My good friend and colleague, Dr. Faris Hawit, a board-certified dermatologist and Mohs micrographic surgeon who has practiced in Calvert County for several years, has graciously consented to sit down with me and field a few questions about melanoma.
1. What is the most important thing concerning melanoma that the CalvertHealth community should know?
Know your ABCDE's. Look at your skin regularly for moles that appear
asymmetric, have irregular
borders, have more than one
color, have a
diameter bigger than a pencil head eraser, and/ or are
evolving in size, shape, color, or diameter.
2. I wrote on this next subject recently, but it’s worth discussing again. Who is most at risk of developing melanoma?
People who have had five or more blistering sunburns between ages 15 and 20 have an 80 percent increased risk for melanoma. Having a previous personal history of the disease also confers a much higher risk. Research studies suggest that both UV light from the sun and tanning beds can cause melanoma and increase the risk of a benign mole turning into a melanoma. Before age 50, rates are higher in women compared to men. After age 50, and in general, men have higher rates. White populations have higher rates compared other races.
Your risk is also increased if you have:
- more than 50 moles, large moles, or atypical (unusual) moles.
- a previous melanoma or nonmelanoma skin cancer, which is more common than melanoma.
- a family history of melanoma.
- sun-sensitive skin (i.e., you sunburn easily; have red or blonde hair; or have blue or green eyes).
- a history of excessive sun exposure or indoor tanning.
- a history of other cancers, such as breast or colorectal cancer.
3. What prevention measures do you recommend?
Melanoma is very easy to prevent! Sunblock, hats, shirts. We know exactly how melanoma develops on a molecular genetic level: it’s a combination of mutations in predisposed, higher-risk persons. Prevention of those mutations through thoughtful and consistent sun protection is key.
4. If a melanoma is suspected, what is the procedure for making a diagnosis and for early treatment?
A trained care provider biopsies the suspected lesion and sends it to a specialized lab which analyzes the specimen to determine if it's a melanoma. If the diagnosis is melanoma in early stage, treatment is as simple as a minor excision under local anesthesia.
5. What is Mohs micrographic surgery?
As defined by the National Cancer Institute, this is a precise and highly successful technique intended to remove layer by layer cancerous tissue involving the skin, continually examining for any residual cancer cells until none are found. This helps minimize the amount of normal skin taken away. It is especially effective for the treatment of basal cell and squamous cell skin cancers. It may also apply in select cases of melanoma.
6. What is the most interesting or exciting thing about melanoma in 2022?
Probably the most exciting thing is that survival rates for advanced stages of melanoma have risen meaningfully since the approval of targeted and immunotherapy treatments. When I started my training in dermatology over 18 years ago, the prognosis for advanced stages of melanoma was much worse.
My thanks to Dr. Hawit for sharing his expertise regarding this preventable cancer.