Melanoma is a skin disease that tends to go untreated because many people do not realize they have developed it. By informing people of the serious risks, there is the potential for skin cancer to be prevented.
Dr. Brian Gastman, the medical and surgical director for Cleveland Clinic’s melanoma and high-risk skin cancer program, shares his expertise on melanoma, and what it means; and more specifically, pregnancy-associated melanoma, and how to help skin melanoma via plastic surgery procedures.
HealthScene Ohio: What are some common misconceptions about melanoma?
Dr. Brian Gastman: People think it is rarer than it actually is. About 70,000 people in the U.S. develop skin melanoma each year. Melanoma is the most common skin cancer in young adults. It’s the leading cause of cancer death in women that are 25-30 years old. People think that melanoma and other skin cancers can easily be removed, but when it spreads, it can be very deadly. The liver, lungs, bones, and brain can be affected by these metastases.
HSO: What are the symptoms of people who develop melanoma?
BG: Most people can develop dark spots, bumps, and moles that change in size or color on their skin that can contain cancerous cells without them even being aware of it. To help with prevention, it is recommended that patients go to their general practitioner for a skin examination regularly, and if suspicious lesions are seen, they should visit a dermatologist.
HSO: What exactly is pregnancy-associated malignant melanoma (PAMM)?
BG: Melanoma is a serious case of skin cancer that anyone can develop. Skin melanoma is a problem in pregnancy and there is a risk of delayed detection. Skin changes and the dark spots develop over time, even during pregnancy. When a pregnancy-associated melanoma develops, it is crucial to have prompt treatment; PAMM has a higher death rate than other melanomas.
HSO: How is the timing of PAMM diagnosis and treatment critical to the patient’s survival?
BG: The timing is everything in every kind of cancer. If treated in its early stages, it will be easier to stop the spread. Since women who are pregnant often times do not realize they have developed melanoma, they are usually found in their later stages, large and small tumors will have started to grow. The timing of diagnosis means everything for the patient’s health and survival.
HSO: What are different kinds of treatment for melanoma and other skin cancers?
BG: The treatment depends on the stage in which the cancer is at, while also taking into consideration the individuality of each patient. The most common types of treatment are radiation, medical procedures, surgery from a specialist, chemotherapy, and other antiviral drugs.
HSO: How can plastic surgery act as a treatment for melanoma and other skin cancers?
BG: As a surgeon and researcher, I can remove large tumors in melanoma, dissolve the tumor and study what’s happening within the immune system without having to do contrived things. After removing the larger tumors, it can decrease the amount of maticitation[WJ2].
HSO: What are your specialties? What is your focus concerning your patients?
BG: I do multiple types of surgeries but my specialty is mainly in the head and neck areas for cancer reconstruction and trauma. My main focus for my patients is their survival, prognosis, their overall quality of life, and when appropriate, their aesthetics and functionality, which go along with the quality of life.
HSO: How conscious should parents be of their children being exposed to UV rays?
BG: The most important thing is for parents to always check their children. If you rub your baby with tanning oil and place them on the beach to play with sandcastles, this is not healthy for the child. They need constant application of sunscreen so they don’t burn. People see their children getting sunburnt and think it’ll eventually be okay, but it’s bad. They should not be getting sunburnt at all. When people get sunburn at a young age it makes them more likely to develop skin cancer as an adult.
HSO: Which individuals are most at risk for developing high-risk skin cancers?
BG: People that generally spend more time in the sun are more prone to developing skin cancer. People who have over 50 spots on their bodies are more prone to developing skin cancer. Ginger haired people have a genetic mutation where their skin is frailer and unable to deflect UV rays the same way as other-haired persons. If there are people in your family that have developed skin cancer, then you are more prone to developing it as an adult.
HSO: What are ways to be more conscious of the prevention of skin cancers that we can bring into our daily lives?
BG: Young adults are more prone to developing skin cancer; they can get sunburnt under their clothes since the UV rays go right through the fabric. People should put on sunscreen as part of their daily routine when going outside. They also need to be cautious of what time they go outside; the sun in the morning will be completely different than in the afternoon or early evening when UV rays peak.
Liz Anastasiadis is a contributing writer. Feedback welcome at feedback@cityscenemediagroup.com.
About the Expert
Dr. Gastman completed his medical education at the University of Michigan and went on to the University of Pittsburgh for two distinct residencies in Otolaryngology and Plastic Surgery. While there he was part of an NIH-funded T32 training grant, during which he developed his expertise in the basic research of cancer. In addition, Dr. Gastman completed fellowship training at Washington University in St. Louis, specializing in Head and Neck surgery and microsurgery. Currently, Dr. Brian Gastman MD is a specialized plastic surgeon and director of melanoma surgery at the Cleveland Clinic.
