Guide to Performing Monthly Skin Cancer Self-Exams

Shannon Smyth
Guide to monthly skin cancer self-exams 15 Minutes That Could Save Your Life...

With summer in full swing and the intensity of the sun’s UV rays at their peak, it’s a great time to talk about skin cancer detection and prevention. Many people are frightened when they hear the words skin cancer or melanoma; but when detected in its early stages, skin cancer is actually highly curable. While it is certainly important to have your skin examined regularly by a dermatologist, there are some things that you can check for at home.

Checking for Moles Most moles are not dangerous, but there are some things you need to become aware of when examining them.  Moles that are of concern medically are those that appear after the age of twenty and look and feel different than other existing moles. The best rule of thumb is to look for apparent changes in a mole’s color, height, size or shape. If you notice changes in a mole’s appearance, shape or size, or if you notice a mole that is bleeding, oozing or itchy, you should have it checked by a dermatologist. The same thing can be said if a mole appears scaly or if it suddenly becomes tender or painful. When examining moles on the body, the most important thing to check for is a change in appearance. If you see any signs of a change in an existing mole or if you happen to notice a new mole, you should see a dermatologist. Guide to performing monthly skin cancer self exams #skincancer #melanoma The ABCDEs of Moles The best way to check moles is to examine your skin with a mirror. You can also ask someone to assist you like a spouse or a friend. It is important to pay special attention to any areas of the skin that are often exposed to the sun such as the hands, arms, chest, face and ears. Dermatologists like to refer to the analogy of the ABCDEs of moles because it is easy to remember. If a mole displays any of these characteristics when you examine it, you should have it immediately checked by a dermatologist because it could be cancerous.
  • A - Asymmetry. If one half of the mole is not symmetrical with the other half in size, shape, color or thickness.

  • B - Border Irregularity. If the border or the edges of a mole are irregular, blurred or ragged.

  • C - Color. The color or pigmentation of a mole should be uniform, not with shades of black, brown, tan, blue, red or white.

  • D - Diameter. The typical diameter of a mole should be the no larger than the eraser of a pencil.

  • E – Elevation or Evolution. If any portion of a mole appears elevated or it is raised away from the skin. Or evolution – if any changes occur in a mole.

These are all signs of moles that should be checked by a dermatologist.

How to do a self-check for skin cancer

An annual skin exam with a dermatologist is recommended.  But monthly self-exams are also recommended to look for any signs or changes. When caught early, most forms of skin cancer are curable.

Self-check procedure:
  1. Examine your face using a mirror to get a clear view. Check your skin, your nose, lips, mouth and ears front and back looking for subtle changes.

  2. Check your scalp next. You may need to use a blow dryer and a mirror to expose different sections of the scalp. Get the help of a family member or ask your hairdresser to check also.

  3. Check your hands and palms, making sure to look between the fingers and under the nails. Continue up the wrist and examine both the front and back of each of your forearms.

  4. Standing in front of a full-length mirror, check your elbows and your upper arms.  Don’t forget the underarms.

  5. Focus on the neck, the chest, and the torso next. Women should also lift their breasts and check the underside skin as well.

  6. Using a full-length mirror and a hand mirror, thoroughly inspect the back of your neck, your shoulders, the back of your upper arms and anything else you can comfortably examine or could not get to in the steps above.

  7. Continue this process using both mirrors scanning your lower back, your buttocks and the backs of both legs.

  8. Finally, sit down and prop each leg up on a stool or a chair. Using a hand mirror, examine your genitals as best you can. Also be sure to check the front, and the sides of both of your legs, top to bottom. Don’t forget your ankles, the top of your feet and between your toes and under your toenails as well. Last but certainly not least, be sure to examine the bottoms of your feet and your heels.

Advanced ways dermatologists can check for skin cancer

Mole mapping utilizing digital dermoscopy is one of the most advanced ways to detect and diagnose skin cancer. With the number of melanoma cases increasing significantly in recent years, this kind of early detection is extremely important. Mole mapping is a process that uses a medical camera that takes whole body photographs. This technology documents or “maps” the location of at risk moles by taking high-resolution microscopic photos. Using this technology, the data for each mole can be analyzed, measured and stored in a digital database. Follow-up visits are then compared to the original data to check for subtle changes. Detecting these very subtle changes using this kind of process is a wonderful way to catch cancer in its very early stages.

Skin cancer is one of the most common forms of cancer around the world. The best form of treatment is early diagnosis and prevention, and this kind of technology makes it easy. The cure rate for early diagnosis is more than 95%, which is very promising.  If you have a history of skin cancer, or if you have a lot of moles, this kind of procedure may be suitable for you. Some other things to consider if you are wondering if mole mapping is right for you are:
  • You have more than 50 moles on the body.

  • You have a family history of skin cancer.

  • You have already had a melanoma.

  • You find moles that are large, or more than 2 inches.

  • You notice changes in your moles.

  • You notice a new mole.

  • You experienced severe sunburn as a child or adolescent.

  • You have extremely sensitive or light skin.

Your risk of skin cancer can be greatly diminished if you continuously perform self-checks, visit your dermatologist for regular check-ups, and protect yourself from the sun using various sun blocking products. The best cure for skin cancer is early diagnosis and prevention. By performing regular self-exams, you will be in tune with your body and you will be sure to notice those subtle little changes. Always check in your dermatologist if you have any questions or concerns. About the contributor: Lisa Rhodes, MD is a Board Certified Dermatologist at Westlake Dermatology & Cosmetic Surgery, an Austin, Texas based dermatology practice. Subscribe to A Girl’s Gotta Spa! Watch our reviews on YouTube, see our pins on Pinterest and check us out on Instagram and G+. Got a Kindle? We’re on Kindle too!

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Melanoma Survivor Story Q & A

Shannon Smyth3 comments
If you are local here in Northeast PA, then you may be aware that our very own Amanda, a DJ on 98.5KRZ, is a melanoma survivor. Amanda is a vibrant personality who is the picture of health. However, at the young age of 25, Amanda noticed something unusual about her skin that led her to obtain a shocking diagnosis: Melanoma cancer.

Since May is Melanoma Awareness Month, I recently interviewed Amanda to find out how she discovered the abnormality and what she is doing now to protect herself from skin cancer.

Q: How old were you when you first noticed that something wasn't right about your skin?

I was 24 when I first noticed what I called a “mark” on my breast. I didn’t call it a mole at first because it was just a dot and it had just recently appeared. (Or at least I had just noticed it was there.) It was something I noticed one day when I got out of the shower and ignored for a few months until I saw that it had changed.

Q: Can you describe what Melanoma looked like?

When I first noticed the “mark” in question, it was a small dark dot. Almost like the tip of a black Sharpie marker. A few months later, it was a larger dark dot that now had a brownish rim around it. The dark center had a faded brown rim with uneven edges that almost looked smeared.

At this point, it was the size of a pencil eraser. I showed a friend and continued to show her every couple of weeks so that she could tell me whether or not she thought it was changing. I didn’t want to overreact about it, but at the same time I kept reminding myself that I didn’t remember ever seeing it there before.

I kept saying that and that gut feeling is what ended up saving my life. I knew that “dot” was turning into a growing, darker mole, was not there before.

Q: Prior to this point, would you say you had a good handle on understanding what Melanoma was?

NOT AT ALL. Actually, I didn’t even really know what Melanoma was or how serious is it. I knew enough about skin cancer to know that it was a red flag to have a mole that is changing, which is the only reason I ended up addressing the mole with my doctor.

Q: Leading up to this, had you been wearing sunscreen on a regular basis?

 No, but I also wasn’t a sun worshiper. Sunscreen was one of those things I would apply if I remembered to, but it wasn’t a priority. I always felt some level of heat exhaustion when I was out in the sun, so I never stayed out in it long in the first place. But before Melanoma, hats were a fashion accessory, not a sun safety must.

Q: Had you ever used a tanning bed or had multiple sunburns?

I have to admit, as much as I wish I never had, I did use tanning beds, but not regularly. If I had to guess, I’d say I probably used a tanning bed between 20-30 times in my life. Just a few times before special occasions to "get a base."

It sounds so stupid now, but I either didn’t know better or didn’t care. Had I known the fear I would feel just a few years later, I would have never directly put myself in that kind of danger.  As far as sunburns go, I grew up in New England and spent some time at the beach growing up, so I’m sure I had a few sunburns, but I can’t recall anything significant. (It only takes 6 sunburns in your lifetime to put you at risk for skin cancer.)

Q: How long did you wait until you asked a medical professional about it?

I waited far too long to show a doctor. Silly me, time was ticking. It was about 6 or 7 months from when I first noticed the “dot” until the “dot” grew into a dark weird shaped mole. Still then, I watched it.

It continued to grow and look funnier for a few months. I continued to show a friend who is very active with the American Cancer Society and her reaction is what made me finally realize I needed to say something.

I didn’t actually see a doctor about it until almost a year after I first noticed that something was up. For anyone reading this who is questioning a mole - PLEASE DO NOT WAIT! Waiting was extremely stupid, but I wasn’t educated enough to know I was allowing the cancer time to spread.

Melanoma Survivor Story Q&A #melanomaawareness #melanoma #skincancer

Q: Once you saw a doctor, what happened next?

I first showed my gynecologist because the mole I was watching was on my breast and because I wasn’t sure it was something to worry about, I waited until my yearly check up. It was very dumb to wait for it to be convenient to get it checked out, but my appointment was coming up and I just figured that would be a good time to show the doctor.

When I showed her what I was worried about, she got serious. She told me I needed to call a dermatologist the moment I left her office and tell them that my doctor said I needed to be seen immediately. I wasn’t expecting the urgency; probably because I didn’t have the slightest clue how fast Melanoma spreads or how serious it is. (While my gynecologist doesn’t know skin as well as a dermatologist, since my experience, she has made an extra effort to check her patients for suspicious looking moles in private areas that primary doctors don’t typically see.)

I called the dermatologist (I was a new patient, I didn’t have any reason to see a derm before) and scheduled an appointment. Next thing I knew, I was having 3 moles removed for biopsy. The one on my breast was the only one I knew about and was worried about. Little did I know, there were 2 more pre-cancerous moles living on me. One was on my back, the second on my other breast. The suspicious mole on my right breast actually was Melanoma.

When my dermatologist first called, I was on the air and told him I couldn’t talk. We were in the middle of our show and to be honest, I wasn’t expecting him to say anything bad. He said he’d stay a little late that night to call me back and give me the news when I got off the air.

When he called again an hour later, he told me that a team of experts reviewed my case and diagnosed me with Melanoma. He then said I would be requiring another surgery immediately. My eyes filled with tears, but to be completely honest, I wasn’t really sure what Melanoma even was.

He told me that my oncologist would be calling in the morning to schedule the surgery because they feared that the cancer may have already begun to spread to my lymph nodes. Wait, I need an oncologist?  Isn’t that a cancer doctor? So for anyone who are under the impression that it’s “just skin cancer, they can just scrape it off,” that is very far from reality and that has become a statement that will throw me right into sun safety preach-mode.

He told me not to go home and Google or look it up on Web MD because the information is very scary. Of course, that’s exactly what I did. To say that I was scared out of my mind doesn’t even begin to describe what I was feeling. I felt dumb. Why did I wait so long to see the doctor? Did I do this to myself?

The surgery was painful. I am sharing these details with hopes that it will reach someone and change the way they think about their time spent in the sun. I don’t wish this experience on anyone, but I am grateful to have caught it in time to warn others.

In order to find which lymph nodes the cancer would likely spread to, I was brought down to the radioactive medicine department and had a radioactive tracer dye injected direction into my areola. (The mole site was nearby.)

I was told this lymph scan with dye is the same scan that breast cancer patients also receive before surgery. To say that the dye stung is a gross understatement. I laid there on a cold metal table surrounded by doctors, weeping. It burned. The injection site and my whole chest burned like it was on fire.

They injected this dye 5 separate times. Wearing a thin paper robe, naked from the stomach up, sobbing on a cold metal table. I laid there for an hour while the machine showed the doctors where to operate and which lymph nodes to remove. I’ve read that this is often done while under general anesthesia, but for me it was not and it was extremely painful. The gist – this is not fun.

Later that day, they put me under and they removed a bunch of lymph nodes (sentinel lymph node biopsy) from under my right arm. In addition to the lymphadenectomy, my surgical oncologist also did a wide local excision of the mole site and the surrounding area. They cut and scooped a 4 inch area on my breast to get all of the infected cancer cells out.

The doctors said it looked like the cancer had just begun to spread to my lymph system, but we literally caught it “just in time” before it got any further. Of course, we didn’t get this news until 1.5 weeks AFTER the surgery.

Telling this story back now loses some intensity because it lacks the time spent worrying in between appointments. The waiting was the worst part. There are weeks in between biopsies that you have absolutely no idea what you’re facing. All you can do is wonder. Is it that bad? Am I catching it in time? Will I have a chance to fight it?

While recovering at home and waiting for the results from this surgery, I daydreamed about my future with my then boyfriend, now husband. I wondered if we’d even have a chance to live the life we dreamed of together (update: we are now married with two beautiful girls.)

My mom was also wonderfully supportive through all of this (especially the waiting) and often reminded me not to worry until there was something to worry about. I was blessed with a chance to tell you what I went through because thankfully, we caught it just in time.

What I learned from this that I hope you take with you, is to know your body. I essentially caught this myself. Melanoma is the fastest spreading skin cancer and the deadliest. It spreads so fast that waiting to get something checked out can cost you your life.

Q: How has Melanoma changed the way you spend your time outdoors and sun safety in general?

Melanoma has changed everything about the way I spend time outdoors. I don’t just hang out outdoors. I go out and live a normal social life, but I take extra steps to make sure I’m prepared to protect myself. I use sunscreen like a regular moisturizer. ALL THE TIME. I’m obsessed with protecting my skin from the sun and I now feel like it’s my duty to educate others about sun safety.

I don’t go to the beach and hang out. I don’t spend long periods of time out in the sun and I don’t drive around during peak hours with my sun roof open. Work wise, I work in radio and we often do live broadcasts outdoors at concerts. Before Melanoma, you would likely find me bopping around all over the place, now you’ll find me under the tent.

My first vacation after Melanoma was terrifying. I was scared to be outside, but realized I also can’t stop living. I went armed with sunscreen, hats and cover-ups. I no longer look at hats as just fashion accessories, but as MUSTS that also happen to be cute. Melanoma is not going to stop me from looking cute, but I am going to embrace being pale.

I try every new sunscreen that hits shelves and have found some favorites that also give a nice glow and even shimmer. The main thing is that now I’m using it! I also wear sunglasses every day. While they are also cute fashion accessories, Melanoma can also form on your eyes and they need to be protected too. I keep a pair of sunglasses on me at all times.

My experience with Melanoma has left me with an overall sense of paranoia about my own skin that I like to just call awareness. I constantly check myself for new “marks” (I still call them that) and even take pictures of moles that I think may be changing. Sometimes I start to convince myself something doesn’t look right because it’s a fear, but that fear stems from learning how serious Melanoma is.

Since my surgery, I have had a few scares and other procedures done. For a 6 month span, I had MRI’s done on my brain because there was fear that the Melanoma had spread there. I also had another mole removed from a very private place that NEVER sees sun. I literally mean NEVER. I also found this myself. Again, I caught this in time before it spread.  

This was another frightening reminder that this is going to be a never ending battle with the sun and with my own paranoia and fear of not catching it in time, next time. My current struggle is with trying to find a balance between awareness and living in a constant state of fear.

Q: What key piece of advice do you want readers to know about Melanoma?

The one thing I hope readers take away is that Melanoma is not a beast you want to fight and a worry you want to have. KNOW YOUR BODY. Do a monthly skin check and know what moles already exist and what they look like. Taking pictures helps.

If you start to worry something is changing, measure it. One thing I try to stress to my friends and family is that you have to be your own finder; your doctor doesn’t see you enough to notice small moles that may change. Know your body, know when it’s changing, and speak up when something doesn’t look right! You could save your own life.

Melanoma is the second most common cancer in women between the ages of 20 and 35, and the leading cause of cancer death in women ages 25 to 30.

Early signs of melanoma are changes to the shape or color of existing moles or the appearance of a new mole. They are often referred to as the ABCDE’s of Melanoma.

  • Asymmetry

  • Borders (irregular)

  • Color (variegated)

  • Diameter (greater than 6 mm (0.24 in), about the size of a pencil eraser)

  • Evolving over time

If it looks suspcious - schedule an appointment right away with your dr!

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