By Maryann Mikhail, MD
Skin cancer is by far the most common type of cancer in the United States. It is also the only type of cancer we can physically see before it becomes a problem. There are 3 main types of skin cancer: Basal Cell Carcinoma, Squamous Cell Carcinoma and Malignant Melanoma. Basal and Squamous Cell skin cancers generally occur in sun-exposed areas and, while the likelihood of spread is low, can cause disfigurement if left untreated. Melanoma can happen anywhere on the body, most commonly on the back in men, the arms and legs in women, and on the hands or feet in people of color. While melanoma accounts for less than 1% of skin cancer cases, it is responsible for the vast majority of skin cancer related deaths. Regardless of race or age, everyone should regularly conduct self-skin exams to check for signs of skin cancer. Here is what to look for:
1) New Growths
Skin cancer has to start somewhere. Most often, it is a new growth or spot that appears on the body, continues to change, and increases in size. This includes pimples that do not heal and scars that appear without a history of trauma. While there are many non-cancerous (benign) growths that occur over a lifetime, every new spot should be evaluated by a dermatologist and monitored to be sure.
2) Growths that Scab or Bleed
Cancer is defined by uncontrolled growth. Oftentimes, the speed of growth outpaces the blood supply, resulting in cell death and non-healing. A persistent sore or ulcer, a spot that bleeds spontaneously, or any lesion that repeatedly scabs could be an underlying skin cancer or pre-cancer. As a general rule, if a spot has not healed within 3 weeks, it should be considered suspicious.
3) Symptomatic Growths
The body has an interesting way of communicating. Skin cancer may, in some cases, be associated with changes in sensation. Any mole or growth that is itchy, painful, or bothersome should be evaluated.
4) The ABCDEs
The ABCDE rule is a guide to help distinguish melanoma from benign moles. Any pigmented lesion that exhibits the following traits should be considered suspicious and checked by a dermatologist:
A – Asymmetry: One half of the spot does not match the other.
B – Border: The edges are jagged, notched or blurred instead of smooth, round or oval.
C – Color: There is more than one color in the same spot.
D – Diameter: The spot is larger than a pencil eraser (6 millimeters across).
E – Evolution: Change in size, shape, color or appearance.
Of the ABCDE criteria, the E is most important. By definition, cancer grows, making change the most important factor in identification of melanoma.
5) The Ugly Duckling
Nevi in the same individual tend to resemble each other in size, color, shape, and clinical pattern. Any outlier, or spot that looks different from the rest, should be considered suspicious and evaluated immediately.
Early detection and prompt treatment is curative in the vast majority of skin cancer cases. Any spot that is new, changing, growing, itching, bleeding, scabbing, violates the ABCDE criteria, or looks different from the rest should be considered worrisome and brought to the attention of a dermatologist immediately.