Skin cancer detection

Main

Skin cancer detection is the process of identifying cancerous growths on the skin early before they spread. Early detection is crucial because when caught early, the 5-year survival rate for melanoma is 99%, but drops to only 27% once it spreads to distant organs.

Techniques for skin cancer detection include:

1. Self-exams: Regularly checking your own skin from head-to-toe, ideally monthly, to look for any new, changing or unusual spots, especially moles. Use the ABCDE criteria: Asymmetry (one half looks different from the other), Border irregularity, Color that is not uniform, Diameter greater than 6mm (size of a pencil eraser), and Evolving size, shape or color.

2. Professional skin checks: Having a dermatologist or other healthcare provider thoroughly examine your skin, typically annually.

3. Dermoscopy: A dermatologist uses a special magnifying tool called a dermatoscope to closely examine suspicious spots. This is done during professional skin checks if needed.

4. Biopsy: Removing part or all of a concerning spot for microscopic examination to definitively diagnose skin cancer. This is done if dermoscopy reveals a highly suspicious lesion.

5. Genetic testing: For people with a strong family history, genetic tests can sometimes clarify their skin cancer risk. This is typically done only for high-risk individuals.

6. Mobile apps: Apps like Miiskin, SkinVision and UMSkinCheck can help you track your moles over time by storing photos and sending reminders for self-exams. However, they do not replace professional evaluation.

Self-exams and professional skin checks should be done regularly by everyone. The other techniques are used by dermatologists as needed based on exam findings. If you notice any concerning spots during a self-exam, see a dermatologist promptly for evaluation.

Terms

• ABCDE criteria: A memory device for the warning signs of melanoma, where A = Asymmetry, B = Border irregularity, C = Color that is not uniform, D = Diameter >6mm, E = Evolving

• Asymmetry: One half of the spot looks different from the other half

• Border: The edges are irregular, ragged, or blurred

• Cancer: A disease in which abnormal cells divide uncontrollably and can invade other tissues

• Color: The color is not uniform and may include different shades of brown, black, pink, white, red or blue

• Diameter: The spot is larger than 6 millimeters (the size of a pencil eraser)

• Evolution: The spot looks different from the rest or is changing in size, shape or color

• Mole: A common growth on the skin that is usually tan, brown or flesh-colored

• Skin cancer: An abnormal growth of skin cells, most often developing on areas exposed to the sun

Analogy

Detecting skin cancer early is like catching a weed in your garden before it spreads and takes over. Just as you would routinely inspect your plants, looking for any suspicious growths to remove promptly, you should regularly scan your skin for any concerning spots and quickly have a dermatologist take a look.

Misconception

Many people think they only need to worry about skin cancer if they have a family history or if they had bad sunburns as a child. In reality, anyone can get skin cancer, even if they have dark skin or no family history. Bob, who has olive skin and no known family history of skin cancer, was shocked when a mole on his back turned out to be melanoma.

History

1. 1804: The first description of melanoma as a disease

2. 1840s: Skin cancers were surgically removed but often recurred

3. 1960s: Dermatoscopes were developed to better examine suspicious lesions

4. 1980s: The ABCDE criteria for detecting melanoma was established

5. 2010s: Sophisticated technologies like digital mole mapping and artificial intelligence are being developed to aid in early skin cancer detection

How to use it

1. Sarah sets a monthly reminder on her phone to do a thorough skin self-exam. She uses a full-length mirror and a hand mirror to check her entire body, including her scalp, nail beds, between her toes, and genitals. Her partner helps examine hard-to-see areas like her back.

2. At his annual physical, John asks his primary care doctor to do a skin check. The doctor notices a suspicious scaly patch on John's nose and refers him to a dermatologist. The dermatologist does a skin biopsy which confirms an early basal cell carcinoma. It is successfully removed with minimal scarring.

3. Mei takes her 7-year-old daughter Lucy to the pediatrician after noticing a new mole on Lucy's arm that looks different from her other moles. The pediatrician reassures Mei that it is a normal mole but teaches Lucy the ABCDE criteria and advises coming back if the mole ever changes.

Facts

• Every hour, one person dies of melanoma in the US

• Survival for early-stage melanoma is 99%, but drops to 27% if it spreads to distant organs

• Indoor tanning increases your melanoma risk by 75%

• Having 5 or more sunburns doubles your lifetime melanoma risk

• Monthly skin self-exams can cut the melanoma mortality rate in half