Skin Cancer Detection
What are the malignant melanoma warning signs?
Malignant melanoma, which is an atypical mole that is having both abnormal growth and biological behaviour, has to be distinguished from normal moles. There are approximately twenty-five to thirty normal moles per person, so that is asking someone to be able to tell the difference between something that belongs there from something that is slightly different than something that belongs there. We use a pneumonic; A, B, C, D and E to look for some of those moles which are of greater concern. A stands for asymmetrical, which means that the mole is different on one side than it is the other. B means border irregularity, which means that the borders are not sharply demarcated. C is colour irregularity, which means the colour is not one uniform colour throughout. D is a diameter greater than a pencil eraser (six millimetres). E means evolving, or a lesion that's changing. I tell my patients that if it looks like a mole was put on by a draughtsman, it's probably ok.
What are the nonmelanoma warning signs?
There are numeral legions that occur on the skin, most of which are benign. When we ask patients to let us know those legions that they're concerned about, that they're worried about, or those legions to bring into a doctor, we're asking a rather sophisticated question: which is to differentiate between all the little bumps and lumps on your skin, and those that are okay, and those that are not okay. Primarily any legion which crusts or bleeds or is persistent or is getting bigger over time and does not look like any other legion on your skin, those are strong warning signs for a legion which needs to be brought to a doctor's attention. We normally see these things, malignancies, on sun-exposed areas, so since 90% of skin cancers occur on the head and neck that would be a common place to look for them. But in any sun exposed areas, such as the arms, the hands, the lower legs as well.
What is a "palpable node" and how can it help detect the spread of cancer?
Most skin cancers—basal cell and squamous cell carcinoma—are localized to the skin, and that's where they do their damage. Unfortunately, malignant melanoma does have the capability, as it grows into the skin, of metastasizing. And the first place it usually metastasizes to is the lymph nodes. The lymph nodes that it goes to are usually the draining lymph nodes, which would be those lymph nodes most geographically in proximity to the atypical mole. When that lymph node has enough tumor in it, it will become palpable—or known as a “palpable lymph node”—that your hand can feel it. That would be—for instance, on the arm, that would be those nodes in the armpit; and on the leg, it would be those nodes in the groin. Finding a palpable node is not something that we would like patients to find because we really want them to find the mole that caused it way before that. Early detection of melanoma is the way to prevent morbidity and mortality from melanoma. Finding a palpable node is not a good sign to have and one that we would prefer to prevent rather than to identify.
