When we switch to t-shirts, shorts and swimwear during the warm summer months, we expose more of our skin to potentially harmful ultraviolet (UV) rays. Though dangerous sun exposure can happen year-round, the temptation to bare skin in the summer prompts Shiv R. Khandelwal, medical director of radiation oncology at Novant Health UVA Health System Culpeper Medical Center, to educate the Culpeper community on signs, symptoms and treatment options for melanoma.


What is Melanoma?


“Melanoma is a type of cancer commonly caused by UV rays that typically begins within a melanocyte skin cell in the epidermis, or top layer of skin,” said Dr. Khandelwal. “UV rays can damage the DNA in our skin cells and affect genes that control how skin cells grow and divide. When these genes don’t work properly, the affected cells may become cancerous.”


The American Cancer Society (ACS) reports that rates of melanoma have been rising for the last 30 years and estimates that nearly 96,500 Americans will be diagnosed with some form of the disease this year.


According to Dr. Khandelwal, a number of risk factors might make someone more prone to melanoma, including:

  • Frequent UV exposure

  • Moles

  • Fair skin, freckles and light hair

  • Family or personal history

  • Weakened immune system


Despite these factors, skin cancer is not discriminatory — anyone of any age, ethnicity or gender can get melanoma.


What to Look For


Melanoma can be detected early through regular self-exams and by paying attention to new moles or dark spots on the body, which are usually the outward signs of the disease.


Dr. Khandelwal recommends using the “ABCDE rule” and seeing your doctor if any of the following apply to a new or changing mole:

  • Asymmetry

  • Borderis irregular, ragged or blurry

  • Color is not consistent

  • Diameteris larger than 6 millimeters across

  • Evolving in size, shape and/or color


“Early diagnoses usually mean less invasive treatments, high likelihood of survival and lower chance that the cancer has spread,” said Dr. Khandelwal.


In fact, the ACS reports that the five-year relative survival rate is 98 percent for localized melanoma that hasn’t spread beyond the skin location where it began.


Treatment Options


Surgery is the recommended treatment option for the majority of melanomas. Radiation is also used in cases where surgery might lead to disfigurement, need for reconstruction or is considered high-risk, or if the tumor is inoperable. Culpeper Medical Center is the only hospital in Virginia that offers superficial X-ray therapy, which targets the skin and five millimeters below its surface to destroy malignant skin cells.


“Treatment plans vary based on patients’ medical history, risk factors and how advanced the cancer is,” said Dr. Khandelwal. “Despite high survival rates, melanoma takes thousands of lives each year. All diagnoses should be taken seriously. It is important to take proactive steps to protect your skin and conduct regular full-body checks for anything new, irregular or concerning.”


Prevention Measures


Limiting direct sun exposure is your first line of defense against melanoma. Seek out shady spots, wear hats, keep your skin covered and wear sunglasses to protect your eyes. Sun exposure adds up day after day.


Avoiding the sun altogether isn’t a realistic option for most of us but getting in the habit of wearing sunscreen every day is your second line of defense. Read labels and fully understand your sunscreen’s strength and limitations. Waterproof sunscreens, for example, should be reapplied after getting wet. While sunscreen doesn’t block all UV rays, do your health a favor and slather it on before you bask in the warm sunshine.


There is no 100 percent fool-proof way to avoid melanoma. Even the most vigilant can receive a diagnosis. Still, there is no denying that the disease is strongly tied to our behaviors. By taking steps to protect your skin all year, and especially in the summer months, you can greatly reduce your chances of a melanoma diagnosis.


For information about cancer care at Novant Health UVA Health System Culpeper Medical Center’s UVA Cancer Care, visit novanthealthuva.org/clinic-locations/uva-cancer-care.aspx.


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