The ABC's of Skin Cancer

Patients often come to see me after they notice a mole that has been changing or turning darker. If you are concerned about a skin lesion, what should you do and what should you look out for?

The first thing to know is that most skin lesions are benign or non-cancerous.

Most moles — even if cancerous — do not cause symptoms. If a mole is bleeding, shows changes, is raised from the skin or itching, however, you should have it evaluated.

Doctors use the ABCDE system to evaluate moles that are suspicious as either pre-cancerous lesions or a melanoma.

A for Asymmetry— if the mole overall shape is irregular.

B for Border— if the border around is not a circle or ellipse but is more irregular.

C for Color— if the color in the mole is varied or changing with areas that are lighter and darker.

D for diameter— if the mole is getting wider on your skin or is wider than 6mm across.

E for evolution- if the mole has been changing over time.  Moles can become increasingly raised, wider, thicker or appear to be growing.  If you notice any of these signs you should seek medical attention for evaluation with either your primary care physician or a dermatologist.

However, not all melanomas are dark and pigmented.  Studies have shown that frequently patients are the first to detect and bring suspicious moles to the attention of their medical providers.  Once evaluated, your provider may opt to perform a biopsy which is generally done in the office.  The most common techniques include a shave biopsy, punch biopsy or excisional biopsy.  It usually takes a week or so to get the results of the test.

The diagnosis of melanoma can be a very scary and anxiety-provoking time. As a surgical oncologist who oversees our melanoma team, most of my patients have had a biopsy performed by their primary medical doctor or dermatologist before they see me. They are typically referred to me for a treatment recommendation and further management.

Based on my experience, I want to stress the importance of seeing a melanoma specialist at the initial time of diagnosis to review your biopsy in order to develop a definitive and expeditious plan of treatment.

As with most types of cancer, the earlier we find the melanoma the better the chances are that it has not spread, and there is less we have to do to treat it.  I recommend all my patients see a dermatologist for skin cancer screening at least on a yearly basis.  Especially if you are fair skinned and freckled, have had a past history of multiple sunburns, tanning salon use, or other skin cancers.  Less than 10 percent of melanomas are genetic; most are caused by previous UV exposure from the sun.

It is very important to protect yourself from the sun, avoiding the hottest time of the day in direct sunlight, reapplying sun screen, avoid burning and to not use tanning salons.

Jeffrey M. Farma, MD, FACS is  an Associate Professor of Surgical Oncology at Fox Chase Cancer Center.

Read more Diagnosis: Cancer here »