If in doubt check it out

Earlier this year, I had a skin cancer check i.e. a specially qualified doctor ‘inspected’ my body to check for anything that already was or might become a melanoma or other skin cancer.  This is something I do regularly and until now has been uneventful. However the outcome this time was that I was advised to have a mole removed. It wasn’t the biggest most obvious mole on my body and I hadn’t noticed that it had changed in any way – in fact it was a small brown ‘mark’ on my lower right leg that had been there for years.

I duly made an appointment for my GP to remove the mole – a simple procedure done with a local anaesthetic. The mole was sent away to a laboratory to be checked and that’s where I thought this story would end. To my complete surprise (and horror), the histology results came back to say that it was ‘melanoma in situ’ i.e. a melanoma waiting to happen.

Melanoma in situ can be thought of as a pre cancer. The cells are in the very earliest stages of melanoma in the top layers of the skin. They have not started to spread or grow into the deeper layers of the skin but if they are left untreated, they can develop into invasive cancer.

So I found myself back at the doctor, this time a specialist melanoma surgeon, who removed more skin from around where the mole had been. The idea being that removing a border of healthy skin from around the ‘melanoma’ will make sure that all cancerous cells are removed. This border of skin is checked in a lab also and I was pleased to learn that it was ‘clear’.  There is very little chance these melanoma in situ cells will come back now they’ve been removed.

Phew – a lucky escape perhaps which has reinforced the need for me to continue to have regular skin cancer checks by a specialist doctor. And in between, to keep an eye on my body myself for changes in moles or other signs of possible melanoma or other skin cancers. Hopefully I can inspire you to do the same.

As we age, we are more likely to see changes in our skin as a result of long-term sun exposure. A quick google of commonly seen skin spots produced a long list of words describing how these might look:

• red, blue, purple, black or pearly dots or nodules (round lumps)
• red spots or plaques with or without spidery like ‘legs’
• flat or raised spots or lumps that may be scaly, crusted or wart-like and can range in colour from pale to dark brown or black
• smooth, waxy, warty surfaces or barnacle-like
• single or grouped

With all these possibilities and knowing they can appear anywhere on your body and they may or may not be itchy or painful, the key message is to get anything new or different checked.

People often come into the pharmacy seeking advice about a spot they’ve got somewhere on their body that isn’t going away – they might describe a never-ending cycle of bleeding, then scabbing over but not ever going away.  Others ask for wart treatments to self-treat something that doesn’t look like a wart to me.  I always try to convince them that getting it checked is best. And it’s best to get it check before you any treatment yourself.

Melanoma New Zealand recommends following the ‘Ugly Duckling Rule’ – if you notice a mole or skin lesion that looks out of place or feels different from others, see a doctor.

Melanomas can often be detected using the ABCDE system, although not all melanoma lesions show these characteristics. (See guide below)

Not all spots, bumps or lumps are skin cancer but if melanoma is diagnosed early then it can be removed with minor surgery, thereby eliminating its potential to spread round the body.

Treatment may be recommended for other types of skin cancer too. And if it’s not cancer then there might be several options for what to do depending on if a spot bothers you because of how it looks.

Summing up, my message to you is to check your body regularly;

• check all-over including skin not normally exposed to the sun.
• ask someone else – family member or friend – to check difficult-to-see areas such as your back, the back of your neck and your scalp.

Useful websites with more information:

https://www.melanoma.org.nz/melanoma/early-detection/

http://www.dermnetnz.org/

Written by: Jenny Cade

This blog pro­vides gen­eral infor­ma­tion and dis­cus­sion about med­i­cine, health and related sub­jects.  The information contained in the blog and in any linked mate­ri­als, are not intended nor implied to be a substitute for professional medical advice.