Assoc. Prof. Chilingirova: Skin cancer is affecting younger people

May has been declared Melanoma Awareness Month by the World Health Organization. Melanoma is the most aggressive form of skin cancer. It is known that around 600 people in Bulgaria are diagnosed with malignant melanoma every year. In the US, 200,000 new cases are registered annually with over 8,000 deaths, while in the EU, over 100,000 people hear the terrible diagnosis every year, and deaths related to this disease exceed 15,000. There is an alarming trend of a 3-5% annual increase in incidence worldwide, including in Bulgaria.

Interview with Assoc. Prof. Natalia Chilingirova, Head of the Complex Oncology Center at the Heart and Brain Hospital in Pleven

– Assoc. Prof. Chilingirova, is there a trend toward younger patients, and what trends have been observed in recent years by age group?

– Yes, unfortunately, in recent years we have observed an alarming trend toward “younger” melanoma patients. Young people, including those under 30, are being diagnosed more and more often. The main reason for this is excessive sun exposure during childhood, as well as the use of tanning beds. In the past, melanoma was typical for people over 50-60 years of age, but this is no longer the case. Current epidemiological data show an increase in cases among young people. Therefore, regular preventive check-ups are crucial, and excessive sun exposure without sunscreen should not be taken lightly.

– In this context, what are the risk factors?

– The main risk factor is excessive and unprotected exposure to ultraviolet (UV) radiation, both from the sun and from artificial sources such as solariums. Other risk factors include fair skin, multiple moles (especially if they are unusual), a family history of melanoma, and a history of severe sunburn during childhood. Genetic predisposition also plays a role, albeit to a small extent.

– What are the symptoms and when do they appear?

– Melanoma most often begins as a change in an existing mole or the appearance of a new, unusual lesion on the skin. Any change in the color, shape, size, or outline of a mole should be cause for concern. Itching, bleeding, inflammation, or asymmetry are also warning signs. This is why regular self-examination and preventive check-ups with an oncologist are important. In advanced disease, symptoms are usually associated with the organs and systems in the body affected by metastases.

– In which area of the skin is melanoma most commonly found?

– In men, it is most commonly found on the back, and in women, on the lower legs. But in practice, melanoma can appear anywhere, including on the scalp, under the nails, in the mucous membranes, and even in the eye. It is this “unpredictability” that makes the disease such a challenge for specialists.

– What is the multidisciplinary approach to the diagnosis and treatment of melanoma at Heart and Brain?

– At our comprehensive cancer center, we rely on close collaboration between different specialists—dermatologists, oncologists, pathologists, surgeons, and imaging specialists. This allows for a quick and accurate diagnosis, timely treatment planning, and patient follow-up. We provide a personalized approach and use all modern therapies, including targeted and immunotherapy. This significantly increases the chances of successful treatment. Patient follow-up is also carried out according to modern standards.

– Is the disease treatable and should it be considered a terminal diagnosis?

– Melanoma is definitely a serious diagnosis, but it should not be considered automatically fatal. When detected at an early stage, it is completely curable in over 90% of cases. The problem is that it is often diagnosed late and at an advanced stage. That is why early detection is crucial. As already mentioned, modern medicine is advancing and has powerful modern weapons in the fight against melanoma, both surgical and medical, and increasingly innovative therapies are being developed.

– What is the prevention?

Prevention plays a key role in the successful fight against this disease. In Bulgaria and Europe, there are a number of initiatives for prevention and early diagnosis, as well as local campaigns for free skin examinations. However, the most important elements remain education about risk factors and symptoms, regular dermatological examinations, as health is primarily a personal responsibility. It is important to encourage the use of sunscreen products and avoid solariums. At Heart and Brain, we also run prevention campaigns and teach patients how to monitor their own skin. However, a national prevention campaign is a cross-institutional initiative and depends on each country’s National Cancer Plan.