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Skin and Summer Sports: The Importance of Self-Exams

Skin Cancer

Dr. Lynn Schuchter and Mike Schmidt

It was fall of 2013 when Mike Schmidt noticed something strange on his hand. The Phillies legend only had a few hours in Florida before he had to catch a flight, but he decided to see if his dermatologist could see him on short notice. What started as a quick check led to a full exam and a biopsy. The Hall-of-Famer got the call a few days later. He had Stage III melanoma.

The most common form of skin cancer, melanoma is one of the fastest growing cancers in the United States and can strike men and women of all ages, races, and skin types. One in 50 Americans will develop melanoma at some point in their lives, with more than 91,000 new cases expected this year alone. It is the leading cause of cancer death in women 25- to 29-years-old and is the second most commonly diagnosed cancer in children and young adults aged 15 to 29. The majority of melanomas occur on the skin but can also occur in the eye, in mucous membranes, or beneath fingernails or toenails.

Schmidt’s doing well these days after a series of treatments, and he recently shared his story as part of Penn’s 16th Annual Focus on Melanoma event, a program designed for patients and caregivers dealing with the disease. Lynn Schuchter, MD, chief of Hematology-Oncology in Penn’s Abramson Cancer Center, hosted the event and spoke with Schmidt both on stage at the conference and later in a Facebook Live session.

“It’s a common tale to hear that melanoma is discovered this way, and it shows the importance of being proactive and taking the initiative to see dermatologists who can give you a full exam,” Schuchter said.

Schmidt spent his career out in the sunshine on the baseball diamond, and even before he turned pro, he played multiple sports, both on organized teams and on the playground. But even for non-athletes, for many people the summer means beach season and extra time exposed to the sun’s rays. Whether you know it or not, that exposure takes a toll on your skin.

“It’s crucial that people wear sunscreen, whether they’re playing sports or not,” Schuchter said. “You shouldn’t get to the end of the summer on one bottle of sunscreen. Use it frequently and make sure you reapply.”

Schuchter also pointed to the dangers of tanning salons, which have been proven to cause serious harm to the skin. The American Academy of Dermatology says people 35 or younger who tan indoors increase their risk of developing melanoma by 59 percent, and that the risk increases with each use. Women under 30 who use tanning beds are six times more likely to develop melanoma. Those numbers hold true whether people burn while tanning or not. Schuchter says spray tans are a safer option for people who want to have a tanned look, but she says the more important fight is to change people’s minds about the need for darker skin.

“We need to help change the notion that a tanned look is a healthy look for skin,” Schuchter said. “It’s associated with signs of aging, but more importantly, it’s associated with skin cancer and can be deadly.”

In addition to taking the right preventative steps, regular self-exams are crucial. The earlier a patient catches melanoma, the more treatable it is, and recent research shows other people inside the home can play a critical role in spotting something suspicious. Penn researchers found married people are less likely to die from melanoma than unmarried people, due largely to the fact that spouses can influence whether or not a partner decides to see a doctor. The Penn study showed 46 percent of married people went to a doctor at the earliest stage of the melanoma, compared with 43 percent of those who were never married, 39 percent of people who are divorced, and 32 percent of widows and widowers.

“People in long-term relationships see their partner’s skin frequently over time, and are able to notice any new or changing lesions, especially in difficult to see areas, such as the back,” said the study’s lead author Cimarron Sharon, MD, a recent graduate of Penn’s Perelman School of Medicine.

“Not only should people get regular skin exams, but they should take someone along to the visit since this can help you make good decisions,” added Giorgos Karakousis, MD, an associate professor of Endocrine & Oncologic Surgery.

Another surveillance strategy harnesses mobile technology. A group of Penn dermatologists developed an app called MelaSight to help those at the highest risk. A trained medical photographer or doctor takes pictures of a person’s skin, then stores them securely in the app. When patients examine their skin at home, they can compare what they see to what pictures showed during their last appointment and look for changes.

“Until now, dermatologists sent patients home with an envelope full of these pictures, but this app takes advantage of current technology and provides patients with a digital tool they can easily use,” said Emily Y. Chu, MD, PhD, an assistant professor of Dermatology in Pathology and Laboratory Medicine. Chu developed the app with Carrie L. Kovarik, MD, and Michael E. Ming, MD, both associate professors of Dermatology, and Andrew Marek, MD, a recent graduate of Penn’s Perelman School of Medicine.

Whether it’s a high-tech solution or an old-fashioned look in the mirror, recognizing changes on the skin is the key to early detection. Once a patient spots something that looks suspicious, it’s important to take action right away, like Schmidt did. In other words: Be Like Mike.

“When you notice something has changed, it should raise all kinds of alarms,” Schuchter said. “That means it’s time to talk to your doctor and get a skin exam.”

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