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San Clemente Journal

Healthy Fun in the Sun

Jun 04, 2015 10:42AM ● By Donia Moore
Dr. Gabriel Carabulea is a Board-certified diplomat of the American Board of Internal Medicine, Medical Oncology, and a member of the American Society of Clinical Oncology. He brings over 20 years of private practice experience to the San Clemente area. As the only physician-operated and supervised Infusion Center in the area, his team is not part of any HMO, nor owned by any hospital system.  They have no financial interests in clinical trials, and therefore, provide objective, unbiased opinions, and treatment recommendations. Dr. Carabulea has extensive knowledge in conditions of  brain tumors, melanoma, lung cancer, and prostate cancer. Cancer screening and prevention are a major priority. Dr. Carabulea believes in "integrated medicine" , addressing  care of the body, mind, and soul simultaneously. He makes each patient an integral part of the decision-making and healing processes. Second opinions are encouraged, and welcomed. 
Dr. Carabulea  and his wife Dana love walking on the beach. She is a USC graduate Dentist. 15 year-old son, Alexander, attends O.C. School of the Arts(OCSA) in the Classical Voice conservatory. He loves to sing and play tennis. 

It’s time for fun in the sun!
Here in San Clemente, we all look forward to playing on the beach and in the water. It’s fun. It’s relaxing. It’s good for us – or is it?

While the Vitamin D we get from sunshine has been shown to have anticancer properties, some of the other effects of enjoying those sunny outdoor days might be overlooked.
One of the most often forgotten dangers of being outside, particularly at the beach, is not your encounter with a great white, but getting a sunburn. We now know that sunburn is directly related to your risk of getting skin cancer, the most commonly diagnosed cancer in the United States  

Skin cancers:
melanoma or non-melanoma.
An estimated 73,000 new cases of melanoma are predicted for 2015. Although melanoma accounts for less than 2% of all skin cancer cases, it is responsible for the vast majority of skin cancer deaths. Overall, melanoma incidence rates have risen rapidly over the past 30 years. 

A,B,C, and Ds of  melanoma 
Important warning signs of melanoma include changes in the size, shape, or color of a mole or other skin lesion, the appearance of a new growth on the skin, or a sore that doesn’t heal. The best way to detect skin cancer early is to recognize new or changing skin growths, particularly those that look different from other moles. Any new or unusual lesion, or a progressive change in a lesion’s appearance (size, shape, color, etc.) should be evaluated by a physician. A simple ABCD rule outlines warning signs of the most common type of melanoma. A - asymmetry (one half of the mole does not match the other half); B - border irregularity (the edges are ragged, notched, or blurred); C - color (the pigmentation is not uniform, with variable degrees of tan, brown, or black); D - diameter greater than 6 millimeters (about the size of a pencil eraser). 

Risk factors 
These include a personal or family history of melanoma and the presence of atypical, large, or numerous (more than 50) moles. Risk factors for all types of skin cancer include sun sensitivity (e.g., sunburning easily, difficulty tanning, or natural blond or red hair color), and a history of excessive sun exposure - including sunburns, use of tanning beds, diseases, or treatments that suppress the immune system.

Screening + early detection = cure
Melanoma is highly curable when detected and treated early. If left untreated, it is more likely than other skin cancers to spread to other parts of the body. For localized melanoma (84% of cases), the 5-year survival rate is 98%. Survival declines to 63% and 16% for regional and distant stage disease, respectively.

For malignant melanoma, the primary growth and surrounding normal tissue are removed and sometimes a sentinel lymph node is biopsied to determine the stage. Melanomas that are deep, or have spread to lymph nodes, may be treated with surgery, immunotherapy, chemotherapy, and/or radiation therapy. With the advent of targeted drugs such as vemurafenib (Zelboraf), dabrafenib (Tafinlar), and trametinib (Mekinist), and the immunotherapy drug ipilimumab (Yervoy) comes new hope for those being diagnosed with advanced, late stage melanoma.

Reducing the risk   
Skin should be protected from intense sun exposure by wearing tightly woven clothing and a wide-brimmed hat, applying sunscreen that has a sun protection factor (SPF) of 30 or higher, seeking shade (especially at midday, when the sun’s rays are strongest), and avoiding sunbathing and indoor tanning. Children should be especially protected from the sun because severe sunburns in childhood may greatly increase the risk of melanoma.
Enjoy your days in the sun. Just don’t forget the sunscreen.b 

Dr. Gabriel Carabulea
Oceanview Medical Group
665 Camino de los Mares,Suite 208
San Clemente, CA 92673

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