In the past two years, breakthroughs in the treatment of advanced metastatic melanoma with new immune-directed and targeted therapies have appropriately garnered most of the media and medical attention around the disease. Nonetheless, primary prevention (synonymous with reduction of ultraviolet radiation exposure to the skin) remains the best guarantee against future melanoma deaths. This issue of The Melanoma Letter highlights two of the most important components of primary prevention: sunscreen and clothing. In the accompanying pieces, our invited authors provide important insights on these subjects that we anticipate will help you better educate and counsel your patients.
Sunscreen is an essential and preferred form of sun protection for our society, which thrives on outdoor activity and bares at least some skin at all times. Even public health campaigns to downplay the role of sunscreen in favor of sun avoidance and full coverage clothing have retreated to a recognition of a major role for sunscreen. Until recently, the sunscreen strategy was challenged by limited data on its ability to prevent melanoma. In their lead story, Drs. Adèle Green and Gail Williams share the results and implications of their groundbreaking study, the first clinical trial ever to show the benefits of regular sunscreen use in melanoma prevention.
With this new evidence that sunscreen can help prevent melanoma, it behooves sunscreen developers to redouble their efforts; much work remains to be done to create better and more effective sunscreens. In their story, Drs. Steven Wang and Judy Hu discuss these challenges, exploring the many significant improvements made to sunscreens in recent years as well as the improvements that still need to be made to achieve optimum protection.
Finally, despite the reluctance of most Americans to cover up completely, most experts consider clothing to be the single best shield against UVR. In their concluding story, Dr. Peter Gies and Alan McLennan examine just what qualities make clothing an effective form of UV protection, and discuss the relative merits of dedicated high-UPF clothing and everyday clothing.
While improvements in early detection and treatment are needed and ongoing, the best solution to the melanoma problem is to avoid getting it in the first place. For the majority of melanomas, which are sun-related, this means primary prevention with sun protection. We hope this issue will help you in your own sun protection efforts and those of your patients.
Allan C. Halpern, MD Editor-in-Chief
Ashfaq A. Marghoob, MD Associate Editor