Melanoma Monday: Shining a Light on Awareness, Prevention, and Breakthroughs in Care With Matthew Hadfield, DO

Sun Safety and Prevention

With increased outdoor activity in the spring and summer, clinicians play a vital role in reinforcing sun safety. Dr. Hadfield emphasizes, “Unfortunately, the incidence of melanoma is increasing, and most of that is related to sun exposure. It’s always important to remember to wear sunscreen and keep your body covered up as much as possible.” He notes that even on cloudy days, ultraviolet (UV) light remains a significant risk factor, underscoring the need for year-round vigilance. Educating patients about consistent sunscreen use, protective clothing, and seeking shade can help reduce melanoma risk.

Early Detection: The ABCDEs of Melanoma

Early identification of suspicious skin lesions remains a cornerstone of melanoma management. Dr. Hadfield highlights the importance of the ABCDEs—asymmetry, border irregularity, color variation, diameter greater than 6 mm, and evolution of lesions. He counsels patients, “If you see something that’s concerning, always talk to your primary care physician or a dermatologist. It’s better to have them say, ‘This is nothing,’ than to miss something serious.” He also points out that referrals for melanoma increase in the warmer months as more skin is exposed, making this a crucial time for clinicians to remind patients about self-examination and prompt evaluation of new or changing lesions.

Advances in Melanoma Treatment

The treatment landscape for melanoma has transformed dramatically over the past decade. “Prior to the development of immune checkpoint inhibitors, overall survival for patients with metastatic melanoma was less than a year. That’s improved to over six years now,” Dr. Hadfield explains. The introduction of immune checkpoint inhibitors, such as ipilimumab and nivolumab, has not only extended survival but has also shifted treatment paradigms to include earlier-stage disease and neoadjuvant settings. For example, the recent paradigm-shifting NADINA trial demonstrated significant benefits with neoadjuvant dual checkpoint inhibition.

Despite these advances, challenges remain. “A significant number of patients are still refractory to checkpoint inhibitors in the frontline setting,” Dr. Hadfield notes. For patients with BRAF mutations, targeted therapies offer additional options, while ongoing research into T-cell engagers and novel immune agonists holds promise for overcoming resistance.

Looking Ahead: The Importance of Vigilance

Dr. Hadfield concludes with a reminder of the importance of early action: “It’s never too early to be concerned about something. Better that your doctor says it’s nothing than to miss a cancer that could have been caught earlier.” He also expresses gratitude to patients who participate in clinical trials, helping to drive progress in the field.

Melanoma Monday: Key Takeaways

• Sun safety education is essential year-round, especially as melanoma incidence continues to rise
• Encourage patients to use the ABCDEs for self-examination and seek prompt evaluation of suspicious lesions
• Immune checkpoint inhibitors and targeted therapies have dramatically improved outcomes, but ongoing research is needed for resistant cases
• Early detection and patient participation in clinical trials remain critical to continued progress in melanoma care
• By staying informed and proactive, oncology clinicians can help reduce melanoma incidence and improve outcomes for their patients

About Dr. Hadfield

Matthew Hadfield, DO, is a Medical Oncologist at Brown University/Legorreta Cancer Center, with a pending faculty appointment at the Warren Alpert School of Medicine of Brown University. He recently completed his Hematology/Oncology Fellowship at Brown University. Dr. Hadfield’s clinical and research interests are in phase 1 clinical trials and developmental therapeutics, as well as cutaneous malignancies and immunotherapy-related adverse events.