Melanoma IVO | How to prevent melanoma? Reviews and photoprotector to avoid skin cancer

Every May 23, the World Melanoma Daya day aimed at raising awareness and promoting actions to combat what is considered the type of more aggressive skin cancer. With its prevalence increasing worldwide, experts remind us of the importance of understanding risk factors and taking preventive measures.

In this sense, the Valencian Institute of Oncology Foundation (IVO) emphasizes that the main prevention depends largely on the individual decisions we make in our daily lives: “From adequate sun protection to actively monitoring changes in our skin, each of us has the ability to influence our own risk of developing this disease,” explains the Dr. Eduardo Nagoreclinical head of Dermatology at the IVO.

Early detection? Prevention and awareness as keys

The importance of prevention and awareness for early detection. According to figures from the Spanish Society of Medical Oncology (SEOM), it is estimated that in 2024 in Spain around 7,900 new melanomas. Of them, around 53% would affect women.

Although the incidence continues to increase “slowly and progressively”, experts also say that the results of awareness campaigns about the dangers of excess ultraviolet radiation, the main risk factor for most melanomas. «Although we see that the need to protect ourselves from the sun in summer has permeated society, we must continue to insist to extend that protection to the rest of the year and specifically to any activity that we do outdoors,” says the clinical head of Dermatology at the IVO.

What is meant by inappropriate exposure?

Regarding inadequate exposure to ultraviolet radiation, experts point out that it leads to excess damage to the DNA of cells. «This happens when burns occur, when there is redness of the skin. Especially when it is accompanied by blisters or pain that lasts at least two days. Experts also talk about the damage that occurs in cells when a large amount of sun exposure accumulates throughout life, or when tanning booths are used. Furthermore, it is worth remembering that “Although each of these forms of exposure is related to different types of melanoma, there are also melanomas that appear without any relationship with exposure to ultraviolet radiation.”

Reviews, photoprotector all year round and alert to changes in the skin

And how should we protect ourselves? Following the usual recommendations, which Dr. Nagore summarizes as “taking appropriate measures to avoid sunburn and excess exposure throughout life”: “This is achieved with common sense using, depending on the type of skin we have and the time of the day and the year, sunscreens and clothing with protective capacity (t-shirts, caps, etc.)». Dr. Nagore also reminds us of the importance of avoiding the hours of greatest solar intensity, using oral protection as a complement, seeking shade, applying sunscreens, “preferably with a protection factor of 50+ and always half an hour before exposure.” (time it takes for the product to settle on the skin and exert its effect) as well as reapply it every 2 hours. “Exercise and bathing accelerate the loss of product, so it is advisable to apply it again after carrying out these activities,” emphasizes the IVO expert.

As Dr. Nagore explains, The simplest and most useful warning sign is finding a skin lesion different from the rest., either because it has appeared again, or because an old one has changed, acquiring a different appearance. «This is the sign of the ugly duckling, although it does not necessarily imply that what has been observed will or will not be a melanoma, but rather it is something that requires an evaluation by a dermatologist. The index of suspicion increases if, in addition, it is perceived to be changing shape or color, if these changes confer an asymmetry to the lesion and are accompanied by discomfort, such as itching or pain.

With the aim of covering the detection of a type of melanoma that grows rapidly, experts focus on self-examine your skin once a month. «The mode must be systematic, covering the entire surface of the skin and emphasizing the areas that are not accessible to our view under normal conditions, such as the soles of the feet, the buttocks, the back of the thighs. , the back or the scalp. It is especially useful to use mirrors or photographs that allow us to observe changes and remember that “1 minute a month can save our life.”

What are the risk profiles?

Risk profiles: with blonde or red hair who have blue or green eyes, or very white skin, which burns or freckles easily, with many moles.

Experts distinguish between two “major risk profiles” for melanoma: The first, people who, for professional or leisure reasons, have been exposed to the sun a lot throughout their lives.. “In addition to melanoma, they usually have other skin cancers, very damaged skin, and it is more common in people over 60 years old, with light skin who have difficulty tanning, although it is not exclusive to them,” explains Dr. Nagore.

The second profile is that of people who have many moles (nevus). «These people have an innate ability for their melanocytes to multiply, so they need less exposure to the sun for melanoma to develop. “Melanoma usually occurs at younger ages than the previous profile, before the age of 50, and typically on the trunk.”

There is also a genetic factor, according to Dr. Nagore. «There are genes that greatly favor the development of melanoma and are inherited, justifying many of the cases in which there are several family members with melanoma (familial melanoma) or the same person suffers from more than one melanoma (multiple melanoma). In addition, there are other genes that shape the characteristics of the person. Specifically, some genes cause us to have skin with a worse response to sun exposure and make us have light skin, low phototypes, and light hair (blonde or redhead). Others result in an increase in the ease for melanocytes to multiply, and are expressed in skin with a high number of moles.

Advances: the immunotherapy revolution

From the IVO they highlight the significant progress that the immunotherapy treatment in the medical field. «Immunotherapy has shown promise in the treatment of cancer, and new drugs and combinations are constantly being investigated to further improve its results. Furthermore, its application in neoadjuvant, that is, before tumor removal, is proving to increase its effectiveness significantly,” says the Dr. Mª José Juanassociate physician at the IVO Medical Oncology Service.

Dr. Juan also highlights that drugs directed against anti-PD1 immune checkpoints and combinations with anti-CTLA4 promote hyperstimulation of the patient’s immune system so that the body is able to recognize and fight tumor cells. «We currently offer immunotherapy treatment to the patient in both the adjuvant and metastatic scenarios, having notably increased in the latter scenario the average survival of the treated patients, reaching almost 50% survival of them at 6 years, figures that with the traditional chemotherapy were unimaginable.

Treatment

Depending on the stage of the melanoma, one or another treatment is chosen. In stages I and II, it is generally addressed with surgery, a field in which IVO is a pioneer in the Mohs technique., which allows 100% of the surgical margins to be analyzed, preserving as much healthy tissue as possible, which is useful for some types of melanoma. Sometimes, surgical treatment is associated with radiotherapy as an adjuvant treatment (additional treatment given after the primary treatment to reduce the risk of relapse), as explained by the Dr. María Luisa Chustclinical head of the IVO Radiation Oncology Service.

And explain how New technologies allow higher doses of radiotherapy to be precisely administered in few fractionswhat is known as radiosurgery or stereotactic brain or body RT: «These techniques, in addition to achieving greater local control, have a synergistic effect with immunotherapy treatments, in such a way that we can improve not only the response to the place where we administer the irradiation, but also at a systemic level, enhancing the action of immunotherapy.

Molecular biomarkers and genomics in melanoma

As explained by Dr. Zaida Garcíaresearcher at the IVO molecular biology laboratory, melanoma is considered a one of the tumors in which the field of molecular biology has contributed the most to the knowledge of the main pathways involved in its development, as well as the identification of molecular targets for its treatment..

“We use the latest massive sequencing technologies in melanoma, as well as liquid biopsy, to contribute to the diagnosis, prognosis and treatment of this disease,” emphasizes the doctor, who also highlights the involvement of the service in the identification of hereditary mutations in predisposition genes to this pathology. “In parallel, we continue to support research with multiple projects underway, many of them in collaboration with the most cutting-edge melanoma centers internationally.”