Diagnosis and symptoms of Skin Cancer
Early signs and skin cancer symptoms
The most important warning sign for melanoma is any change in size, shape, or colour of a mole or other skin growth, such as a birthmark. It is important to use the ABCDE rule to evaluate skin changes over a period of time and contacting the physician if any of these changes are observed.
- A is for asymmetry. One half of the mole or skin growth doesn't match the other half.
- B is for border irregularity. The edges are ragged, notched, or blurred.
- C is for colour. The pigmentation is not uniform. Shades of tan, brown, and black are present. Dashes of red, white, and blue add to the mottled appearance. Changes in colour distribution, especially the spread of colour from the edge of a mole into the surrounding skin, also are an early sign of melanoma.
- D is for diameter. The mole or skin growth is larger than 6 mm (0.25 in.) or about the size of a pencil eraser. Any growth of a mole should be of concern.
- E is for evolution. There is a change in the size, shape, symptoms (such as itching or tenderness), surface (especially bleeding), or colour of a mole.
Signs of melanoma in an existing mole include changes in:
- Elevation, such as thickening or rising of a previously flat mole.
- Surface, such as scaling, erosion, oozing, bleeding, or crusting.
- Surrounding skin, such as redness, swelling, or small new patches of colour around a larger lesion (satellite pigmentations).
- Sensation, such as itching, tingling, or burning.
- Consistency, such as softening or small pieces that break off easily (friability).
Melanoma can develop in an existing mole or other mark on the skin, but it often develops in unmarked skin. Although melanoma can grow anywhere on the body, it often occurs on the upper back of men and women and on the legs in women. Less often, it can grow on the soles, palms, nail beds, or mucous membranes that line body cavities such as the mouth, the rectum, and the vagina. On older people, the face is the most common place for melanoma to grow. And in older men, the most common sites are the neck, scalp, and ears.
Late signs of melanoma include:
- A break in the skin or bleeding from a mole or other coloured skin lesion.
- Pain in a mole or lesion.
Symptoms of metastatic melanoma may be vague and include:
- Swollen lymph nodes, especially in the armpit or groin.
- A colourless lump or thickening under the skin.
- Unexplained weight loss.
- Gray skin (melanosis).
- On-going (chronic) cough.
Skin Cancer Diagnosis: Exams and Tests
Evaluation of a skin lesion
A physical exam of the skin is used to evaluate the skin for melanoma. If melanoma is suspected, a skin biopsy will be done. If the biopsy shows melanoma, the pathologist will measure the thickness of the melanoma to find out how advanced the cancer is.
Other techniques may include total-body photography to monitor for changes in any mole and to watch for new moles appearing in normal skin. A series of photos of the suspicious lesions may be taken. Then the photos can be used as a baseline to compare with follow-up photos.
Evaluation of lymph nodes
Larger than normal lymph nodes may be followed by a sentinel lymph node biopsy to see whether the melanoma has spread to the lymph system.
Evaluation for possible metastases (spread of cancer)
A complete medical history and a physical exam are needed to find out whether the cancer has spread (metastasized) to other parts of the body. Imaging tests, including positron emission tomography (PET scan), computed tomography (CT scan), or magnetic resonance imaging (MRI), may be used to identify metastases in other parts of the body, such as the lungs, brain, liver, or other organs.
Skin self-exam is a good way to detect early skin changes that may point to melanoma. A skin self-exam is used to find suspicious growths that may be cancer or growths that may develop into skin cancer (pre-cancers). Adults should examine their skin once every month. Look for any abnormal skin growth or any change in the colour, shape, size, or appearance of a skin growth.
There are other steps that can help prevent skin cancer or detect it at an early stage.
- Be aware of the risk of skin cancer and the steps required to prevent it, including staying out of the midday sun, wearing protective clothing, and using sunscreen on exposed skin.
- Examination of any suspicious skin changes especially if the
- Familial atypical mole and melanoma (FAM-M) syndrome, which is an inherited tendency to develop melanoma. Examine skin every month and be examined by a physician every 4 to 6 months, preferably by the same one each time.
- Increased exposure to ultraviolet (UV) radiation because of job, hobbies, or outdoor activities.
- Abnormal moles called atypical moles (dysplastic nevi). These moles are not cancerous. But their presence is a warning of an inherited tendency to develop melanoma.