Melanoma Today: Prevention, Prognosis, and Precision Testing

In this episode of The Spot Check, Jamie Restivo, PA-C, is joined by Andrew Baker, MBA, PA-C, for a timely, practice-focused discussion on where melanoma care stands in 2026. From prevention strategies that change patient behavior to advances in risk stratification and precision testing, they break down what’s working, what remains challenging, and how emerging tools are reshaping clinical decision-making.

They begin with prevention, still the highest-leverage intervention but one that remains difficult to translate into daily behavior. Baker emphasizes simple, concrete messaging—sunburns, especially blistering ones, carry real weight over time, and indoor tanning before age 35 significantly increases risk. The challenge is making risks feel immediate enough to matter.

From there, they discuss adherence. Sunscreen works, but only if patients use it. Anchoring use to existing routines, prioritizing cosmetic elegance, and connecting UV exposure to visible changes like photoaging are what actually move the needle. “Behavior change isn’t just about education alone,” Baker says. “It’s really about designing habits that are easy to repeat.”

They then step back to review the broader epidemiology. Melanoma incidence continues to rise, driven in part by better detection and more frequent screening, but also by cumulative UV exposure and an aging population. At the same time, mortality has not declined proportionally, largely because more aggressive subtypes don’t follow predictable patterns and are harder to catch early.

When it comes to diagnosis, the fundamentals still hold. Breslow depth, ulceration, and mitotic rate remain central to staging and prognosis.  Layered onto that is a growing role for gene expression profiling (GEP). Tests like DecisionDx and Merlin add another level of biologic insight, helping refine decisions around surveillance, referral, and procedures like sentinel lymph node biopsy.

The throughline is integration. Melanoma care today is about combining prevention, clinical examination, pathology, and tumor biology to more precisely define patient risk and guide management.

The views expressed in this episode are those of the speakers and do not necessarily reflect those of Dermsquared. This program is intended for health care professionals and is provided for educational purposes only.  

Clinicians are responsible for applying independent clinical judgment in patient care.