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Melanoma need not be fatal... the ABCs of early detection
Melanoma need not be fatal... the ABCs of early detection All it takes is understanding some acronyms and checking one's own body frequently for the appearance of irregular moles.

Just like in grade school, one of the rudimentary lessons childrenare taught are the ABC's. One of the most important lessons adults need to learn are the ABC's of skin cancer detection, especially the warning signs of potentially cancerous moles, which can appear on any part of the body. I firmly believe that early detection of moles can play a key role in saving people from potentially fatal skin cancers. All it takes is understanding some acronyms and checking one's own body frequently for the appearance of irregular moles. Here are a few of my tips and recommendations for mole detection:

A - Stands for asymmetry. If one divides the mole or growth in half and one side does not equal the other, this should raise a red flag.

B - Stands for irregular border. If the perimeter of the mole is jagged rather than smooth, this too might signal a pre-cancerous condition.

C - Stands for color variation. Color should not be speckled, as in a little black or a little brown. Moles should not present with what is known as a patriotic mole, which can be red, white, and even bluish. This too could signal signs of melanoma.

D - Stands for diameter. A mole growing larger than a pencil eraser or even a small mole that exhibits some of the above characteristics should be checked out. People who have moles that meet any of the above criteria should immediately consult with a dermatologist. I recommend that my patients conduct a thorough, full body self-exam to check for the presence of irregular moles. This exam should occur in spite of the family's medical history or skin type, and should be done at least every few months and at least once a year by a dermatologist. It is best to start at the top with the scalp, as most people do not realize that when they swim, they are exposing themselves to the sun. This is especially important for men who have thinning hair or baldness. For those who have little hair coverage on their scalp, I suggest a sunscreen in a gel or lotion form that will spread more easily in hair bearing areas. After checking the scalp for moles, people should proceed to the neck, ears, and face, looking closely at the eyelids, lips, and corners of the nose, which can often be overlooked. These are areas of the body where one can often detect the most common forms of skin cancer. The other area, surprisingly, and especially among women who are quick to use sunscreen to ward off the aging effects of the sun on their faces, are the legs. The number one spot for melanomas among women are the legs, especially for women who often seek to tan their lower extremities.

I suggest that for parts of the body difficult to see, that people use a mirror or have a friend or spouse examine them. It is important to look underneath the arms, around the genitalia, on the legs, feet, and even between the toes. Many people mistakenly think that if an area such as between the toes are not exposed to the sun, then they are not at risk for melanoma. This is absolutely false. Melanoma can also be genetically determined; therefore, sometimes occurring in non-sun exposed areas. A suspicious growth does not always signal melanoma. It could be a basal cell skin cancer, a squamous cell, or a dysplastic mole. The latter is an abnormal mole that possesses some of the same characteristics mentioned in the ABC's. The distinction is that the cell type is abnormal, but not abnormal enough to label it a skin cancer. Some dermatologists do feel that these dysplastic moles can be precursors to malignant melanoma. Many times, we see severely dysplastic moles or a history of melanoma, which can be grouped into a syndrome called dysplastic nevus syndrome. Those who fall into this category need to be closely monitored. Statistically, their chances of developing melanoma can be higher. Even those people without a history of suspicious moles should obtain a complete skin exam once a year by a dermatologist.

Who is most at risk for melanoma? Everyone is at risk. There have even been some cases of African Americans developing melanoma. Everyone can take steps to avoid melanoma by protecting the skin from the sun by a sunscreen containing an SPF 15 or higher. It may be surprising to some, but a tan is the body's defense mechanism. Even those who tan rather than burn are at risk, it may simply take longer for them to develop skin cancer. People are also misguided regarding the use of tanning beds. Tanning booths have been popular for some time. Although the UV rays emitted from the bulb are UVA rays rather than the UVB rays more commonly associated with burning, the UVA rays penetrate deeper in the skin and cause more premature aging and wrinkling than the sun.

At present, there is a higher incidence of melanoma than ever before, which is due in part, to the thinning ozone layer. Each year, over 1 million cases of skin cancer are diagnosed in the United States. This means that one of about 320 people will be diagnosed with skin cancer in his or her lifetime. It is the most common cancer diagnosed in America today -- and can be one of the most curable if caught early. It is also perhaps THE most preventable form of cancer. Taking precautionary measures against the sun, as well as following the ABC's, can drastically reduce the incidence of melanoma, or aid in early detection. The bottom line is no one ever has to die of melanoma. In the early stages, it is often 100 percent curable.

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"Melanoma need not be fatal... the ABCs of early detection"
   authored by:
DERMATOLOGY
Dr. Stuart received her Doctor of Medicine degree from Tulane University School of Medicine. She completed a highly competitive one-year internship at Mercy Hospital Medical Center in San Diego followed by a residency at Emory University, one of the ...



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