Melanoma in children, while rare, is the most common skin cancer in children. Melanoma is dangerous because it can spread to other parts of the body.

We’re not sure why children get melanoma. Most adult skin cancers can be attributed to exposure to the sun. But melanoma in children may behave differently than in adults. When found early, treatment success is more than 90%. Melanoma is more common in adolescents. Among 15-to-19-year-olds, it accounts for up to 6% of all cancers.

St. Jude melanoma referral clinic

In 2016, we established the St. Jude Pediatric and Adolescent Melanoma Referral Clinic to bring patients and their families to campus for comprehensive evaluations and consultations. Creating the clinic gave us the opportunity to not only provide enhanced multidisciplinary evaluation and care, but also provided opportunities for families to share their experience, attend educational sessions and enroll on a registry and tissue bank for research.

The clinic is a partnership with the University of Tennessee Health Science Center College of Medicine and Le Bonheur Children’s Hospital. We provide patients, families and their referring physicians with optimal treatment recommendations based upon input from a multidisciplinary team of oncologists, pediatric dermatologists and cancer surgeons.

Day One of the two-day clinic begins with a complete examination and patient history. Then in the afternoon, a group of physicians go over each case and reach a consensus on how to proceed and answer the referring physician’s questions.

We also present seminars and other educational sessions for patients and families about moles and other melanoma-related information.

Parents and patients can also get together and have a little fun.

COVID and the clinic

Last year, the pandemic forced us to cancel the in-person clinic in the spring and threatened the fall clinic, so we decided to hold a virtual melanoma clinic. Physicians sent us their patients’ information, and our clinic team met virtually to discuss the cases. We then met via telehealth to relay the information to the physicians and patients.

So far, it has worked well, but we hope to host an in-person comprehensive melanoma clinic again later this year.

The great thing about this clinic is that we can support referring physicians. Although a handful of these patients are referred here for clinical trials, most cases are done to support the treating physicians.

To prevent extreme sun exposure in children:

  • Use sunscreen to prevent sunburns — Sunscreen should be broad spectrum (effective against both UVA and UVB rays) and at least 30 SPF, although there is little evidence that anything above 50 SPF provides additional protection.
  • Regular reapplication of sunscreen is necessary — The term water-resistant does NOT indicate that a sunscreen should be applied only once. No more than a couple of hours should pass between applications, especially if one is sweating and in and out of the water.
  • Avoid tanning beds — The increase in melanoma among teenagers is partly due to their use of tanning beds. The International Agency for Research on Cancer has determined that indoor tanning beds increase melanoma risks 75% in people who begin using them before age 30.
  • Stay indoors when sun’s rays are the strongest — Between 10 a.m. and 2 p.m., children should avoid direct UV rays as much as possible.
  • For infants younger than 6 months of age, no sun at all is best — They can be at the beach or outdoors this summer, but need to be covered up, have on a hat and shield their neck and extremities. It is best to minimize sunscreen use on babies younger than 6 months because they can get significantly more exposure to the chemicals in sunscreen than older patients can.
  • Early diagnosis is key – If a child has a mole, parents should make their pediatrician aware as soon as possible. Early identification and removal of melanoma is critical. If caught early, chances for survival are significantly high. Early detection means less invasive surgical procedures may be necessary, as well as a decreased chance of the tumor spreading.