Scott Webb (Host): This is One-on-One with Regional One Health, your inside look at how we're building healthier tomorrows for our patients and our community. Join us as we get to know some of the individuals who help provide life-saving, life-changing care for our community.

I'm Scott Webb, and today we're talking with Dr. Chelsea Olson from Regional One Health Cancer Care. Dr. Olson is a surgical oncologist and one of her areas of focus is treating patient's with melanoma. She's here to discuss skin cancer prevention and what's known as CT DNA research, which is leading to new and improved treatment and monitoring options for patients.

 Doctor, it's nice to have you here today. We're going to talk melanoma research and prevention, and you are an expert, so it's great to have you here. And I just want to have you start by telling us like what you wish patients knew about melanoma. Like what are the risk factors, causes, maybe care options?

Chelsea Olson, MD, DABS: Some of the things that we look for in terms of risk factors for patients who develop melanoma, you know, some things that lead towards it are specifically UV exposure. So any exposure to sunlight, previous sunburns, especially in childhood, previous tanning bed use, things like that are all risk factors for developing a melanoma.

Host: Okay. Yeah, and maybe we can get into some of the causes and care options as well. I'm going on a cruise soon, you know, and I'm already thinking about the SPF as high as I can get it, and clothing with UV protection, you know, all that stuff. But maybe you could talk about some of the causes and care options.

Chelsea Olson, MD, DABS: You know, causes, cumulative sun exposure. We want to limit that. And the ways that we can prevent that are having adequate sun protection. So what I tell a lot of my patients are to use sun protective clothing. Not a lot of people think about that when they think about preventing melanoma, but if you purchase clothing that's protective of your skin, there's actually qualities in some of the fabrics these days that block out UV rays. And so that's actually really nice for patients. And anybody who wants to prevent prolonged sun exposure, that's something that you don't have to necessarily reapply like a sunscreen.

Host: Hmm.

Chelsea Olson, MD, DABS: You know, you mentioned SPF.

Host: Yeah.

Chelsea Olson, MD, DABS: And how effective is that and kind of what we recommend and if you're going to use a sunscreen, I, I typically recommend somewhere between SPF 30 to 50. Anything beyond 50 is kind of just extra credit, if you want to call it that. What's really important about sunscreen is the application of sunscreen.

Making sure that you're putting on enough sunscreen, and that you're reapplying when that runs out. You want to look at the back of the bottle and reapply when it says to reapply it. And usually that's every hour or two, that you're in the sun. Again, with the protective clothing, we like to think about, providing as much, protection to ears and face and other parts of our bodies that we may not necessarily think about.

For some patients, I think a lot of times we don't think about protection of our legs. We may focus on application of sunscreen to our faces or to our shoulders or backs, but our legs sometimes get exposed to sun and aren't very well protected. We actually see a melanoma develop in women a lot on their legs more than men. So something to think about. Mm.

Host: Yeah, I, I've heard some of the stuff you said before. You know, like those sunburns we get as kids sometimes that bill comes due later, if you will. I've been reading and learning about the UV protective clothing and reapplication, and I definitely skimp on my legs. So I'm, I'm taking some notes along with listeners.

I'm like, right, don't just do your arms and your face and do those legs and, and maybe your feet and your toes and you know, all of that. Right? So then what can we do to do our part, if you will, to prevent skin cancer? Is it just following your advice here today?

You know, like, and how effective are these steps in your experience?

Chelsea Olson, MD, DABS: Yeah. So, we know that sunscreen and the sun protective clothing is very effective in preventing sunburns, and that's basically what we want to try to avoid. Now, I always tell people who come to me, you know, who have been diagnosed with a melanoma, we can't change the past. We can't change the sunburn that we got when we were you know, kids running around and in the sun and not really have much sunscreen on, there's nothing we can do to change that, but we can prevent more accumulation of that radiation damage, of that sun damage. And so even though, you know, the damage is sort of done, you know, so to say, there are things that we can do to prevent even more.

So, knowing that there's just a cumulative risk, as we get more sun exposure. It's always good practice to take those protective measures. . And as I kind of alluded to, you know, the efficacy, the usefulness of sunscreen, it really does have a lot to do with how we apply it.

But also SPF, so, you know, I, I don't typically recommend anything below an SPF 30 and, again, don't really typically recommend anything above SPF 50. But kind of right in between there is a good sweet spot. And then, you know, also just the daily application of of sunscreen or a sun protection.

I oftentimes recommend like a face cream for patients that has some type of SPF in it as a daily protection from the sun.

Host: Yeah, I use a moisturizer. I'm not ashamed to admit that has a UV protection built-in. And, and I feel, and I feel pretty good about that choice.

Chelsea Olson, MD, DABS: Yeah, that's a good choice for sure. Yeah.

Host: So I know doctor, along with treating patient's, you're active in research, including CT DNA research. So I want to know what that is exactly? And what are some of the latest developments?

Chelsea Olson, MD, DABS: So CT DNA is a type of marker in the blood that we can use to follow cancers. And it's being used a lot in colon cancer and a lot of other types of cancer, actually. It is basically a marker that looks at DNA in the blood that's kind of spilling off of the cancer. And we can pick up those little fragments of DNA in the blood and sort of see if patient's are at-risk for having recurrence or if cancer is coming back or something like that.

We haven't started that research just yet, but it is something that we're interested in, the group that I work with and, a lot of it is also related to sort of the genes expressed on each individual melanoma cell. We do some research with that too, where we look at the proteins that the melanomas are producing.

And as you can imagine, everybody's different. Everybody's melanomas is a little bit different. And so we can actually look at the DNA of each person's melanoma and sort of come up with a risk factor for, you know, is this melanoma very aggressive? Is this something that we need to watch closer?

Is it something that we need to, you know, keep an eye on for a longer period of time or with special scans? Those are all kind of put together as part of our plan to help patients after their diagnosis of melanoma. So CT DNA is, is a tool that's being used in a lot of other cancers and I think it could have an application in melanoma. So it's definitely something that we're looking into.

Host: Yeah, because I was going to ask you once this gets, gets rolling and gets cranked up, whatever the right expression is, but once, you know, once the research begins, you know, how will patients benefit from, do you suspect any, what's your suspicion or your crystal ball telling you how they would benefit from CT DNA related to melanomas?

Chelsea Olson, MD, DABS: Gosh, I wish I had a crystal ball. But you know,

Host: Not quite there yet. Yeah.

Chelsea Olson, MD, DABS: The hope in general for these types of markers is really to help catch cancers earlier and to catch cancer. If we diagnose somebody with a melanoma and we cure them of their melanoma; they're always at-risk for having another melanoma come back or having a new melanoma, and so we're always looking for ways to find those recurrences or to find new cancers faster. Right now we have imaging that is very helpful in that. But a lot of times that imaging can't find the very, very small, recurrences or the very beginning. And so we're always looking to kind of move that start line a little bit earlier.

I think that CT DNA I think that a lot of these other tumor markers are ways that we can try to do that.

Host: Yeah, it's really fascinating. No one ever wants cancer ever, but in talking to experts like yourself, doctor, like if you have a melanoma or any kind of cancer like this is an amazing time for, you know, uh, predicting risk, assessing risk, treating cancers. It's really remarkable the science and the medicine and all that stuff that's out there, and I'm sure that's what draws you to it.

Chelsea Olson, MD, DABS: Absolutely. Yeah. And I am very fortunate in, in that I have a lot of colleagues that are also interested in this, but the information is changing monthly, weekly, sometimes even daily, depending on

Scott Webb: May have changed while we're on today. Right. You never know. Yeah. Yeah. It's really amazing. Well, it's been a pleasure having you on. I want to finish up and just give folks a sense like why it's important, why you believe it's important for them to see someone like yourself. Because you specialize in this cancer type and you're involved in the research.

Why would it be good for them to come see you if they're worried, if they know they're at higher risk, whatever it might be.

Chelsea Olson, MD, DABS: Oh yes, absolutely. I'm happy to see anybody who's high-risk for melanoma. We have basically a built-in genetics program that will give genetic counseling and even genetic testing for patients who may be at a higher risk for melanoma because of their family history or maybe even personal history.

But you know, when I see patients in clinic, I do full skin exams. I evaluate, you know, if they have a diagnosis of melanoma, give them options for treatment and the next steps in the treatment and, hopefully cure of their disease. And, we also work with a multidisciplinary group, so. I have a, a lot of other physicians that I work with, medical oncologists, radiation oncologists, a whole group of us that get together for a multidisciplinary tumor board to talk about very high-risk patients and also treatments for each patient. So, you know, I think we are very equipped to handle any type of concern that comes to us regarding melanoma or anything like that. And, a lot of good treatment options as well. And then lastly, you know, after cure, I do a lot of melanoma surveillance. And so basically after our patients had their surgery or had their treatment; we watch out for any recurrence that can happen.

Again, we're doing full skin exams and taking detailed history and making sure there's no other symptoms.

Host: Yeah, it's all pretty remarkable and it's all the stuff we all want to hear, of course, that it's, individualized, it's personalized, it's multidisciplinary. It's a team approach that you stay with patients after they've been hopefully cured through surveillance. Like all the important stuff that's just so popular and common and we all expect. I'm glad that Regional One Health is delivering and that you're delivering. So thank you so much.

Chelsea Olson, MD, DABS: Absolutely.

Host: Learn more at regionalonehealth.org/cance-care. For an appointment called 901-515.-HOPE. That's 4673.

Host: And thanks for making One-on-One with Regional One Health, part of your journey to better health. Join us next time as we introduce you to another member of the Regional One Health Family. I'm Scott Webb. Stay well.