Skin cancer clinic monitors people at increased risk of melanoma due to hereditary gene mutations

A dedicated Dermatology clinic for people with genetic mutations that can lead to skin cancer is now seeing patients in Charleston in partnership with the Hollings Hereditary Cancer Clinic. 

MUSC Health dermatologist Graciela De Jesus, M.D., sees patients referred to her from the Hereditary Cancer Clinic, providing them with regular skin checks and education about steps they can take to reduce their already heightened risk of skin cancer, particularly melanoma.

“I love it,” she said. “It makes me excited to feel like I'm giving back a little bit and helping these people. I love my patients, and I love being able to reassure them and tell them what they should be looking for – because it causes anxiety to know that you are at an increased risk of any kind of cancer.”

The Hereditary Cancer Clinic at MUSC Hollings Cancer Center provides a centralized location for people with cancer-causing genetic mutations to see a clinician who will work with them on a plan to manage their risks. That could mean more frequent screenings, more advanced screening or prophylactic measures like a preventive mastectomy.

After almost three years since it started, the hereditary clinic now manages care for about 550 people, said director Kevin Hughes, M.D.

"I love my patients, and I love being able to reassure them and tell them what they should be looking for – because it causes anxiety to know that you are at an increased risk of any kind of cancer."

Graciela De Jesus, M.D.

Most cancers are caused by acquired mutations – gene mutations that happen throughout a lifetime, whether because of lifestyle factors like smoking or just through the regular aging process.

But about 5% to 10% of cancers are caused by genetic mutations that are passed down through families. Some of these “family cancer syndromes” include Hereditary Breast Ovarian Cancer syndrome, Li-Fraumeni syndrome, Cowden syndrome and Lynch syndrome.

Depending on the syndrome, an individual could be at increased risk of breast, colon, ovarian or pancreatic cancer – or melanoma.

Hughes, a breast cancer surgeon, and Maria Jen Diaz, a certified adult nurse practitioner, work with patients at the clinic to understand their options. They also regularly consult with their specialist colleagues throughout the cancer center – and now De Jesus is part of the growing partnership.

De Jesus follows the National Comprehensive Cancer Network guidelines for how often to screen these patients, though they can also message her between visits if they notice a suspicious mole.

Annual skin checks are recommended for many adults. But Hughes realized that his patients needed a seamless pathway between his clinic and dermatology.

Dermatology clinics are always busy, De Jesus said. Patients may be discouraged by wait times or show up one year but decide not to return.

“Having one centralized person to send the patients to makes coordination of care and continuity a lot easier,” she said.

She noted that the Hereditary Cancer Clinic also has a research function. For example, although it’s known that some of these genetic mutations can cause an increased risk of melanoma, it’s not clear how much of an increase.

“There’s little information out there,” she said. “So, I think that's one of the long-term goals – to have enough information to see if we can answer these questions.”

People with these genetic mutations should follow the same sun safety procedures as everyone else: wear sunscreen, wear sun-protective clothing and avoid the sun in the middle of the day.

“We talk about what to look for, including the ABCDEs of melanoma, and what to do to decrease the risk of developing melanoma,” De Jesus said.

The ABCDEs of melanoma are:

A: Asymmetry. When a mole looks different on one side from the other.

B: Border. When the border of a mole is irregular or jagged.

C: Color. When a mole is different colors or is lighter or darker than all of your other moles.

D: Diameter. When a mole is larger than 6 millimeters (about the size of a pencil eraser).

E: Evolution. When a mole is growing, changing color or shape or oozing or otherwise symptomatic.

Related Links

More MUSC Hollings Cancer Center news

Subscribe to our newsletter

Hollings Horizons magazine