Skip to Main Content

Melanomas: The Consequence of Too Much Sun

Too much exposure to the sun can lead to minor burns or worse, to life-threatening cancers. Surgical oncologist Dr. Michael Egger talks about the prevention and treatment of melanomas.
Season 18 Episode 7 Length 26:48 Premiere: 11/13/22

About

Join host Dr. Wayne Tuckson, a colorectal surgeon, as he interviews experts from around the state to discuss health topics important to Kentuckians.


Funding for this program is made possible in part by:


About the Host

A native of Washington, D.C., Dr. Wayne Tuckson is a retired colon and rectal surgeon based in Louisville. For more than 20 years, he has served as host for Kentucky Health, a weekly program on KET that explores important health issues affecting people across the Commonwealth. A graduate of Howard University School of Medicine, Tuckson is a past president of the Greater Louisville Medical Society and is a recipient of the Community Service Award from the Kentucky Medical Society, the Thomas J. Wallace Award for “Leadership in Promoting Health Awareness and Wellbeing for the Citizens of Jefferson County” given by the City of Louisville and the Lyman T. Johnson Distinguished Leadership Award given by the Louisville Central Community Centers.

Oncologist Discusses Preventing and Treating a Life-Threatening Skin Cancer

On this episode of Kentucky Health, host Dr. Wayne Tuckson speaks with Dr. Michael Egger, a surgical oncologist with the Brown Cancer Center at UofL Health. Dr. Egger discusses diagnosing, treating, and preventing melanoma, a life-threatening form of skin cancer.

How Melanomas Are Diagnosed

The most common types of skin cancers are basal cell and squamous cell carcinomas, Egger says. These cancers appear on surface areas of the skin exposed to excessive sunlight, they are slow growing, and they are less likely to spread to other parts of the body than melanomas are. Most carcinomas can be successfully removed.

Melanoma is “a different kind of skin cancer,” Egger says. “It originates from the melanocytes, which are the cells that give us our pigment, that make us either lighter or darker.”

The most common cause for melanoma also is exposure to ultraviolet (UV) radiation through sunlight. It is most often diagnosed in people in their 60s and 70s, but Egger says that in recent years there has been an uptick in melanoma diagnoses in younger adults.

“The two biggest risk factors for melanoma are having fair skin and then sun exposure,” Egger says. But he adds that use of tanning beds, which expose the skin to UV light in a controlled setting, are also associated with a higher risk of getting melanoma.

Such exposure is more damaging if it occurs at high intensity for a short duration rather than longer periods at lower levels, he explains. If the high-intensity exposure happens at a young age, that’s worse.

“One of the highest risk factors for developing melanoma would be having blistering sunburns, especially as a child or young adult,” he says.

Persons with fairer complexions are at a higher risk for melanoma, but Egger cautions that Blacks and Latinos can also get the disease. Those with darker skin are at higher risk for developing acral litigious melanoma, a type of the disease that appears on the palms of the hands or the soles of the feet.

People can also develop melanoma in the mucosal membranes of the anal canal and in an eye – areas of the body that also produce melanin. However, Egger says these forms of melanoma are far less common than ones caused by sun exposure.

“Melanomas are typically found either through dermatology screenings or skin exams, or (the patient) comes in with a problem – a funny-looking mole,” Egger says. “They can develop oftentimes as a new mole, something that’s come up where they had no other spot before, a pigmented lesion that is itching, bleeding, or causing problems. Or sometimes it’s a mole that’s changed. Perhaps they’ve had a mole for their whole life – it’s been a round, brown, innocent-looking mole, and all of a sudden, it’s changed.”

Prevention Strategies and the Importance of Self-Screening

“Certainly, prevention is the best thing – never developing a melanoma is the best way not to die from a melanoma,” Egger says. “Protecting yourself from chronic sun exposure and blistering sunburns is best done with a combination of sunscreen, mechanical barriers (such as) floppy hats and long-sleeved shirts, and avoiding high sun exposure, especially in the middle of the day when the UV rays are most intense.”

Egger recommends applying a sunscreen with a sun protection factor (SPF) of 30 or higher before going outside for an extended period of time.

“Having a history of melanoma or trying to avoid melanoma does not mean you need to live in the basement,” says Egger. “You need to be outside and be healthy, and that’s all good – you just need to do so safely and with protection.”

If a person does notice a new mole on their skin or changes in one they’ve had for a while, it’s time to see a dermatologist. Self-screening is very important to catch melanomas when they are small and have not had the time to grow and potentially spread to other parts of the body. The guidelines to assist with self-screening correspond to the start of the alphabet, says Egger.

“We’re looking for asymmetry, where (the mole) is lopsided in appearance. Irregular borders, so rather than having a nice, smooth circle, it sort of gets scalloped out. And C is color,” he says. “Brown, sort of regular-looking lesions are probably more innocent than those that have a sort of inky, black look, or what we call variegated color where some areas are darker than the others.

“D is diameter,” he continues. “We typically say anything greater than six millimeters in size, which is about the size of the tip of a number 2 pencil eraser. And then E means evolution, which really means changes – a change in lesions over time.”

It’s important to remember that people develop skin lesions as they grow older. Egger says most of them will be benign, but since melanoma risks increase with age, he advises patients to be vigilant when conducting self-exams of their skin and to take note of any blemish that looks suspicious or that changes.

Treatment Options and Success with Immunotherapy

If a suspicious lesion is found, the dermatologist will shave off part of it during an office visit and send it to a pathologist.

“From there, we can make the diagnosis and decide on the treatment,” Egger says.

If a melanoma is diagnosed, Egger says the thickness of the lesion determines the path of subsequent treatment.

“That’s measured under the microscope, and we characterize melanomas as either thick, thin, or intermediate thickness,” he explains. “Thin melanomas without any other sort of adverse features or high-risk features under the microscope are treated by excising the area with a rim of normal skin around it, and that’s typically all you need to do.”

For intermediate thickness and thick melanomas, Egger says they will be staged during the initial excision process in order to detect if any of the cancer has spread to nearby lymph nodes.

When removing the melanoma, Egger says that for lesions smaller than a millimeter in size, the surgeon will cut out an area of skin measuring a centimeter that encircles it. For any lesion bigger than a millimeter in diameter, the excision will be two centimeters. Egger says those measurements may seem small but are in fact large enough to leave a visible scar once the surgery is completed.

A procedure called Mohs micrographic surgery is commonly used for less invasive skin cancers, but some surgeons also use it for early-stage melanomas, says Egger.

“It’s a technique in which a very narrow margin (of skin) is taken on skin lesions, and those margins are evaluated essentially in real time under the microscope,” he explains. “They are checked, and if additional margins are needed, (the surgeon) takes additional margins.”

At advanced stages, melanomas may spread to distant organs, the lungs and brain being the most common. Egger says using chemotherapy in the traditional sense has never worked well in treating metastatic melanoma. But he says the use of immunotherapy – drugs that signal a patient’s immune system to recognize and destroy cancer cells in the body that previously had been undetected – has been a “game changer.”

“What we sort of figured out a way to do is to turn the immune system back on – we basically cut the brakes, if you will,” he continues. “Cut the inhibition of the immune system in order to allow the immune system to wake up, recognize the melanoma, and attack it accordingly.”

According to Egger, until about 15 years ago the five-year survival rate for metastatic melanoma was around 10-15 percent. Now, the survival rate is up to 30-35 percent. He says that’s due to the success of immunotherapy.

Patients who have surgery to remove melanomas that have not spread to lymph nodes or farther are monitored closely after the procedure. Egger says the surveillance is more oriented toward spotting a new, developing melanoma rather than a recurrence in the original area.

“Typically for thin-melanoma patients, they’re seen by their dermatologist for a total body scan every three months initially,” says Egger. “Then we start spacing that out over time.”

Sponsored by:

Season 18 Episodes

Nursing Homes: Ensuring That Critical Needs Are Met

S18 E26 Length 26:41 Premiere Date 05/07/23

The Environment and Cardiovascular Disease

S18 E25 Length 27:01 Premiere Date 04/30/23

Domestic Violence Is a Public Health Issue

S18 E24 Length 26:40 Premiere Date 04/23/23

Public Health: Good Policy, Good Sense

S18 E23 Length 26:37 Premiere Date 04/16/23

Preventing Deaths from Coronary Artery Disease

S18 E22 Length 26:32 Premiere Date 04/09/23

Anesthesia: You Won’t Feel a Thing

S18 E21 Length 26:31 Premiere Date 04/01/23

Food: It Does A Body Good

S18 E20 Length 26:32 Premiere Date 03/25/23

Physicians: A Trusted Source for Healthcare

S18 E19 Length 26:31 Premiere Date 03/19/23

Treatment of Substance Abuse: It's Complicated

S18 E18 Length 26:32 Premiere Date 02/26/23

Causes and Impact of LGBTQ+ Health Inequity

S18 E17 Length 26:32 Premiere Date 02/19/23

The Science of Sleeping Better

S18 E16 Length 28:11 Premiere Date 02/12/23

Working Together: State Public Health Policies

S18 E15 Length 27:15 Premiere Date 02/05/23

Sports Medicine: It's Not Just for the Athlete

S18 E14 Length 27:48 Premiere Date 01/29/23

Diabetes: It's Not Just Your Fathers' Insulin

S18 E13 Length 27:49 Premiere Date 01/22/23

Vaccinations: The Good, the Bad, the Misconceptions

S18 E12 Length 27:47 Premiere Date 01/15/23

Birth Control: Methods to Prevent Conception

S18 E11 Length 27:49 Premiere Date 01/08/23

Diet and Nutrition: The Halos and Horns of Our Food

S18 E10 Length 27:48 Premiere Date 12/18/22

Preventing Infections Through Wastewater Surveillance

S18 E9 Length 27:50 Premiere Date 12/11/22

Insects: Most Are Good, But Watch the Bad

S18 E8 Length 26:57 Premiere Date 11/20/22

Melanomas: The Consequence of Too Much Sun

S18 E7 Length 26:48 Premiere Date 11/13/22

Healthy Practices: Inform, Cajole or Mandate, Whatever Works

S18 E6 Length 27:49 Premiere Date 11/06/22

Diverticulosis: Little Pouches, Big Problems

S18 E5 Length 27:49 Premiere Date 10/30/22

Down Syndrome: Chromosome Number 21 Is Just the Beginning

S18 E4 Length 27:47 Premiere Date 10/23/22

COVID-19, Monkeypox, and Sexually Transmitted Diseases

S18 E3 Length 27:06 Premiere Date 10/16/22

Over the Counter Medications

S18 E2 Length 27:18 Premiere Date 10/09/22

Meeting Medical Supply Needs at Home and Overseas

S18 E1 Length 27:19 Premiere Date 10/02/22

See All Episodes

caret down

TV Schedules

Jump to Recent Airdates

Upcoming

Breast Cancer: Innovations Beyond Screening - S19 E9

Medical oncologist Dr. Jeffrey Hargis talks about breast cancer, one of the most common cancers among women.

  • Wednesday December 13, 2023 11:00 am ET on KETKY
  • Wednesday December 13, 2023 10:00 am CT on KETKY
  • Friday December 15, 2023 1:30 pm ET on KETKY
  • Friday December 15, 2023 12:30 pm CT on KETKY
  • Sunday December 17, 2023 12:30 am ET on KETKY
  • Saturday December 16, 2023 11:30 pm CT on KETKY
  • Sunday December 17, 2023 7:00 am ET on KET2
  • Sunday December 17, 2023 6:00 am CT on KET2
  • Sunday December 17, 2023 9:00 am ET on KETKY
  • Sunday December 17, 2023 8:00 am CT on KETKY

Taste Not Waste - S19 E10

Chef Christopher Stallard talks about making delicious and nutritious dishes from leftover food.

  • Sunday December 17, 2023 1:30 pm ET on KET
  • Sunday December 17, 2023 12:30 pm CT on KET
  • Sunday December 17, 2023 5:30 pm ET on KETKY
  • Sunday December 17, 2023 4:30 pm CT on KETKY
  • Monday December 18, 2023 2:00 pm ET on KET2
  • Monday December 18, 2023 1:00 pm CT on KET2
  • Wednesday December 20, 2023 11:00 am ET on KETKY
  • Wednesday December 20, 2023 10:00 am CT on KETKY
  • Friday December 22, 2023 1:30 pm ET on KETKY
  • Friday December 22, 2023 12:30 pm CT on KETKY
  • Sunday December 24, 2023 12:30 am ET on KETKY
  • Saturday December 23, 2023 11:30 pm CT on KETKY
  • Sunday December 24, 2023 7:00 am ET on KET2
  • Sunday December 24, 2023 6:00 am CT on KET2
  • Sunday December 24, 2023 9:00 am ET on KETKY
  • Sunday December 24, 2023 8:00 am CT on KETKY

Senior Care: Better Health Care for the Golden Years - S19 E3

Dr. Misha Rhodes talks about better patient-centered care for seniors. A 2023 KET production.

  • Sunday December 24, 2023 1:30 pm ET on KET
  • Sunday December 24, 2023 12:30 pm CT on KET
  • Sunday December 24, 2023 5:30 pm ET on KETKY
  • Sunday December 24, 2023 4:30 pm CT on KETKY
  • Monday December 25, 2023 2:00 pm ET on KET2
  • Monday December 25, 2023 1:00 pm CT on KET2
  • Wednesday December 27, 2023 11:00 am ET on KETKY
  • Wednesday December 27, 2023 10:00 am CT on KETKY
  • Friday December 29, 2023 1:30 pm ET on KETKY
  • Friday December 29, 2023 12:30 pm CT on KETKY
  • Sunday December 31, 2023 12:30 am ET on KETKY
  • Saturday December 30, 2023 11:30 pm CT on KETKY
  • Sunday December 31, 2023 7:00 am ET on KET2
  • Sunday December 31, 2023 6:00 am CT on KET2
  • Sunday December 31, 2023 9:00 am ET on KETKY
  • Sunday December 31, 2023 8:00 am CT on KETKY

Sleep Apnea: New Treatments - S19 E4

Otolaryngologist Dr. Kevin Potts talks about treating obstructive sleep apnea. A 2023 KET production.

  • Sunday December 31, 2023 1:30 pm ET on KET
  • Sunday December 31, 2023 12:30 pm CT on KET
  • Sunday December 31, 2023 5:30 pm ET on KETKY
  • Sunday December 31, 2023 4:30 pm CT on KETKY
  • Monday January 1, 2024 2:00 pm ET on KET2
  • Monday January 1, 2024 1:00 pm CT on KET2
  • Wednesday January 3, 2024 11:00 am ET on KETKY
  • Wednesday January 3, 2024 10:00 am CT on KETKY
  • Friday January 5, 2024 1:30 pm ET on KETKY
  • Friday January 5, 2024 12:30 pm CT on KETKY
  • Sunday January 7, 2024 12:30 am ET on KETKY
  • Saturday January 6, 2024 11:30 pm CT on KETKY
  • Sunday January 7, 2024 7:00 am ET on KET2
  • Sunday January 7, 2024 6:00 am CT on KET2
  • Sunday January 7, 2024 9:00 am ET on KETKY
  • Sunday January 7, 2024 8:00 am CT on KETKY

Rural Healthcare: Crisis or Opportunity on the Horizon - S19 E11

We expect access to a healthcare provider and a hospital when we need them, but for a growing number, this may not be true for much longer. Dr. Stephen Toadvine talks about the status of rural healthcare in Kentucky. A 2024 KET production.

  • Sunday January 7, 2024 1:30 pm ET on KET
  • Sunday January 7, 2024 12:30 pm CT on KET
  • Sunday January 7, 2024 5:30 pm ET on KETKY
  • Sunday January 7, 2024 4:30 pm CT on KETKY
  • Monday January 8, 2024 2:00 pm ET on KET2
  • Monday January 8, 2024 1:00 pm CT on KET2
  • Wednesday January 10, 2024 11:00 am ET on KETKY
  • Wednesday January 10, 2024 10:00 am CT on KETKY
  • Friday January 12, 2024 1:30 pm ET on KETKY
  • Friday January 12, 2024 12:30 pm CT on KETKY
Jump to Upcoming Airdates

Recent

Breast Cancer: Innovations Beyond Screening - S19 E9

  • Monday December 11, 2023 2:00 pm ET on KET2
  • Monday December 11, 2023 1:00 pm CT on KET2
  • Sunday December 10, 2023 5:30 pm ET on KETKY
  • Sunday December 10, 2023 4:30 pm CT on KETKY
  • Sunday December 10, 2023 1:30 pm ET on KET
  • Sunday December 10, 2023 12:30 pm CT on KET

Pelvic Prolapse - S19 E2

  • Sunday December 10, 2023 9:00 am ET on KETKY
  • Sunday December 10, 2023 8:00 am CT on KETKY
  • Sunday December 10, 2023 7:00 am ET on KET2
  • Sunday December 10, 2023 6:00 am CT on KET2
  • Sunday December 10, 2023 12:30 am ET on KETKY
  • Saturday December 9, 2023 11:30 pm CT on KETKY
  • Friday December 8, 2023 1:30 pm ET on KETKY
  • Friday December 8, 2023 12:30 pm CT on KETKY
  • Wednesday December 6, 2023 11:07 am ET on KETKY
  • Wednesday December 6, 2023 10:07 am CT on KETKY
  • Monday December 4, 2023 2:00 pm ET on KET2
  • Monday December 4, 2023 1:00 pm CT on KET2
  • Sunday December 3, 2023 5:30 pm ET on KETKY
  • Sunday December 3, 2023 4:30 pm CT on KETKY

Climate Change and Insect Vectors - S19 E1

  • Sunday December 3, 2023 9:00 am ET on KETKY
  • Sunday December 3, 2023 8:00 am CT on KETKY
  • Sunday December 3, 2023 12:30 am ET on KETKY
  • Saturday December 2, 2023 11:30 pm CT on KETKY
  • Friday December 1, 2023 1:30 pm ET on KETKY
  • Friday December 1, 2023 12:30 pm CT on KETKY
  • Wednesday November 29, 2023 11:00 am ET on KETKY
  • Wednesday November 29, 2023 10:00 am CT on KETKY
  • Monday November 27, 2023 2:00 pm ET on KET2
  • Monday November 27, 2023 1:00 pm CT on KET2
  • Sunday November 26, 2023 5:30 pm ET on KETKY
  • Sunday November 26, 2023 4:30 pm CT on KETKY

Heart Failure: Prevention and Treatment - S19 E8

  • Sunday November 26, 2023 9:00 am ET on KETKY
  • Sunday November 26, 2023 8:00 am CT on KETKY
  • Sunday November 26, 2023 12:30 am ET on KETKY
  • Saturday November 25, 2023 11:30 pm CT on KETKY
  • Friday November 24, 2023 1:30 pm ET on KETKY
  • Friday November 24, 2023 12:30 pm CT on KETKY
  • Wednesday November 22, 2023 11:00 am ET on KETKY
  • Wednesday November 22, 2023 10:00 am CT on KETKY
  • Monday November 20, 2023 2:00 pm ET on KET2
  • Monday November 20, 2023 1:00 pm CT on KET2
  • Sunday November 19, 2023 5:30 pm ET on KETKY
  • Sunday November 19, 2023 4:30 pm CT on KETKY
  • Sunday November 19, 2023 1:30 pm ET on KET
  • Sunday November 19, 2023 12:30 pm CT on KET

Better Cancer Screening: The Answer Is in the Blood - S19 E7

  • Sunday November 19, 2023 9:00 am ET on KETKY
  • Sunday November 19, 2023 8:00 am CT on KETKY
  • Sunday November 19, 2023 7:00 am ET on KET2
  • Sunday November 19, 2023 6:00 am CT on KET2
  • Sunday November 19, 2023 12:30 am ET on KETKY
  • Saturday November 18, 2023 11:30 pm CT on KETKY
  • Friday November 17, 2023 1:30 pm ET on KETKY
  • Friday November 17, 2023 12:30 pm CT on KETKY
  • Wednesday November 15, 2023 11:00 am ET on KETKY
  • Wednesday November 15, 2023 10:00 am CT on KETKY
  • Monday November 13, 2023 2:00 pm ET on KET2
  • Monday November 13, 2023 1:00 pm CT on KET2
  • Sunday November 12, 2023 5:30 pm ET on KETKY
  • Sunday November 12, 2023 4:30 pm CT on KETKY
  • Sunday November 12, 2023 1:30 pm ET on KET
  • Sunday November 12, 2023 12:30 pm CT on KET

Alzheimer's Disease and Related Dementia - S19 E6

  • Sunday November 12, 2023 9:00 am ET on KETKY
  • Sunday November 12, 2023 8:00 am CT on KETKY
  • Sunday November 12, 2023 7:00 am ET on KET2
  • Sunday November 12, 2023 6:00 am CT on KET2
  • Sunday November 12, 2023 12:30 am ET on KETKY
  • Saturday November 11, 2023 11:30 pm CT on KETKY
  • Friday November 10, 2023 1:30 pm ET on KETKY
  • Friday November 10, 2023 12:30 pm CT on KETKY
Top

Explore KET