Superficial spreading melanoma
Dear Dr. Roach: I was recently diagnosed with superficial spreading melanoma. I had a wide excision and was told to follow up with a dermatologist. The dermatologist says to follow up every six months; is this frequent enough? It was found during a routine annual skin check, and I never expected this outcome.
I am amazed at the number of people I have encountered since who have had one or more melanoma excisions. How important is sunscreen for melanoma?
I am told that it can recur anywhere anytime; does this mean as a skin lesion or internally as well?
I was told by a doctor to have my genital and rectal areas checked routinely as well. Is this something dermatologists do regularly, or do they defer this to gynecologists or primary care physicians? At what point might a medical oncologist get involved? Finally, why do they not use scanning as a tool during these early findings? — F.W.L.
Answer:
DR. ROACH
Melanoma is not the most common skin cancer, but it’s by far the most dangerous. Although there have been dramatic improvements in the care of melanoma, preventing it is still the best option, with the second choice being to catch early before it has a chance to spread.
Since ultraviolet light is the main risk factor for melanoma, avoidance is the key. Staying out of the sun, using sun-protective clothing, and applying sunscreen are all effective. I recommend a broad-spectrum (UVA and UVB) sunscreen with an SPF of at least 30.
Higher numbers are more effective, with SPF 100 being more effective than SPF 50, contrary to some advice that I have read.
