Each year, doctors diagnose approximately 75,000 new cases of melanoma — the most serious type of skin cancer. You may not think of it as something you can inherit, but a small number of melanoma types may run in your family.
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We spoke with oncologist Pauline Funchain, MD, to find out what you need to know about familial melanoma.
Q: What is familial melanoma?
A: It’s a set of genes that makes people more susceptible to getting melanoma. About a decade ago, we found mutations in two main genes — CDKN2A and CDK4 — that link to the condition. In the past few years, we have found 10 more genes associated with the condition.
And we know that people who have these gene mutations running in their families are more likely than the average person to get melanoma and certain other cancers, including breast, ovarian, pancreatic and kidney cancers, and mesothelioma (a tumor of the lining of the lungs or abdominal cavity).
When we know someone has familial melanoma, it helps us protect them and their family members from other cancers in the future.
Q: How frequently does familial melanoma occur?
A: Some research shows that about 1 to 2% of melanoma cases are inherited. Some literature says it’s higher, maybe closer to 12%.
Among my patients, I see two to three each week with cancer that has some kind of familial connection. When you add that up, the number is pretty significant. I would say it’s anywhere from 10 to 20%.
Q: Does having familial melanoma affect a person’s treatment of melanoma?
A: No, it doesn’t. As far as we know, melanoma that is familial acts like any other melanoma.
However, if someone has melanoma, their family members often have a lot of similar risk factors for melanoma, such as similar hair, skin color, and sun habits. We already tell someone with melanoma, whether they have a familial melanoma or not, that all of their first-degree relatives need to get annual skin checks.
What does change with familial melanoma is how closely we watch for other cancers besides melanoma that may develop in that person, including breast, kidney, or pancreatic cancer.
Q: What are the risk factors for melanoma?
A: People are at increased risk if they:
- Have fair skin that freckles easily.
- Have blue or green eyes.
- Have red or blonde hair.
- Have spent a lot of time in a tanning bed or have a sun-exposing job or hobby (such as farming, golfing or swimming).
- Have a lot of moles (Note: If you have moles, watch for the ABCDs — asymmetry, and change in border, color and diameter).
Q: How might you know if melanoma runs in your family?
A: We are currently studying people who have had two or more melanomas in one person or in their family. People should consider joining this study if they have melanoma and have family members with other cancers like breast or kidney cancer.
My guess is that melanoma is going to end up being like the canary in the coal mine. It’s the bell that rings, alerting you to a family with a higher predisposition for having a number of cancers — especially in fairer-skinned Caucasian populations.
Q: How can you reduce your risk of melanoma, regardless of your genetics?
A: Don’t use tanning beds. And you can lower your risk by staying out of the sun — but you don’t have to live indoors. We encourage wearing sunscreen with SPF 30 every day. And you can wear sun-protective clothing and wide-brimmed hats.
Researchers in Australia, which has a lot of fair-skinned people who receive a lot of sun exposure, conducted a study where half of the participants wore sunscreen daily and the others only when needed. After 20 years, the sunscreen group had half as many instances of melanoma than the other group.
The bottom line? It’s best to avoid tanning beds and always take precautions when you’re out in the sun — whether melanoma runs in your family or not.
Talk to your doctor if you think you may have inherited a higher risk of melanoma. They can help you watch for problems and advise you on how to protect yourself from other cancers in the future.