend my day trying to do. There is a lot of effort by the American Academy of Dermatology to do this. Its very difficult as "tanning" has been glorified in the media. I think we are doing a better job as the younger generation is more aware that the sun not only causes skin cancer, but contributes to the signs of aging. I recommend starting early. When your kids or grandkids are young, get them to wear sunscreen and make it a part of their routine. Explain to them the dangers of indoor tanning and tanning beds, especially teenagers. Have them use sunless tanning creams which are safe.

  Jan (Antioch, IL) - 11:17 AM:
I have already had malignant melanoma removed from ankle. What are my odds for getting it again? Thank you.
Dr. Ross Levy (NorthShore)
There are have various studies looking at the incidence of second melanomas and there is no clear answer to you question. We do know that you are at a higher risk to get another melanoma compared people have have never had melanoma, but we just don't know exactly what that number is. The best thing you can do perform regular monthly skin exams and see your dermatologist as often as she or he recommends.

  Leslie (Evanston, IL) - 11:20 AM:
Is there more than one type of melanoma?
Dr. Ross Levy (NorthShore)
Melanoma is cancer of the pigment producing cells of your body, which are also known as melanocytes. There are various subtypes of melanoma which have generally been characterized as to they way the cells look under the microscope and their growth pattern. These subtypes are not as important for prognosis as many other factors or qualities of an individual's melanoma. Many people in the field believe that classifying melanomas in this way is of limited value.

  David (Skokie, IL) - 11:24 AM:
I'm a frequent visitor of the tanning salon. Do beds increase or decrease your risk of melanoma or other skin conditions?
Dr. Ross Levy (NorthShore)
David, this is a significant risk factor for developing melanoma and skin cancer. I can't encourage you enough to stop this practice. Not only does it significantly increase the risk of skin cancer but it will also contribute to the development of wrinkles and aging. No amount of tanning, especially at a tanning salon, is healthy.

  Michelle (Glenview, IL) - 11:27 AM:
Who is most at risk for developing melanoma? Should I take family history into account?
Dr. Ross Levy (NorthShore)
This is a great question. There are genetic factors at play and there have even been a number of genes that have been identified. Much work is being done to determine the role of testing for these genes however at the current time, we still have a ways to go with respect to being able to test an individual's genetic risk by searching for specific geners. You do inherit you "skin type" from your family so if your parents are fair skinned than you are also likely fair skinned and we know that is a risk factor. Other risk factors include a family history of melanoma, exposure to ultraviolet radiation (i.e the sun), increased numbers of benign moles on your body (usually greater than 50-100) and personal history of "atypical moles"

  Jean (Chicago, IL) - 11:34 AM:
Am I at greater risk for melanoma if I typically get burned 1-2 times each year?
Dr. Ross Levy (NorthShore)
In general, those people who are exposed to intermittent high intensity sun exposure are more at risk to develop melanoma than those people who have chronic lower level sun exposure. Therefore if you go out a few times a year, either on vacation or the first nice day in May and burn, you are at higher risk than those people who do not. The fact that you burn, tells me that your are probably fair skinned and therefore even more at risk. Remember that burning (and the tanning that follows) is your skin's way of saying it was injured by the sun and it is trying to protect itself by creating a tan. However, a tan is really a low level of sun protection and should not reassure you that you can go out in the sun without protection. Therefore its never a good idea to go to a tanning salon before a trip to get a good "base tan" because this will give you a false sense of protection.

  Lisa (Highland Park, IL) - 11:42 AM:
Does Melanoma treatment require radiation therapy?
Surgery is the mainstay of the treatment of melanoma. Radiation has a limited role in the treatment of early or intermediate stage melanoma. Occasionally radiation is used to treat advanced or metastatic melanoma

  Alison (Highland Park, IL) - 11:48 AM:
How likely is it for melanoma to travel through the bloodstream? If a sentinel lymph node biopsy is negative, is this the main concern?
Dr. Ross Levy (NorthShore)
The ability of a melanoma to spread is dependent on a number of factors, some of which we know and some we don't know. In generally the later the stage, the greater the risk of metastasis. The data on sentinel lymph node biopsy is still being accumulated and we don't fully know the role it will play.

Catherine (Moderator) - 11:50 AM:
Thank you everyone for your great participation, the chat will be ending in approximately 10 minutes. Please submit any final questions you have.

  Craig (Evanston, IL) - 11:53 AM:
What is "skin mapping"?
Dr. Ross Levy (NorthShore)
"Skin mapping" can mean different things to different people. In general, I use to the term to refer to the mapping of a person's moles using total body photography. We use this sometimes in people who are have many moles and have a history of either melanoma or atypical moles. It can allow the patient and physician to follow individual moles over time to see if they are changing.

Catherine (Moderator) - 12:00 PM:
Thank you again for participating in our chat today. For more information please visit our Kellogg Cancer Center pages.

Also, a transcript of this chat will be available shortly.

Dr. Ross Levy (NorthShore) - 12:01 PM:
Thank you for all the great questions this morning. Remember to practice your Sun Smarts while you are having fun this summer and protect yourself from the sun! If you have any further concerns, please contact the Dermatologic Surgery Unit at 847-663-8062 or the Division of General Dermatology at 847-663-8060.

This chat has ended.

Thank you very much for your participation.