Early Detection of Melanoma
Because melanoma usually begins on the surface of the skin, it often can be
detected at an early stage with a total skin examination by a trained health
care worker. Checking the skin regularly for any signs of the disease
increases the chance of finding melanoma early. A monthly skin self-exam is
very important for people who have any of the known risk factors, but doing
skin self-exams routinely is a good idea for everyone.
Here is how to do a skin self-exam:
After a bath or shower, stand in front of a full-length mirror in a well-lighted room. Use a hand-held mirror to look at hard-to-see areas.
Begin with the face and scalp and work downward, checking the head, neck, shoulders, back, chest, and so on. Be sure to check the front, back, and sides of the arms and legs. Also, check the groin, the palms, the fingernails, the soles of the feet, the toenails, and the area between the toes.
Be sure to check the hard-to-see areas of the body, such as the scalp and neck. A friend or relative may be able to help inspect these areas. Use a comb or a blow dryer to help move hair so you can see the scalp and neck better.
Be aware of where your moles are and how they look. By checking your skin regularly, you will become familiar with what your moles look like. Look for any signs of change, particularly a new black mole or a change in outline, shape, size, color (especially a new black area), or feel of an existing mole. Also, note any new, unusual, or "ugly-looking" moles. If your doctor has taken photos of your skin, compare these pictures with the way your skin looks on self-examination.
Check moles carefully during times of hormone changes, such as adolescence, pregnancy, and menopause. As hormone levels change, moles may change.
It may be helpful to record the dates of your skin exams and to write notes about the way your skin looks. If you find anything unusual, see your doctor right away. Remember, the earlier a melanoma is found, the better the chance for a cure.
In addition to doing routine skin self-exams, people should have their skin
checked regularly by a doctor or nurse specialist. A doctor can do a skin exam
during visits for regular checkups. People who think they have dysplastic nevi
should point them out to the doctor. It is also important to tell the doctor
about any new, changing, or "ugly-looking" moles.
Sometimes it is necessary to see a specialist. A
dermatologist (skin doctor) is
likely to have the most training in diseases of the skin. Some plastic
surgeons, general surgeons,
oncologists, internists, and
family doctors also have a special interest and training in moles and melanoma.
Melanoma may run in families, and members of these families are at high risk
for the disease. In some of these families, certain members also have a large
number (usually over 100) of
dysplastic nevi.
These people have an especially high risk of developing melanoma. When two or
more family members develop melanoma, it is important for all of the patients'
close relatives (parents, brothers, sisters, and children above the age of 10)
to see a doctor and be examined carefully for dysplastic nevi or any signs of
melanoma. The doctor can then decide how often each person needs to be seen.
(Doctors may recommend that these family members have checkups every 6 months.)
Anyone who has a large number of dysplastic nevi also should be examined regularly.
A doctor may want to watch a slightly abnormal mole closely to see whether it
changes over time. Pictures taken at one visit may be compared with the
appearance of the mole at the next visit. Sometimes a doctor decides that a
mole should be removed so that the tissue can be examined under a microscope.
The removal of a mole, called a biopsy, is usually done in the doctor's office
using a local anesthetic. It
generally takes only a few minutes. The patient may require stitches, and a
small scar will remain after healing. A
pathologist examines the tissue
under a microscope to see whether the melanocytes are normal, dysplastic, or
cancerous.
Because most moles, including most dysplastic nevi, do not develop into
melanoma, removing all of them is not necessary. A doctor can recommend when
and when not to remove moles. Usually, only moles that look like melanoma,
those that change, or those that are both new and look abnormal need to be
removed.
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