Meet the Doctor: Dr. Vernon Sondak

Meet Dr. Vernon Sondak! This year the MRF is excited to have Dr. Sondak participate in our 2020 Virtual Pediatric Melanoma Summit from September 21-25, 2020 to help spread awareness about pediatric melanoma. Get to know more about him below! 

Dr. Sondak is Chair of the Department of Cutaneous Oncology at the H. Lee Moffitt Cancer Center and Research Institute in Tampa, Florida. A graduate of Boston University School of Medicine, he did his surgical training at the University of California Los Angeles. Prior to joining Moffitt in 2004, Dr. Sondak was a Professor of Surgery in the Division of Surgical Oncology at the University of Michigan.

Dr. Sondak holds the Richard M. Schulze Family Foundation Distinguished Endowed Chair in Cutaneous Oncology and is also a Professor in the Departments of Oncologic Sciences and Surgery at the University of South Florida Morsani College of Medicine. He has received numerous awards, including the Golden Scalpel Award (Outstanding Chief Resident) from the UCLA Division of General Surgery, a Distinguished Alumnus Award from Boston University School of Medicine, the William W. Coon Award for Outstanding Faculty Teaching from the University of Michigan Section of General Surgery, and the Rays of Hope Leadership Award from the Shade Foundation of America, devoted to skin cancer education and prevention for children. He is a member of the National Cancer Institute’s Board of Scientific Counselors for Clinical Sciences and Epidemiology, the group responsible for peer review and oversight of the NCI’s intramural research program. He is also North American Vice President of the Melanoma World Society, a member of the Lancet Oncology International Advisory Board, as well as an external advisor to several SPORE grants at other US institutions.

Dr. Sondak is the author or coauthor of over 430 articles in peer-reviewed publications, 238 scientific abstracts, 8 books and 82 book chapters. He has served as a peer reviewer for manuscripts in over 50 different medical journals, including virtually all of the most prestigious surgery, oncology and dermatology journals, and he has lectured all over the world on adult and pediatric melanoma.

Ask the Doctor:

Q: Why did you want to pursue a career in cutaneous oncology?

Since my first year of medical school (1975!) I was always interested in the types of cancer that were taken care of primarily by cancer surgeons (surgical oncologists) and not other types of surgeons. Over the years, that led me to pursue my internship, residency and further specialty training at UCLA – which at the time was one of the leading centers in the world for the treatment of soft tissue sarcomas and melanoma. I split my clinical and research time between these two areas of surgical oncology until I moved to Moffitt Cancer Center in Tampa, Florida in 2004. Once in Florida, it was clear that there a tremendous need for surgical care of patients with melanoma and other forms of skin cancer, and I soon concentrated almost all my efforts on cutaneous oncology. By 2010, we were starting to see dramatic advances and progress in the treatment of advanced melanoma, and it’s been exciting – and very unexpected – to be able to participate in a small way in bringing these advances to patients with melanoma, Merkel cell cancer and advanced skin cancers of other types. As an interesting side-note, although I didn’t know it when I started my medical career studying melanoma, as I learned more about the disease I discovered my own grandmother had died from metastatic melanoma.

Q: How does pediatric melanoma differ from adult cutaneous melanoma?

Obviously, the difference is a lot bigger than just the age of the patient! Pediatric melanoma is defined as any melanoma that begins when the patient is still a “child,” and most people consider age 18 to be the start of adulthood. So we use that cutoff for pediatric melanoma, but we recognize that just because the melanoma started when the patient was under 18 doesn’t mean that it won’t still be a problem in their adult years. Some pediatric melanoma cases today are similar to adult melanoma in every way – and indeed in the past might not have been discovered until the patient was older than 18 and therefore not even recognized as “pediatric.” But other pediatric melanoma cases are clearly different in who gets them, how they look on the skin and under the microscope and how they behave and respond to treatment. The Spitzoid melanomas, which under the microscope look similar to a kind of benign mole common in childhood called a Spitz nevus, are the best example of this kind of pediatric melanoma. Melanomas in very young children, including newborns, tend to be extremely different from adult melanoma – and offer arise from very large birthmarks called giant congenital nevi (“nevi” is the plural form of “nevus”, which is the medical term for a mole). In extremely rare cases, a pregnant woman with melanoma can end up with the melanoma cells spreading to and growing in her unborn child, only to be discovered months after the baby is born. Thankfully this is so rare it hasn’t happened in this country in years, but we make a special effort to work with our pregnant melanoma patients and their obstetricians to be on the lookout for signs of this, and to reassure the family when those signs are not there.

Q: What do you think are the biggest obstacles for pediatric melanoma today and what are ways we can help overcome them?

Just as was once the case many years ago with adult melanoma, a lack of awareness of the disease by patients, family members and medical personnel is the biggest obstacle for pediatric melanoma. Like other forms of skin cancer, the earlier melanoma is diagnosed the better. Many people are aware of the ABCD criteria for differentiating melanoma from normal moles, but not many people realize that pediatric melanomas are much less likely to be picked up using these ABCD criteria than adult cases – and the younger the child the less well the criteria work. But it’s not just patients and families that don’t have a lot of awareness about pediatric melanoma, most pediatricians and even many dermatologists don’t know as much about melanoma in children as we would like them to. Awareness efforts like this series of blogs and social media posts by the Melanoma Research Foundation are a start to improving the situation, but we clearly have a long ways to go.

Q: What advice would you give parents for safeguarding against pediatric melanoma?

Pediatric melanoma is still a very rare condition, but melanoma and other forms of skin cancer in adulthood are extremely common. The common denominator of all these conditions is ultraviolet exposure – so parents should protect their children from the sun as much as possible, and instill good sun protection habits than can last a lifetime. Beyond that, I would urge parents to be aware of their children’s moles and birthmarks and be alert to unusual changes in those skin lesions. If a parent is sure that their child’s mole is changing in suspicious ways, they should insist on the mole being evaluated – including with a biopsy if necessary. As I said before, pediatricians and even dermatologists are not always familiar with pediatric melanoma, so parents have to trust their own instincts.

Q: What do you tell your patients how to best protect themselves from melanoma?

A broad-spectrum sunscreen with at least 30 SPF is very important, but even better is staying out of the sun during peak hours of ultraviolet intensity (10 am to 3 pm, particularly in the summertime). Wearing sunglasses to protect the eyes and sun protective clothing with long sleeves and long pants as well as a broad-brimmed hat that protects the neck and ears as well as the face, are critical – I always say you might forget to put on sunscreen but you rarely forget to put on clothes!

Q: What are you biggest accomplishments since joining Moffitt Cancer Center?

Watching our melanoma program grow and develop into one of the world’s leading centers for clinical care and clinical research during the 16 years I’ve been there has been extremely gratifying. Helping so many young doctors become skilled surgical oncologists in their own rights, many with a specialty in melanoma, is also something I’m particularly proud of. But the success of our pediatric melanoma program is most especially meaningful to me, and watching those kids grow up healthy and embark on their own lives is clearly the best part of my job.

Q: What do you do in your free time?

Like so many of us, the coronavirus pandemic has disrupted what I do in my free time. Before the virus, I regularly played ice hockey – I’m a goaltender – and have always enjoyed doing that. I also enjoy playing golf, but usually don’t have time for that until I go on vacation – so I try to fit as much golf in when I’m taking time off. Of course, I always wear sun-protective long sleeves, a big hat and lots of sunscreen when I golf! Finally, I’ve always done a lot of traveling, often but not always for work, but that of course has been put on hold. I used to fly someplace almost every single week (that’s a lot of frequent flier miles and the people at the airport knew me by sight), but I haven’t flown anywhere since February. I sure hope the situation improves for all of us in the months to come.