Why should we have skin cancer screenings?
The statistics for skin cancer are daunting, and speak to the importance of regular skin cancer screenings. Skin cancer is the most common cancer in the United States. One in five Americans will develop skin cancer in their lifetime. Melanoma rates in the United States have doubled in the past 20 years. Melanoma, the most serious type of skin cancer, has a good prognosis if detected early. However, this type of skin cancer can spread quickly to other parts of the body, making it deadly. Quite often, there are no symptoms, and patients are not even aware of the cancerous growth until it is too late. The 5-year survival rate for melanoma that has been detected and treated before it spreads to the lymph nodes is 98%. However, when melanoma is detected in the later stages, the prognosis can be grim. The 5-year survival rate for regional and distant stage melanomas drops to 63% and 17%, respectively. On average, one American dies from melanoma every hour. The most common skin cancers, basal cell carcinomas and squamous cell carcinomas, are highly curable if detected early. These types of skin cancers are usually not life-threatening, but can invade deeper tissues and cause scarring.
If you have no personal or family history of skin cancer, no personal history of dysplastic nevi (abnormal moles) or actinic keratoses (pre-cancers), a skin cancer screening by a qualified dermatology medical professional is recommended yearly. If you have a history of any of the above, a skin cancer screening is recommended more frequently - at least every 6 months. Self-skin-checks at home are recommended monthly, regardless. You should also have an eye exam yearly by an ophthalmologist, as melanoma can also occur in the eye.
Preparing for your skin cancer screening
Do your self-skin-check at home and make note of any new or changing moles, growths, or marks. Make sure to point these out to your healthcare provider at the visit.
Wear clothing that is easy to remove. Try not to wear makeup or anything that can make it more difficult to evaluate the skin. Remove nail polish from the fingernails and toenails. Melanoma can occur under the nails, so these areas should not be overlooked.
The skin cancer screening
At the office, you will be given a gown and asked to undress. Ideally, all clothing, including underwear, should be removed, as well as shoes, makeup and jewelry. All parts of the body will be examined, from head to toe. Your healthcare provider will most likely use a dermascope to aid in examining lesions that need special attention. The dermascope has a magnifying lens and light so that your provider can see pigment patterns and characteristics of the lesion that cannot be seen with the naked eye. Some characteristics of moles that your provider will be evaluating can be summarized in the ABCDEs of melanoma, which is also a good guideline for your self-skin-exams at home.
A A is for asymmetry - if one half of the mole does not match the other half.
B B is for borders - if the border is irregular.
C C is for color - if the color is not uniform, or if the color is very dark.
D D is for diameter - if the size of the lesion is greater than 6mm (pencil eraser).
E E is for evolution - if the lesion is changing, especially suddenly.
Other types of lesions that your healthcare provider will be looking for include red or pink growths or patches that can be scaly or bleeding. A growth or patch that started off looking like a pimple or injury but has not healed in the normal expected time is worth testing, to rule out basal cell carcinoma and squamous cell carcinoma.
Sun protection and sun avoidance can help minimize your risk of skin cancers. It is important to wear a broad-spectrum sunscreen of at least SPF 30 daily, on sun-exposed areas. It is also important to reapply sunscreen every 1-2 hours. Regular skin cancer screenings by a trained dermatology provider are important to ensure that skin cancers are not overlooked and are treated in a timely fashion should they arise.
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