By Andrew Lazar M.D.
Nearly every day in my practice as a dermatologist, I diagnose a patient with basal cell skin cancer. It sounds frightening, but it is very treatable. I see a suspicious-looking spot, do a detailed examination and often remove the growth, leaving a small scar and usually a healthy patient.
In addition to striving to prevent skin cancer (applying sunscreen, wearing hats, etc.), the key to preventing yourself from suffering from it is, as with so many cancers, early detection. Here’s how to detect the most common form of cancer in the U.S. and when to seek medical attention.
Basal cell is one of three main types of skin cancer. The other types are squamous cell and melanoma.
Roughly 95 percent of skin cancers are of the basal cell variety, which manifests itself as a spot that does not heal, looks different than other spots and bleeds more easily if you rub it. Basal cell-infected spots appear most often around the face, neck or scalp.
Squamous cell occurs in about 3 percent of skin cancers. You may have squamous cell cancer if you notice a mole that will not heal, and it often resembles a wart because of its crustiness and scaly appearance.
Malignant melanoma (1.5 percent) is the least common form of skin cancer, afflicting about 1 in 70 Americans during their lifetime, but it is the most dangerous. Nine of every 10 skin cancer deaths are due to melanoma, which kills one American every hour.
Melanoma-malignant moles will appear different than other moles on your body, often emerging on the neck, upper back and trunk of men and lower legs of women. I recommend the “A-E test” to analyze a mole:
A) Is the mole not symmetrical?
B) Is the border jagged or scalloped—as opposed to smooth?
C) Is there a mixture of colors in the mole?
D) Is the diameter wider than the eraser on top of a pencil?
If you suspect the answer to any of these questions is yes, dermatologists can conduct an exam to confirm if you are correct.
We then move to question E: Does the mole evolve and change appearance? If it does not change, it’s not cancerous. If it does, we can still often treat it successfully. More than 95 percent of patients survive for at least five years when we catch melanoma before it spreads to the lymph nodes.
That’s another reason why early detection is so important in mitigating harm from skin cancer—especially if you have a family history, which places you at greater risk.
Roughly 1 in 5 Americans will get skin cancer in their lifetime. Even if you have a lot of moles, that does not mean any of them are more likely to be malignant.
If you are not sure whether a spot is a sign of cancer, visit your dermatologist. (Patients with my medical group can also securely e-mail pictures of suspicious-looking growths.) We can make diagnoses clinically or via a biopsy. Many times a quick, simple exam is all you will need to rule out cancer and head home relaxed.
Want to know more about skin cancer detection? Check out this page from the American Academy of Dermatology, which has several links to visual aids.
Andrew Lazar, MD, is a board-certified dermatologist with the Mid-Atlantic Permanente Medical Group. The group’s dermatology chief in its Washington service area, Dr. Lazar has chaired the American Medical Association’s Dermatology Section. He sees patients at Kaiser Permanente’s Capitol Hill Medical Center.