skin exams for melanoma: how to spot skin cancer before it spreads
6 minute read
only about 20 to 30 per cent actually arise from a pre-existing mole. the remaining 70 to 80 per cent show up as new growths or changes.
adobe
stay up to date on this topic
skin cancer of all types is highly prevalent in canada, with melanoma alone accounting for roughly 11,300 cancer cases each year. as many as one in 24 canadians will develop melanoma in their lifetimes. while melanoma and other skin cancers are curable if caught early, melanoma in particular can be highly deadly if left to spread to other areas of the body.
“thicker melanomas grow into the layers of the skin, so the thicker the melanoma is, so the more it grows into the layer of skin, then the more concerning it is. because if it grows into the deepest layer of the skin, that’s where the blood vessels and little lymph channels are, and that’s how it can spread,” said krista rubin, melanoma nurse practitioner at mass general brigham.
the survival rates of melanoma vary depending on how far its spread, but at stage four, the rate drops significantly to between 16 and 32 per cent. that’s why both prevention and early detection are so vital.
what is melanoma?
many people may assume that melanomas, like other types of skin cancers, tend to come from pre-existing moles. however, that’s not always the case. in fact, only about 20 to 30 per cent actually arise from a pre-existing mole. the remaining 70 to 80 per cent show up as new growths or changes.
it can also be tricky to spot as well.
“do you have a spot on your skin that’s itchy, that’s been bleeding, that seems irritated and it hasn’t gone away? i generally tell people two weeks or more is something that they need to pay attention to,” said rubin.
essentially, an injury, bug bite, or other issue that can arise on the skin can lead to itchiness, bleeding or irritation, but after about two weeks’ time, those symptoms start to dissipate. with melanoma, they tend to last longer.
in some cases, melanomas may present asymptomatically as well, so you won’t notice any irritation or “dark, really kind of ugly” signs on the skin.
advertisement
“that’s what’s challenging about melanoma is that it can be very difficult to diagnose because not all melanomas follow those rules [of having typical visual signs],” said rubin. “some melanomas don’t have really any distinguishing characteristics.”
they can look like simple skin-toned growths or bumps that look far less alarming than what people visualize when they think of melanoma.
“the problem with the kind of education that many of us have had growing up is that we’ve been told to look for dark, ugly spots, something that’s changing, but what about this spot that just kind of appears out of nowhere? not from a mole and may be flesh colour, and we don’t really pay as much attention to it?”
this can be especially true for people with lighter skin tones whose existing moles typically have little pigment.
because melanoma is easily treated and it doesn’t always show up with the same characteristics as people generally think it would, knowing what to look for and how to check for changes is crucial to avoid developing a melanoma that has time to spread to other areas of the body.
how to monitor for melanoma
monitoring yourself for skin cancer can be “intimidating to a lot of people,” but once you have the basics down, it can be a simple way to avoid letting any new growth go unchecked for too long.
one widely recognized way is the abcde method, which involves looking for the following characteristics of changing growth and moles:
- asymmetry (a)
- uneven borders (b)
- a mole that is more than one colour (c)
- the size or diameter (d)
- whether it’s getting bigger, enlarging, or evolving (e)
essentially, you want the mole to have mirror symmetry on both sides so that, if you fold it over, it would fit together perfectly, with smooth, even borders. moles that are malicious can have more than one colour, such as a black mole with red or blue colouring in some of it, so if it is all one colour, it’s less of an alarm. moles larger than a pencil eraser (about 6 millimetres) should also raise red flags, as should moles that continue to grow and change over time.
sponsored by:
wellspring cancer support
advertisement
“if you have a mole that has one or those characteristics or possibly even two, it doesn’t guarantee that it’s a melanoma, but it’s something that you want to pay attention to,” said rubin. “ideally, if there’s any concern, have it checked out by a dermatology provider.”
that said, since some melanomas present differently, there are other things you can do to ensure that even if a spot passes the abcde check, you’re still aware of what’s on your body and whether it warrants medical intervention.
“i liken it to doing breast exams in women in the sense of a woman is doing a breast exam, not necessarily to find a lump, but to be familiar enough with her own breast that she knows whether that lump has been there or that bump or that dimple,” said rubin. “it’s basically to be familiar enough with your body that you can identify a change.”
you can perform this skin exam by standing in front of a mirror and documenting all the spots and moles you see on your body, as well as any bumps that you have. you want to look in “all the nooks and crannies”, so rubin recommends getting in your birthday suit and examining every inch of skin you can, including the genital area, in between fingers and toes, under the breasts, armpits and behind your ears and scalp, working from your scalp down.
it can also be helpful to get a partner or friend to help you look at your back or areas that are hard to see with a handheld mirror.
however, photos are the best bet to ensure that nothing’s changing.
“it’s extraordinarily helpful to provide if you go in and say, ‘this is what it looked like three months ago’ or even three years ago and then compare it to what it looks like today,” said rubin.
keeping track of changes and seeking medical exams if necessary
for some people, checking for any changes in their skin can be done once a year, with rubin noting that she recommends doing it on their birthdays so it’s easy to remember.
advertisement
“i’ll tell people, on your birthday, get in your birthday suit and do an exam,” she said.
for others, though, checking more often may be necessary.
“if you’re somebody that’s had a skin cancer or has a family history of skin cancer and you’ve partnered with your dermatology provider, they may recommend that you do monthly skin exams,” she said. “so, it’s going to vary person to person based on risk, how many moles, how anxious you are, that type of thing. but as a general rule, you want to know where your moles and freckles are.”
by performing the self-exam on a regular basis, or as recommended by your dermatologist, you can help to avoid more invasive cancers in the long run and improve your odds or curing melanoma as opposed to having to treat it.
“skin cancer is essentially curable if caught early. the earlier it’s caught, the more likely the chance of a successful outcome. the surgery is less of a big deal, and then also, approaching 99 per cent cure rates when melanomas are caught early,” said rubin.
“we can avoid that [spread and worsened disease] with early identification and early intervention. so, it’s really important that these are diagnosed early.”
share story
