joelhall
07-07-13, 19:46
As there have been a couple of threads on this, and it's that time of year, I just wanted to dispel some of the myths surrounding skin cancers.
1. All irregular-shaped moles are melanoma
FALSE. Asymmetry is only ONE sign of a cancerous mole. Although it is often said that moles should always be round, this is not the case - many benign moles are irregularly shaped. Simply put there are several signs of a cancerous mole:
An irregular shape
Satellite moles around the edge
Borders which are not smooth
Uneven colouring across the mole
Size greater than 6mm across.
A good way to remember this is A,B,C, D - Asymmetry, Borders, colours, Diameter (We have one American professor who loves reciting these things to help us remember them).
BETTER signs are:
The colour is changing
It is growing in size across
It is becoming more irregular in shape
The major characteristic of cancer cells, is that they divide rapidly and invade surrounding tissue!
2. Skin cancer is easy for a doctor to spot
HLAF-TRUE: Some cancers only need looking at to be obvious. Others not so much. Biopsy and lab-testing are the only reliable ways to diagnose skin cancers.
3. You should only watch out for moles
MOSTLY FALSE: Melanoma which is characterised by abnormal moles, is actually the rarest form of skin cancer. Basal cell carcinoma and squamous cell carcinoma are far more common and account for around 95% of all skin cancers (basal cell being the most common, around 50-60% of all skin cancers). These are often much more aggressive looking than melanoma, and therefore patients are more likely to see a doctor.
Some basal cell carcinomas are pigmented like melanomas however, but the major signs are:
Basal cell carcinoma: These originate as the base layer of the skin, and usually appear as lumps, which can bleed and are usually red or pinkish. Sometimes they may have a white, waxy, appearance with visible blood vessels.
They may also appear as patches, which are sometimes pigmented and usually look scale-like, and these can grow quite large (I have seen one as large as 5 inches across before).
The lumps can sometimes bleed, but it unusual for them to cause pain.
The 'lumpy' type usually is seen around the head, face, neck or arms, whilst the torso is a ore likely site for the patches.
Squamous cell carcinoma: These are often much more aggressive looking, and occur on the outer layer of the skin. They usually appear as red lumps or mopre often scabbed over lesions which do no heal. They may also be covered by scales and look very nasty. It is actually very unusual for someone not to see a doctor when they have these tumours, as they can be very alarming just looking at!
In both cases however, it is unusual for people to ignore these symptoms. They really do stand out, which is why a lot of public attention is aimed at the more subtle looking melanoma.
The main things to look for here are: scaley appearance, bleeding, lesions, a nasty scab-looking lump, or patches of discolouration. However, to reiterate, these are not usually the sort of things patients ignore if they see.
4. I use sun-screen at all times, and so am safe from skin cancer
FALSE, BUT STILL GOOD ADVICE. Preferably with a high factor too! Although most cancers are due to radiation damage from the Sun, there can be other risk factors, such as genetics. However, it should be remembered that the major cause IS radiation, and even on cloudy days or cold ones, UV rdiation hits your skin.
Just to state the obvious: a breeze, a hat, cold weather, rain and cloud DO NOT eliminate UV radiation hitting the skin
5. This all sounds very worrying
HALF-TRUE. Melanoma has historically been more dangerous due to its ability to spread more easily than other skin cancers, but also because many patients did not recognise the signs. For example, melanoma in England and Wales in 2003 according to the Oxford Textbook of Clinical Medicine, accounted for 1.8% of all cancers and 1.0% of cancer deaths.
By contrast however, the other skin cancers were responsible for 14.1% of all cancers, but only 0.3% of all deaths. This makes skin cancers the most common cancer in the UK, but the least likely to actually kill.
This isn't the same of course as the risk of dying from skin cancer: in fact the melanoma (the most dangerous) 5-year survival even before 2010 we 83.6% of male patients and 91.6% of female patients. By contrast for other skin cancers the survival rate in 2010 was 99.4%.
But the idea here isn't to worry unecessarily. The majority of moles looked at by practitioners are benign. Even those which have the risky signs of melanoma can be benign. The end advice as always is - if in doubt, see someone but do not worry. Skin cancer is quite unlikely to kill in this country, due to better awareness and excellent treatments available.
1. All irregular-shaped moles are melanoma
FALSE. Asymmetry is only ONE sign of a cancerous mole. Although it is often said that moles should always be round, this is not the case - many benign moles are irregularly shaped. Simply put there are several signs of a cancerous mole:
An irregular shape
Satellite moles around the edge
Borders which are not smooth
Uneven colouring across the mole
Size greater than 6mm across.
A good way to remember this is A,B,C, D - Asymmetry, Borders, colours, Diameter (We have one American professor who loves reciting these things to help us remember them).
BETTER signs are:
The colour is changing
It is growing in size across
It is becoming more irregular in shape
The major characteristic of cancer cells, is that they divide rapidly and invade surrounding tissue!
2. Skin cancer is easy for a doctor to spot
HLAF-TRUE: Some cancers only need looking at to be obvious. Others not so much. Biopsy and lab-testing are the only reliable ways to diagnose skin cancers.
3. You should only watch out for moles
MOSTLY FALSE: Melanoma which is characterised by abnormal moles, is actually the rarest form of skin cancer. Basal cell carcinoma and squamous cell carcinoma are far more common and account for around 95% of all skin cancers (basal cell being the most common, around 50-60% of all skin cancers). These are often much more aggressive looking than melanoma, and therefore patients are more likely to see a doctor.
Some basal cell carcinomas are pigmented like melanomas however, but the major signs are:
Basal cell carcinoma: These originate as the base layer of the skin, and usually appear as lumps, which can bleed and are usually red or pinkish. Sometimes they may have a white, waxy, appearance with visible blood vessels.
They may also appear as patches, which are sometimes pigmented and usually look scale-like, and these can grow quite large (I have seen one as large as 5 inches across before).
The lumps can sometimes bleed, but it unusual for them to cause pain.
The 'lumpy' type usually is seen around the head, face, neck or arms, whilst the torso is a ore likely site for the patches.
Squamous cell carcinoma: These are often much more aggressive looking, and occur on the outer layer of the skin. They usually appear as red lumps or mopre often scabbed over lesions which do no heal. They may also be covered by scales and look very nasty. It is actually very unusual for someone not to see a doctor when they have these tumours, as they can be very alarming just looking at!
In both cases however, it is unusual for people to ignore these symptoms. They really do stand out, which is why a lot of public attention is aimed at the more subtle looking melanoma.
The main things to look for here are: scaley appearance, bleeding, lesions, a nasty scab-looking lump, or patches of discolouration. However, to reiterate, these are not usually the sort of things patients ignore if they see.
4. I use sun-screen at all times, and so am safe from skin cancer
FALSE, BUT STILL GOOD ADVICE. Preferably with a high factor too! Although most cancers are due to radiation damage from the Sun, there can be other risk factors, such as genetics. However, it should be remembered that the major cause IS radiation, and even on cloudy days or cold ones, UV rdiation hits your skin.
Just to state the obvious: a breeze, a hat, cold weather, rain and cloud DO NOT eliminate UV radiation hitting the skin
5. This all sounds very worrying
HALF-TRUE. Melanoma has historically been more dangerous due to its ability to spread more easily than other skin cancers, but also because many patients did not recognise the signs. For example, melanoma in England and Wales in 2003 according to the Oxford Textbook of Clinical Medicine, accounted for 1.8% of all cancers and 1.0% of cancer deaths.
By contrast however, the other skin cancers were responsible for 14.1% of all cancers, but only 0.3% of all deaths. This makes skin cancers the most common cancer in the UK, but the least likely to actually kill.
This isn't the same of course as the risk of dying from skin cancer: in fact the melanoma (the most dangerous) 5-year survival even before 2010 we 83.6% of male patients and 91.6% of female patients. By contrast for other skin cancers the survival rate in 2010 was 99.4%.
But the idea here isn't to worry unecessarily. The majority of moles looked at by practitioners are benign. Even those which have the risky signs of melanoma can be benign. The end advice as always is - if in doubt, see someone but do not worry. Skin cancer is quite unlikely to kill in this country, due to better awareness and excellent treatments available.