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Dr. Hugh Greenway is a dermatologic surgeon at Scripps MD Anderson Cancer Center in La Jolla. Courtesy Photo
Dr. Hugh Greenway is a dermatologic surgeon at Scripps MD Anderson Cancer Center in La Jolla. Courtesy Photo
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Scripps doctor brings awareness to skin cancer prevention

REGION — As doctors report an uptick in advanced-stage melanoma diagnoses, Dr. Hugh Greenway, a dermatologic surgeon with Scripps MD Anderson Cancer Center, is ramping up his message of prevention and treatment for Skin Cancer Awareness Month this May.

Since COVID-19, many patients later diagnosed with advanced-stage melanoma, the most serious of skin cancers, weren’t conducting frequent check-ups with healthcare providers.

“We have had a number of patients who just didn’t go see their doctor and thus didn’t get checked early, so we’re seeing a rebound and an increased incidence of melanoma in many patients,” Greenway said. “Unfortunately, this means there was also an increase in the melanomas that perhaps are a little more advanced because the patient couldn’t be seen for a couple of years for various reasons, including COVID-19. If you’re going to live here in San Diego, I tell all our people that you need to have your skin checked at least once a year, either by your dermatologist or your family physician.”

When getting accessed, Greenway and his team of dermatologists look for the three types of skin cancers in patients when they come into the office.

“There are three main types of skin cancer: basal cell carcinoma, squamous cell carcinoma, and melanoma,” Greenway said.

Melanoma, the biggest threat to patients’ lives, is closely looked for when getting an exam.

“We pay significant attention to it because melanoma’s the type of skin cancer that can spread and metastasize and can lead to killing people,” Greenway said. “However, if you catch it early, we can easily cure it with surgical excision. We have somewhere between 7,500 to 8,000 people who die of melanoma each year, but we’re doing better in terms of our cure rates and things for advanced melanoma.”

Several reasons, including genetics, prolonged sun exposure and a history of sunburns, can cause melanoma. Greenway and his office of 25 other dermatologists see around three to four new melanoma cases each week.

When it comes to a treatment plan, catching melanoma in an early stage makes it easier to cure. But if it is further along, immunotherapies are used to combat cancer.

“The mainstay for treatment of melanoma is to remove it surgically, and we do that in my clinic in Scripps. We do a Mohs surgery on some melanomas and a wide excision on others, depending on the case,” Greenway said. “If they’re a little more advanced, then the patient may have their lymph node removed. If the melanoma has spread beyond that, perhaps to the liver, brain, or other organs, we’re much better today in treating advanced melanoma patients with immunotherapies.”

Even with treatment, there is a chance that melanoma may come back in the patient’s lifetime at about a 10% chance once it is removed.

“Now, one out of ten is a fairly low risk, but it’s much higher than that of somebody in the average population who’s never had a melanoma,” Greenway said. “So, if you’ve had a melanoma, we want you to be seen more often. We usually say three months for every three years, then six months for a couple of years, but after that, at least once a year to be checked.”

According to Greenway, there are numerous steps for prevention to avoid getting any of the three types of skin cancer.

“We understand, as doctors, you’re going to be out in the sun. But you need to avoid getting sunburnt, which falls into the area of needing to wear sunscreen,” Greenway said. “You need sunscreen on the exposed skin of at least a UV 30.”

Greenway also recommends scheduling activities when the sun is not at its highest point, either in the morning, later afternoon or night. Wearing a hat and sunglasses while using sunscreen is also an effective tool for added protection against prolonged sun exposure.