Memorial Day weekend kicks off warmer weather and greater sun exposure.
While basking in the sun on the beach, by the pool, or on the mountain is the hallmark of a summer vacation, that exposure can catch up with us later — in the form of skin cancer.
Skin cancer remains the most common cancer in the U.S., more than all cancers combined.
To get us ready for the season and in recognition of Skin Cancer Awareness Month, Estelle Kahn, MD, dermatologist at the San Rafael Medical Center, discusses sun safety, why skin cancers are increasing, and the latest treatment options.
What’s driving the increase in skin cancer, given the emphasis on sun safety in recent years?
Today’s cancers often reflect sun exposures from decades ago.
Cumulative sun exposure is a well-established driver. As our population ages, more people are living long enough for those past exposures to catch up with them.
Tanning bed use is another significant contributor that people may not realize. Using a tanning bed before age 35 increases the risk of melanoma by 75%. The International Agency for Research on Cancer, which is part of the World Health Organization, places them in the same category as tobacco and asbestos. There is no safe dose.
Tell us about detection innovations
We now have better detection through dermoscopy, a handheld magnifying light device to spot features not visible to the naked eye. The good news is that we’re catching more cancer cases earlier.
Kaiser Permanente is leading the way with early detection and treatment because of our teledermatology program. The program works well because our care model is coordinated and connected. In teledermatology, primary care clinicians photograph a concerning growth for a dermatologist to review the same day. The program more quickly diagnoses cancers. This is one of Kaiser Permanente’s true gems, and it’s nationally recognized for good reason.
What are the most common types of skin cancer?
The 3 we see most are basal cell carcinoma, squamous cell carcinoma, and melanoma.
Melanoma has a well-deserved reputation as the most dangerous skin cancer. Advanced melanoma cases rose about 46% from 2016 to 2026, according to the American Academy of Dermatology.
However, it is important to note that most melanomas are caught early, making them very treatable. It is advanced melanoma where the stakes are highest. But treatment advances of the last 2 decades have been transformative.
How are treatment and survival different now?
The transformation in melanoma treatment is one of the great success stories of modern oncology.
As recently as 20 years ago, advanced melanoma was considered one of the most difficult cancers to treat. Traditional chemotherapy produced limited short-lived, responses.
That prognosis changed dramatically when researchers identified specific genetic mutations that drive melanoma tumor growth. This sparked a wave of drug development focused on blocking these mutations directly.
Patients have also benefited from immunotherapy, and more recently, a newer cellular therapy approach, TIL therapy, which harnesses the patient’s own tumor-fighting T cells to treat melanoma.
A patient diagnosed with metastatic melanoma today has real treatment options and realistic hope for long-term survival that did not exist 15 years ago.
Let’s talk about sun safety. What’s your guidance? What are common mistakes?
Sun protection is the foundation of skin cancer prevention. We recommend broad-spectrum SPF 30 or higher on all exposed skin, consistently applied and reapplied every 2 hours or more frequently if sweaty or if you’ve been swimming.
A common mistake is that people think sunscreen is enough. Equally important are protective clothing, a broad-brim hat, and UV-protective sunglasses.
We also encourage patients to seek shade and avoid prolonged sun exposure during peak UV hours from 10 a.m. to 2 p.m. And tanning beds should be avoided entirely.
Tips for self-screening
Skin cancer happens in all skin tones and on less sun-exposed areas, Dr. Kahn said. Patients should perform a systematic self-exam every few months from scalp to toes. The goal is simple: Notice what is new, changing, or does not look like everything else — dermatologists call this the ugly duckling. In addition, contact your clinician to evaluate lesions that bleed, itch, crust, or fail to heal.
