Skin cancer is the most common form of cancer, and melanomas are the most serious form of this disease. “And we project an increase every year of 20 to 30 percent more cases,” said Merve Hasanov, MD, a James skin cancer and melanoma expert whose research focuses on how melanomas metastasize and spread to the brain. In this episode, Hasanov describes how exposure to ultraviolet light from the sun is the leading cause of all the different types of skin cancer, and that family history is another indicator. “Sun exposure creates a cumulative risk over a lifetime and some people, with a fair complexion, are at higher risk,” she said. Precautions that reduce risk “are decreasing your exposure to the sun, using sun block and reapplying every 50 to 90 minutes and avoiding tanning beds, which use UV rays,” Hasanov said. “Wear a hat or long sleeves, and, even when it’s cloudy or during the winter the UV rays are coming from the sun.” Advances in treatment have led to better outcomes for patients, especially when melanomas are detected in the earlier stages, before they have metastasized and spread to other parts of the body. Because of this, “it’s now recommended that you should, once a year, get a thorough dermatological exam,” Hasanov said, and she also explained the A-B-C-D-E method of detecting skin cancer: asymmetry, border, color, diameter and evolving. Immunotherapy has been a big breakthrough for the treatment of melanomas. “Melanomas have a lot of molecular and genetic changes that can be recognized by the immune system,” she explained. “But cancer cells are smart and can shut down the immune system. But immune checkpoint inhibitors [in immunotherapy drugs] take the brakes off the immune system so the T cells better recognize and kill cancer cells.” Hasanov said that the melanomas in 10 to 12 percent of patients diagnosed in the early stages of their disease will eventually metastasize and travel to the brain. “My research focuses on detecting this earlier when we have better treatment options and survival rates,” she said. Hasanov and her lab have developed a scoring system to determine which early-stage melanoma patients are most likely to develop brain metastasizes. These patients can then be screened on a regular basis. “We’re hoping that this information will lead to better guidelines and trying to spread this information to more physicians and oncologists.”