Detecting and Diagnosing Skin Cancer
Skin cancer is the most common form of cancer in the United States. The good news is that it’s highly treatable when found early. The key is knowing what to look for on your skin, along with annual skin check exams from your doctor to look for any unusual areas that should be tested.
Monthly Self-Exams Increase the Likelihood of Early Detection of Skin Cancer
Performing self-exams to check for skin cancer signs is an easy and effective way to be proactive about your health. The Skin Cancer Foundation recommends head-to-toe self-examinations of the skin once a month and an annual exam by a dermatologist once a year. Lesions, ulcers, or tumors on the skin should be checked out by a dermatologist or skin cancer specialist right away.
What to Look For on Your Skin
It can be challenging to identify which marks on your skin are normal and which are not, especially if you’re prone to freckles or moles. The American Cancer Society recommends that you be on the lookout for an “ugly duckling” on your skin — any mark that looks different than all the others.
A for Asymmetry: Half of the mole or mark doesn’t match the other half.
B for Border: Irregular, jagged, blurry or notched edges.
C for Color: Non-uniform color that includes different shades of black, brown, red, white, pink or blue patches.
D for Diameter: The growth is more than ¼ inch in diameter (about the size of a pencil eraser.)
E for Evolving: The mole is growing or changing color or shape.
Not all skin cancers follow these rules, but many do. When in doubt about any mark or growth on your skin that seems unusual, be cautious and have it looked at by a dermatologist. You should also look for any sores that don’t heal on their own after a few days.
Skin cancer sometimes looks differently for people with darker skin tones. Unfortunately, it's a myth that having dark skin will protect you from skin cancer, which sometimes causes darker-skinned people to miss cancer in its early stages. If you have dark skin, you should pay special attention to spots on your hands, the soles of your feet, and under your nails. This can indicate a particularly bad form of melanoma.
How to Check Your Skin
Checking your skin means taking note of all the spots on your body. Spots typically include freckles, moles, birthmarks, age spots, bumps, sores, scabs, open wounds that bleed, and scaly patches.
For your self-exam, you’ll need a full-length mirror, a hand mirror, bright lighting, and a place to record your findings. When possible, ask someone to help check hard-to-see places.
Examine your body front and back in the mirror, then look at the right and left sides with your arms raised. Women should lift breasts to view the undersides.
Bend elbows and look carefully at forearms, underarms, and palms. Also, check between fingers and under fingernails.
Look at the backs of your legs and feet, between your toes, and the soles of your feet.
Check the back of your neck and scalp with a hand mirror. Part the hair to get a closer look. A hairdryer may be helpful in raising up your hair so it’s easier to see.
Examine your back and buttocks with a hand mirror.
Sun exposure isn’t the only risk factor when it comes to developing skin cancer; that is why it’s important to examine all of your skin, including places that aren’t often (or ever) exposed to the sun or UV rays.
Resources for Tracking Changes in Your Skin
It’s also a good idea to download a body map and record your findings. On a diagram of the body, simply make marks that correspond to the marks on your skin, then draw lines out to the margin to record the approximate size, color, and date. Use the same map to record your findings each month.
Using smartphone apps like SkinVision and MySkinPal can also be helpful in tracking and taking pictures of spots. These apps should never, however, be used for diagnosis.
With each self-exam, you’ll become more familiar with what is normal for you, so anything unusual will draw your attention quickly, and you can have it checked out.
Diagnosing Skin Cancer
In most cases, skin cancer is diagnosed by a general practitioner or a dermatologist as an abnormal area on the skin. However, they won’t know if it’s cancerous or not until it’s removed and tested. This is a biopsy. A biopsy is the only sure way to diagnose skin cancer.
In some cases, your doctor may choose to remove an apparently innocent mole rather than take the risk of allowing it to grow if it’s cancerous.
Your skin biopsy may take place in a doctor’s office or as an outpatient in a clinic or hospital. Where it is done depends on the size and place of the abnormal area on your skin. You probably will have local anesthesia.
There are four common types of skin biopsies:
Punch Biopsy: The doctor uses a sharp, hollow tool to remove a circle of tissue from the abnormal area.
Incisional Biopsy: The doctor uses a scalpel to remove part of the growth.
Excisional Biopsy: The doctor uses a scalpel to remove the entire growth and some tissue around it.
Shave Biopsy: The doctor uses a thin, sharp blade to shave off the abnormal growth.
The dermatologist will never “shave off” or cauterize a growth that might be melanoma. An excisional biopsy will be performed, or if the growth is too large to be removed entirely, a tissue sample will be taken.
Once you have gotten confirmation of a skin cancer diagnosis, the next step is to determine its extent. Staging skin cancer helps guide the treatment plan tailored to your specific needs. If the cancer has grown deep into the skin or has spread to lymph nodes, additional treatments are needed to be sure all of the cancer cells are destroyed after surgery.
Based on the stage, an oncologist will determine which treatments are necessary, creating a personalized skin cancer treatment plan.