Melanoma: A Surgeon and Survivor’s Perspective

I can still remember the hum of the intensely bright ultraviolet lights and the feel of the hard vinyl plastic of the indoor tanning bed against my back. Being born to parents of northern European decent, my skin has always been pale, with sunburns happening all too frequently during my childhood. I began using indoor tanning beds in my early teens to acquire that “healthy” base tan before heading to the beach for summer vacations. At the time I did not realize that the healthy glow I was so desperately seeking was actually caused by DNA damage from the UV radiation. Twenty years would pass before the damage eventually surfaced as a small pink dot in the middle of my back. A biopsy performed by my dermatologist confirmed the diagnosis of malignant melanoma, the most deadly form of skin cancer.

As a surgical oncologist and a board-certified surgeon specializing in the surgical care of melanoma patients, I never imagined that I would become a patient. But there I was at age 36 with two small children and a potentially deadly cancer. The treatment for my melanoma involved removing an ellipse of skin from my back, leaving a seven-inch scar, and removing lymph nodes from underneath my arm to determine whether the cancer had spread. The 5-year survival rate for melanoma that has traveled to distant organs is only 15%. Fortunately, my melanoma was discovered at an early stage, and there was no evidence that the cancer had traveled to other parts of my body.

As a doctor, my job is to do everything I can to achieve the best possible outcomes for my patients. But as a cancer survivor, I feel a huge responsibility to help prevent new melanoma cases. Exposure to UV radiation from either the sun or artificial tanning lamps is the leading cause of skin cancers worldwide.

Advice from a Surgeon and Survivor

What advice do I have to offer as a surgeon and survivor? When you are outside during the midday hours, try to stay in the shade and avoid direct sunlight. Wear sunscreen with a sun protective factor (SPF) of 15 or higher, and reapply if you have been swimming or have been outside for prolonged periods of time. Clothing can be the best protection against UV radiation—especially clothing that covers your arms and legs—and do not forget a hat. In addition, one piece of advice that I feel personally strong about: never use an indoor tanning bed.

Everyone should know the warning signs of melanoma, which are as simple to remember as A, B, C, D and E:

• “A” stands for asymmetrical. Does the mole or spot have an irregular shape with two parts that look very different?
• “B” stands for border. Is the border irregular or jagged?
• “C” is for color. Is the color uneven?
• “D” is for diameter. Is the mole or spot larger than the size of a pea?
• “E” is for evolving. Has the mole or spot changed during the past few weeks or months?

Any concerns or questions regarding a skin lesion should be brought to the attention of a dermatologist. Melanoma that is detected in the early stages is highly treatable.

We must educate ourselves that there is no such thing as a healthy tan. My advice is simple: wear sunscreen, limit your exposure to UV radiation with clothing and shade, and never use an indoor tanning bed.

Find out more about protecting your skin.