Nearly two years ago, Carl R. Darnall Army Medical Center physician Dr. Joan Ingram noticed something different on the small mole on her inner right ankle.

"One edge looked a little irregular and had gotten a little larger," said the Family Medicine physician who serves as CRDAMC's deputy commander for Quality and Safety. "It wasn't particular angry looking, but there was a slight change."

Even though she had diagnosed melanoma in her patients, she said the changes still didn't jump out at her as a melanoma mole.

Still, she said, it gave her the "willies," so she went to her dermatologist.

A biopsy confirmed Ingram's concerns. It was Melanoma, which was later surgically removed.
An avid cyclist, the cancer-free Ingram said she was doing all the right things to protect her from the sun.

"I was wearing the right clothes and even the right socks that covered the area," she said, adding that she has worn full sun screen since it was invented.

"But when I was a child, we didn't have the high SPF (sun protection factor) sunscreens that we have now," said the former summer life guard, admitting she was one of those teenagers who loved the summer tan. "I was outside a lot."

Ingram's fair skin was the sun's best friend, which resulted in multiple sunburns. It wasn't until medical school she learned how sunburns upped the ante for skin cancer.

"I got tired of getting sunburns, so I became better at prevention," she said, adding that she recommends a sunscreen with a SPF rating of 30 or greater to reduce the risk of sunburns. "A history of four or more sunburns in adolescences more than doubles the risk of melanoma later in life."

Besides the higher SPF rating, Ingram discourages the use of tanning beds.

"You're still exposed to the ultraviolet rays," she said, reminding parents to be diligent about protecting their children. "I really want to inspire people to do the right thing because reducing skin cancers later in life is about reducing sun exposure in childhood."

According to the Centers for Disease Control and Prevention (CDC), "Skin cancer is the most common cancer in the United States. Most cases of melanoma, the deadliest kind of skin cancer, are caused by exposure to ultraviolet (UV) light."

The following options are what CDC recommends to lower one's skin-cancer risk:
• Stay in the shade, especially during midday hours.
• Wear clothing that covers your arms and legs.
• Wear sunglasses that block both UVA and UVB rays.
• Use sunscreen with SPF 15 or higher and both UVA and UVB (broad spectrum) protection.
• Avoid indoor tanning.

May also is Skin Cancer Awareness Month, which Ingram said reminds everyone to do a self-skin exam and enlist a partner to inspect hard to see areas.
"When detected early, skin cancer is highly treatable," she said. "I am just so fortunate to have caught it when I did."
For a detailed list of skin cancer prevention tips and more about Skin Cancer awareness Month, go to the American Academy of Dermatology's website at