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Published on May 12, 2016

Healthy Skin Is In: Rural Missourians Join War Against Skin Cancer

Dermatologists urge prevention, early detection during National Skin Cancer Awareness Month

Life in rural communities often means a life spent under the sun. For 35-year-old Atina Roberts, heavy sun exposure, coupled with her fair complexion, was a combination that could have been deadly. 

At age 33, the Moberly woman was diagnosed with Stage 3 melanoma, a potentially fatal type of skin cancer.

“I basically grew up outdoors, riding horses and working in the hay fields,” Roberts said. “I had a mole on my arm that had been there as long as I can remember. One spring, it started to itch and bleed. That’s when I knew I needed to get it looked at.”

Roberts met with Kristen Fernandez, MD, a dermatologist with University of Missouri Health Care, who quickly had the mole biopsied. The results came back positive for Stage 3 melanoma, meaning the cancer had spread from her skin to her lymph nodes. Roberts soon underwent surgery to have the mole removed, but because of the advanced stage of her diagnosis, she underwent a full lymph node dissection and immunotherapy to kill any remaining melanoma cells and to prevent the cancer from coming back.

Two years later, Roberts is cancer free, and she strongly encourages others to take note of their skin and seek care if they notice a change.

“In rural areas especially, it can be easy to overlook your health because of busy schedules,” Roberts said. “It may be the farmer who’s ignoring spots on his back, but everyone needs to be mindful of their skin. I know how easy it is to make excuses to put off a check-up, but trust me, it’s not worth the risk.”

As part of National Melanoma and Skin Cancer Detection and Prevention Month in May, MU Health Care dermatologists are taking action to prevent skin cancer and reduce the risk of ultraviolet damage.

“This year, more than 76,000 new cases of melanoma will be diagnosed in the United States, and more than 10,000 people are expected to die of melanoma,” Fernandez said. “If we can wage a war on melanoma and raise awareness of the importance of prevention and early detection, we can save lives. When it is detected and treated early, skin cancer can be prevented, and often, cured.”

When working in the sun, Fernandez recommends these skin-protection tips:

  • If possible, limit your exposure to sunlight when UV radiation from the sun is strongest — from 10 a.m. to 4 p.m.
  • Always wear sunscreen if you will be outside in the sun. Choose a sunscreen with broad-spectrum protection against UVA and UVB light, with an SPF rating of at least 30.
    • If you are going outside in the sun, cover yourself in clothing made of tightly woven fabric, which blocks UV light.
    • Regularly check your skin for changes.

“Men are more likely to have a melanoma on their back, and women are more likely to have it on the back of their legs,” Fernandez said. “These are areas that you can easily miss. I encourage everyone to do a self-check once a month. Use a mirror or have a family member look at your skin, starting at your scalp and working your way down. If you have a mole that has changed from your last check-up, contact a dermatologist.”

Fernandez recommends following the A, B, C, D and E signs of skin cancer when examining yourself:

  • A is for asymmetry, when one half of a mole or birth mark doesn’t match the other.
  • B is for border, if the edges of a skin spot are irregular, ragged, notched or blurred.
  • C is for color, when the color of the mole isn’t the same all over and may include different shades of black or brown, or sometimes patches of pink, red, white or blue.
  • D is for diameter, when the spot is larger than six millimeters across — about the size of a pencil eraser.
  • E is for evolution, when a mole changes over time — whether shape, size, color or other changes.

“Despite what you may have heard, there’s no such thing as a safe tan,” she said. “When you tan or sunburn, it is your body’s way of protecting itself from further DNA damage. I grew up in rural Missouri, and I know what it’s like to spend a lot of time outdoors for work and recreation. If you must be outside, always practice sun-protective measures.”

For more information, please visit or call 573-884-4854 to schedule an appointment with a skin cancer specialist.