The COVID-19 pandemic has given everyone time to reevaluate their habits and take a much-needed look at their overall health and wellbeing. “I know I need to eat better.”, “I need to exercise more often”, “I need to wear sunscreen and avoid direct sunlight.” In 2020, COVID-19 makes us more aware of how well we really are.

To the Editor:
The COVID-19 pandemic has given everyone time to reevaluate their habits and take a much-needed look at their overall health and wellbeing. “I know I need to eat better.”, “I need to exercise more often”, “I need to wear sunscreen and avoid direct sunlight.” In 2020, COVID-19 makes us more aware of how well we really are.
Melanoma is the most aggressive and deadliest skin cancer. It’s the last diagnosis I want to give to a patient. Over the years, I’ve given this diagnosis to many friends and families who I care about. It will always be the worst part of my job. Today, I’m looking for the “Silver Lining in a Black Cloud, Melanoma.”
The unfortunate news is that new cases of Melanoma continue to grow exponentially each year. From 1950 to 2001 the incidence of Melanoma increased 690% and the Mortality Rate increased by 165%. In my first year of practice in 1996, I saw 10 patients with Melanoma. In 2019, our practice diagnosed 96 cases of Melanoma. NINETY-SIX! Our local pathology group reported a total of 105 Melanomas in 2019 and 96 were from Western Maryland Dermatology.
Why are we seeing such a dramatic increase in Melanoma? The two biggest factors for melanoma risk are genes and sun exposure. You can’t do much to change your genetic make-up, but you can protect yourself better by wearing sunscreen, seeking shade, and NEVER going into a tanning bed! Most of my skin cancer patients start their consultation with one of the following: “My sister and I laid out on the roof with Baby Oil and Iodine to get a better tan.", “My friends and I went to the tanning bed all winter to keep our tans.” or,” I’ve worked outside my whole life.” We are all guilty of allowing too much sun onto our skin over the years, myself included. We can all make positive changes to better protect our skin!
Here’s the silver lining: For the first time in my career, I am happy to report that the mortality rate for melanoma is going down instead of up! The March 2020 issue of the American Journal of Public Health states, "From 2013 to 2016 there was a large decrease of 17.9% in Melanoma Mortality.” From 1986 to 2013 the overall mortality rate for skin cancer grew 7.5%, then it dropped 17.9% over the next three years.
Why did we see such a tremendous drop in Melanoma mortality? There are several reasons. First, our surveillance system for catching early signs of skin cancer has gotten much better. I can’t get my teeth cleaned without the dental hygienist looking over my face and checking my lymph nodes. All health care providers are doing a great job of recognizing suspicious skin lesions and referring those patients to a dermatologist. I see patients referred from local physicians, physical therapists, occupational therapists, nurse practitioners, physician assistants, and nurses. Everyone is more aware of the warning signs and is doing their part to educate people and motivate them to take the next steps. Regardless if you’re a medical professional or just a friend, if you notice a suspicious mole or lesion on a loved one, always ask about it. Tell them to see their Dermatologist as soon as possible—even if it’s just for a routine check-up.
People are being more “sun-smart”. They acknowledge the warnings from health professionals and are more likely to wear sunscreen or cover-up. This is such a change from when I was a child. I remember my mother telling me, “Get outside you don’t look good”, when she just wanted us out of the house for a break. This isn’t something you’ll hear as often today! People are getting the message. More sun equals more skin cancer and it AGES YOU much faster.
New medicines are the best news. Patients with Melanoma today are much more likely to survive than 20, 10, or even five years ago. There are whole new classes of drugs available now that are working very well. A Melanoma that may have killed a patient only ten years ago is now a less daunting diagnosis. Even patients with Advanced Melanoma are experiencing better results!
You will always be your first defense against skin cancer. Regular personal examinations will help you notice changes in your skin. Most women do a breast exam once a month, and this is the perfect time to examine all parts of your body as well. It should also be a reminder to tell the men in your life to examine their skin, too. You know yourself better than anyone, so take the time to know your skin just as well!
I’ve always been an optimist, we will do better in the future with viruses, vaccines and skin cancer. Spring and Summer is a good time to make your Dermatology appointment. You are starting to wear T-shirts and shorts. Keep an eye out for anything different or unusual. Know your ABC’s and make sure you see your skin cancer and skin care experts. In the Tri-State area Western Maryland Dermatology are your skin experts.

Dr. Sean McCagh, MD