In recognition of Skin Cancer Awareness Month, medical experts are emphasizing the critical importance of prevention strategies and highlighting significant advances in treatment approaches for one of America's most common cancers.
With 1 in 5 Americans developing skin cancer in their lifetimes and an estimated 90% of cases considered preventable, healthcare professionals are calling for renewed focus on both prevention and innovative treatment approaches.
Multimodal Treatment Approaches Advancing Care
Dr. Michael E. Kasper, board-certified radiation oncologist and director of radiation oncology at the Eugene M. & Christine E. Lynn Cancer Institute at Boca Raton Regional Hospital, points to multimodality treatment as one of the most significant recent advances.
"What has probably been one of the best advances is the multimodality approach," Dr. Kasper explained. "Patients are seen by all the skin cancer specialists at the same visit. The surgical oncologist, medical oncologist, radiation oncologist—all who have specialized in skin cancers—see the patient at the same time."
This coordinated approach is particularly valuable for complex cases like Merkel cell carcinoma, which many dermatologists might encounter only once or twice in their careers. At specialized centers like the Lynn Cancer Institute, the team might see approximately 20 such cases annually.
The comprehensive care model extends beyond physician specialists to include psychosocial support, dietitians, and nurse navigators who help coordinate appointments and care plans. The team then collaborates with radiology and pathology to review each case thoroughly.
"Not many places have an advanced cutaneous malignancies multimodality clinic, and I think it is a shame," Dr. Kasper noted. "When you have a coordinated effort like this and an expert team, I think it can make a huge difference."
Therapeutic Innovations Transforming Treatment Options
Recent years have seen remarkable progress in skin cancer therapeutics. Immunotherapy has revolutionized treatment for metastatic melanoma and other advanced skin cancers. Additionally, targeted agents have emerged for large basal cell cancers and squamous cell carcinomas.
These advances complement traditional approaches while offering new hope for patients with advanced disease who previously had limited options.
Prevention Remains the Most Powerful Tool
Despite treatment advances, Dr. Kasper emphasizes that prevention remains the most effective strategy against skin cancer.
"We know that by limiting sun exposure, particularly in the first 20 years of life, we can dramatically reduce, if not eliminate, skin cancers," he stated. "Over 90% of our sun exposure usually comes by age 20."
The challenge lies in changing societal norms and behaviors around sun exposure and tanning. Dr. Kasper advocates for better education, particularly targeting young people and their parents about the long-term consequences of excessive sun exposure and tanning bed use.
Young skin is especially vulnerable to UV damage, which accumulates over time and can lead to skin cancer decades later. Severe sunburns in childhood are strongly linked to melanoma risk, while early sun exposure can increase mole development—another risk factor for skin cancer.
Radiation Therapy: An Underutilized Option
Dr. Kasper highlighted a significant knowledge gap regarding treatment options, particularly concerning radiation therapy for skin cancer.
"There's no question that surgery, and often Mohs surgery, is the gold standard and the main approach to most skin cancers," he acknowledged. "But particularly for frail and elderly patients, or in sites where there is possibly functional or structural damage that could occur and the reconstruction is going to be complex, radiation should at least be considered as an alternative."
He expressed concern that radiation therapy is often not presented as an option until patients have undergone multiple surgeries. "It is a shame that radiation is not considered as an equivalent or a good alternative for managing skin cancers in the right positions," he said.
Dr. Kasper also addressed misconceptions about "gentle" or "soft" radiation being marketed as something new, clarifying that superficial radiation has been available for about 80 years and represents just one type of radiation therapy suitable for a specific subset of skin cancers.
Addressing Disparities and Misconceptions
While acknowledging that fair-skinned individuals of Northern European descent are at higher risk for skin cancers, Dr. Kasper emphasized that people of all skin tones can develop the disease.
"There is a misconception that people of color do not develop skin cancers. That is incorrect," he stated. "I think it is important to educate our patients of color that they also can be at risk and to not ignore suspicious skin changes and to not bake in the sun as well."
Preventive Measures and Future Directions
Effective prevention strategies include seeking shade, wearing protective clothing and hats, using sunglasses, applying broad-spectrum sunscreen, and avoiding tanning beds. These simple measures, when adopted consistently from childhood, can significantly reduce skin cancer risk.
As AI and advanced imaging technologies continue to develop, they offer promising tools for early detection and monitoring of suspicious lesions. These technologies may help identify subtle changes that warrant biopsy or closer examination.
With continued advances in treatment options and a stronger emphasis on prevention and early detection, the medical community hopes to reduce the burden of skin cancer—a disease that, while common, is largely preventable through education and behavioral changes.
