Research News

As summer arrives, we naturally think about protecting our skin from the sun. However, the causes of skin cancer and melanoma extend beyond sun exposure.  

We sat down with dermatologist and melanoma researcher Joshua Arbesman, MD, to learn about current state of skin cancer prevention and melanoma research. Dr. Arbesman’s research focuses on identifying skin cancer risk factors beyond sun exposure, including whether melanoma is hereditary, to find new methods of skin cancer prevention and treatments.  

What are the types of skin cancer? 

“Skin cancer” is an umbrella term for any disease involving uncontrolled growth and division of cells in our skin. Different skin cells give rise to different cancers. There are three major types: 

• Melanoma, which affects melanocytes, the cells that generate melanin in our skin and other organs
• Squamous cell carcinoma, which affects the major components in the upper layers of our skin
• Basal cell carcinoma, the most common form of skin cancer. It is thought to affect cells in the deeper layers of our skin, though the cancer’s origin is debated in the field 

As a dermatologist, Dr. Arbesman primarily treats individuals who are at high risk of developing melanoma. His interest in melanoma research stemmed from wanting to help patients beyond skin cancer diagnosis and treatment, particularly in prevention. 

How can we prevent melanoma and skin cancer? 

The best way to reduce your risk from skin cancer includes keeping track of any changes in moles or freckles on your skin in addition to the right sunscreen or protective clothing, Dr. Arbesman explains. 

“Sometimes, you can do everything right in the sun and still develop skin cancer, so regular screening is essential to catch early-stage melanoma before it becomes too hard to treat,” he says. “Unfortunately, right now we aren’t sure what else can be done to lower skin cancer risk. Once in a while, a patient will come in asking about things they heard about on Instagram or TikTok. Some of that stuff is probably hogwash and some of it is probably based upon real studies, but none of it has really been rigorously tested to make sure it’s as safe and effective as people claim." 

Dr. Arbesman hopes to one day have more recommendations for patients at-risk for developing melanoma or skin cancer through his research. 

Is skin cancer hereditary? 

Melanoma risk is influenced by genetics, but it isn’t strictly hereditary in the same way as some cancers, like BRCA-associated breast and ovarian cancer. Dr. Arbesman has recently shown that 10% - 15% of patients with melanoma carry significant gene variants in cancer susceptibility genes. However, he hesitates to call melanoma a “genetic cancer.” 

“There is no single gene whose variants guarantee a melanoma diagnosis,” he says. “Instead, certain genetic variants may increase the likelihood of developing the disease, sometimes significantly, with lifetime risks reaching up to 80%.” 

What are genetic risk factors of melanoma? 

Dr. Arbesman has identified several gene variants that can increase an individual’s risk of developing melanoma when mutated. 

“15% of our patients had variations in the genes we knew to look at, and 85% of our patients didn't. But many of those 85% still clearly had something going on, environmentally or genetically,” he says. “Many of my patients and their family members have had five, ten, even fifteen melanoma diagnoses. So, it’s likely that there are more melanoma-related genes we still don’t know about.” 

Dr. Arbesman and his colleagues are developing a registry of individuals who have been diagnosed with melanoma to perform more in-depth genetic studies. 

Why is it important to know if our melanoma is caused by genetic risk factors? 

Part of Dr. Arbesman's research program asks whether genetic risk factors should influence the treatment plans he develops for his patients who have already developed melanoma. His work has identified melanoma subtypes where associated gene variants made the cancer more successfully treated with immunotherapy. 

“You can get melanoma in organs that don’t get any light at all, like the brain or the lymph nodes. So, avoiding the sun isn’t the only thing we can do to prevent melanoma,” he says. “Understanding how else the disease develops is critical to understanding what we can do to reduce our overall risk.”