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Can Melanoma Be Inherited? Understanding Who Gets Melanoma

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Published on May 9, 2015

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Transcript | Can Melanoma Be Inherited? Understanding Who Gets Melanoma

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That's how you’ll get care that's most appropriate for you.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you

Andrew Schorr:

I'm sure patients come to you and they say, Dr. Gimbel, you're treating me for melanoma.  I'm going to have surgery.  Is there a hereditary connection?  My daughter's here, my son's here, we live in Phoenix, there's a lot of sun.  What do you tell them because people are terrified? 

Dr. Gimbel:

The majority or the overwhelming majority of patients get melanoma because of ultraviolet radiation sun exposure. The genetic component to melanoma is a very small fraction of patients I see, and those patients are usually identified early on in life. 

So when I see the typical 50-, 60-, 70-year-old who's been out in the sun their whole life and they have a spot on their skin that's been changing, typically these are not genetic.  It's when someone shows up in an earlier stage or an earlier age that we start to consider more genetic components based on family history.  But that's not one that I approach typically as a treatment path or a causative path.  Most of these, if not 99 percent of what I see, is because of an acquired defect due to radiation from the sun. 

Andrew Schorr:

I get you're not a big fan of tanning booths. 

Dr. Gimbel:

Absolutely not.  So my—the population, the age population of my patients has been decreasing and especially with women.  I'm seeing a lot of younger women in their 20s, with pretty significant melanomas, and I relate that all to tanning, tanning booths, baby oil, what they can do to get that tan, and it's really accelerated the rate of melanoma in younger people.  And it's terrible. 

Andrew Schorr:

And for sun exposure, so let's say somebody has had that early melanoma.  So now you say, okay, doctor, what can I do to limit my risk of recurrence, not developing melanoma again?  What do you tell them?  Is it SPF 50, or should they be in the sun? 

Dr. Gimbel:

Should they be in the sun?  It's hard to say you can't be in the sun. 

Andrew Schorr:

Especially in Phoenix. 

Dr. Gimbel:

Especially from Phoenix, walking from the car to the office or what-have-you, but the issue with melanoma is that the radiation you get, the effects of it are cumulative throughout your life, so the damage that's been done has been done.  But what I tell my patients is you can get more damage, and we need to protect your skin going forward.  So I always recommend at least an SPF of 30, loose clothing, swim shirts if they're outside, being sun smart. 

Andrew Schorr:

Hats. 

Dr. Gimbel:

Hats, absolutely.  Especially a lot of golfers out here.  And one of the more problematic things that we see is when there's melanoma on the ears and the nose, because those are cartilaginous organs, and having to remove tumors off those can be pretty disfiguring.  So I really make sure that I tell my older men who are out there golfing to slather up the sunscreen on their ears and on their nose to make sure—and their scalps. 

Andrew Schorr:

Okay.  And so you're part of this team where you're seeing changing even for advanced patients.  Are you hopeful that even though you're seeing the incidence of melanoma increase among younger people that you're starting to have a broader range of treatments, surgery included, but the immunotherapies and others to help people? 

Dr. Gimbel:

Working with one of my medical oncologists, we kind of kid around how six years ago when we first started doing this—or even five years ago—that our treatment regimen was pretty limited.  The steps that have really taken over the past five years have expanded what we can use. And some of the results we've seen have been pretty much amazing, where someone who has widespread metastatic disease, they start immunotherapy and the disease melts away. 

Now, it's not always typical, but we never had that before.  It was chemotherapy, and if you respond, then maybe you're lucky. But now we're seeing tumors melt away with some of these newer medications out there, and it's—it's awesome. 

Andrew Schorr:

Okay.  Well, you'll have a long career. I'm not trying to put you out of business with surgery, but hopefully we can prevent more.  And unfortunately if it spreads, it sounds like there are more approaches, too.  Thank you for all you do. 

Dr. Gimbel:

All right.  Thank you very much. 

Andrew Schorr:

Appreciate it.  Dr. Mark Gimbel from Banner MD Anderson Cancer Center.  

I'm Andrew Schorr.  Remember, knowledge can be the best medicine of all.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you