Genetics and fear of skin cancer

[Jolivia]

Dear Doctor,

I am a 41-year old woman from Finland.

I would like to ask you about the genetics of melanoma. I have two cases melanoma in my relatives (second-degree relatives), one is my grandmother on my father's side (was diagnosed at age 85..at her back) and another from my mother's side, my aunt at age 75. My aunt has tanned for decades, I remember her being all brown all the time (with reddish hair, lot of freckles). So one case both sides of the family in older age. There is no history of other cancers in my near relatives. Melanoma of my grandmother is a complete mystery.

Well, I have became nearly paranoid about having melanoma after my aunt was diagnosed. After three years of diagnosis at age 80, she is doing well (Breslow 1,7, Clark IV, clear lymph nodes).

I have lot of moles, mostly in my arms and a stupid history of tanning beds mostly when I was age 28-30. No sunburns as a child as you know the climate in Finland is not so warm and sunny as there..But I do have my history of trips to Creece etc and had my share of sunburns as well here in Finland age 20-30. But I deeply regret ever gone to sunbeds...I have no freckles and according to my dermatologist my moles although multiple look "good" and are relatively small. I have pale skin, burn, but tan also. Gray-blue eyes.

I have visited dermatologist yearly after my aunt was diagnosed, because I cannot look at my moles myself..it is just too scary. Ridiculous, I know. There is no history of atypical moles in my family, exept my aunt (in old age).

Can you please tell me what my risks are or is there possibly underlying genetic factor..how elevated is my risk? I have not sunbathed for almost a decade...We have about 800 cases of melanoma per year in Finland.

I would be very grateful for your help, thank you in advance,

Joanna

[Bhupinder Kaur, MD]

Hello,
I can understand your concern regarding melanoma. It is the most common cancer in women aged 25-29 years and is second only to breast cancer in women aged 30-34 years. Hereditary factors are important causes and similarly sun exposure increases the risk. But there are many other risk factors also like atypical/dysplastic nevi (particularly >5-10) and common nevi> 100.

Melanomas are usually >6 mm in size,with irregular borders ,asymmetrical and dark in color. If you notice changes in the mole's/mark’s color, height, size or shape, you should have a dermatologist evaluate it. You also should have it checked if it bleeds, oozes, itches, appear scaly, or become tender or painful. You should get an yearly examination done from a dermatologist.

It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.

[Jolivia]

I am sorry, did I post this in a wrong place...I would very much like Dr Rockoff to answer this one. Please advice, should I post this elsewere and how?