What if I find something suspicious?
It's important to know the difference between melanoma and a
harmless mole. A normal mole is most often an evenly colored brown,
tan, or black spot on the skin. It can be either flat or raised. It can
be round or oval. Moles are usually less than 1/4 inch across, or about
the width of a pencil eraser. Moles can be present at birth or they can
appear later. Several moles can appear at the same time.
Once a mole has developed, it will usually stay the same size,
shape, and color for many years. Moles may fade away in older people.
Most people have moles, and almost all moles are harmless. But
it is important to recognize changes in a mole — such as its size,
shape, or color — that suggest a melanoma may be developing.
Be sure to show your doctor any area that concerns you. A
qualified doctor should be able to identify any suspicious areas you
may have. If your doctor suspects you might have skin cancer, he or she
will use one or more of the following methods to find out.
History and physical exam
Usually the first step is to take your medical history (ask
questions about symptoms and risk factors). The doctor probably will
ask your age, when the mark on the skin first appeared, and if it has
changed in size or appearance. You may also be asked about past
exposures to known causes of skin cancer and if you or anyone in your
family has had skin cancer.
During your physical exam, your doctor will note the size,
shape, color, and texture of the area in question, and if there is
bleeding or scaling. The rest of your body may be checked for spots and
moles that may be related to skin cancer.
The doctor may also feel the lymph nodes (bean-sized
collections of immune system cells) under the skin near the suspicious
area. Some skin cancers may spread to lymph nodes. Affected lymph nodes
may become larger and firmer than usual.
If you are being seen by your primary doctor and skin cancer
is suspected, you may be referred to a dermatologist (a doctor who
specializes in skin diseases), who will look at the area more closely.
Along with a standard physical exam, many dermatologists use
dermoscopy (also known as epiluminescence microscopy (ELM),
surface microscopy, or dermatoscopy) to help determine if a spot might be a
melanoma or other type of skin cancer. This involves the use of a
dermatoscope, which is a special magnifying lens and light source held
near the skin. Sometimes the doctor will use a thin layer of oil with
this instrument. A digital or photographic image of the spot may be
taken. The use of these tests by experienced dermatologists can improve
accuracy in finding skin cancers early. It can also often reassure you
that a lesion is benign (non-cancerous) without the need for a biopsy.
Skin biopsy
If the doctor thinks that an area of skin might be cancerous,
he or she will take a sample of skin from that area to look at under a
microscope. This is called a skin biopsy. Different methods can be used
for a skin biopsy. The choice of method depends on the possible type of
skin cancer, where it is on the body, and the size of the affected
area. For more detailed information on biopsies, see our documents,
Melanoma Skin Cancer
and Skin Cancer: Basal and Squamous
Cell.
If a spot is found to be cancerous or pre-cancerous, your
doctor may recommend further tests or treatment. If the spot is small
and localized, a more extensive biopsy or some type of surgery may be
needed. For cancers that might be more extensive (especially
melanomas), imaging tests might be done, and treatment might include
chemotherapy or radiation. Again, for more detailed information, see
our skin cancer documents.
Additional resources
More information from your American Cancer Society
The following information may also be helpful to you. These
materials may be ordered through our toll-free number,
1-800-ACS-2345.
National organizations and Web sites*
In addition to the American Cancer Society, other sources of
information and support include:
American Academy of Dermatology
Toll-free number: 1-888-462-3376 (1-888-462-DERM)
Web site: www.aad.org
National Cancer Institute
Toll-free number: 1-800-422-6237 (1-800-4-cancer); TYY: 1-800-332-8615
Web site: www.cancer.gov
Skin Cancer Foundation
Toll-free number: 1-800-754-6490 (1-800-SKIN-490)
Web site: www.skincancer.org
No matter who you are, we can help. Contact us anytime, day or
night, for information and support. Call us at
1-800-ACS-2345 or visit www.cancer.org.
References
American Cancer Society. Cancer
Facts and Figures 2009.
Atlanta, Ga: American Cancer Society; 2009.
Carucci JA, Rigel DS, Friedman RJ. Basal cell and squamous
cell carcinomas of the skin. In: Lenhard RE Jr, Osteen RT, Gansler T,
eds. Clinical Oncology.
Atlanta, Ga: American Cancer Society;
2000:563-576.
Food and Drug Administration. FDA Proposes New Rule for
Sunscreen Products. 2007. Available at:
www.fda.gov/bbs/topics/NEWS/2007/NEW01687.html. Accessed April 2, 2008.
Food and Drug Administration. Sunless Tanners and Bronzers.
2006. Available at: www.cfsan.fda.gov/~dms/cos-tan4.html. Accessed
April 2, 2008.
Levy SB. Sunscreens and Photoprotection. eMedicine. 2006.
Available at: www.emedicine.com/derm/topic510.htm. Accessed April 2,
2008.
Meadows M. Don't Be in the Dark About Tanning. FDA Consumer.
2003;37:16-17. Available at:
www.fda.gov/fdac/features/2003/603_tan.html. Accessed April 2, 2008.
Naylor MF, Rigel DS. Current concepts in sunscreens and usage.
In: Rigel DS, Friedman RJ, Dzubow LM, Reintgen DS, Bystryn JC, Marks R,
eds. Cancer of the Skin.
Philadelphia, Pa: Elsevier Saunders;
2005:71-83.
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