When to get a mole checked? Everything you need to know about Melanoma.

Last updated: April 26, 2021


Contributed by:
Dr. Amna
Khan
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Melanoma is a type of skin cancer that presents itself as an unusual mole. It happens due to abnormality in the skin cells called melanocytes responsible for the production of the pigment melanin. Melanin acts as a shield to protect the skin against harmful rays. That is why any disturbance in the production of melanin renders the skin susceptible to many skin ailments. So when should you get a mole checked?

At Your Doctors Online, we usually get patients with abnormal moles and sometimes, those moles do turn out to be precancerous or atypical moles. I will discuss a few short stories our patients have agreed to share and explain everything you need to know about melanoma. 

‘My mole that grew larger than 6 millimetres’ – Melanoma Survivor Story

“My melanoma story began when I first noticed a darkly stained itchy mole with different colours in it. It seemed quite unlike a regular mole to me. I found it on my neck and mistook it to be a type of acne scar, but it kept on growing larger and larger. As neither a mole nor an acne scar grows this quickly thus, I decided to seek medical advice via Your Doctors Online.

Dr. Mavra Farrukh was humble and empathetic, and  I shared my experience regarding the mole on my neck. I had severe itching in that area. Dr. Farrukh asked for some pictures of my mole and had a detailed conversation with me. She asked me to look for any swollen lumps in the neck region as well. To my bad, I had not noticed that I had swollen lymph nodes in my neck earlier. The doctor on inspection diagnosed it to be a melanoma, and this news shook me as a whole.

Dr. Farrukh referred me to a local dermatologist who further confirmed that I was bearing a stage 3 melanoma. This diagnosis hit me hard when I was informed about having surgery in no time. I have had the affected lymph nodes removed and have been on immunotherapy lately. During this challenging time, Your Doctors Online provided me with medical and emotional assistance whenever I needed it.” – Alison T.

Lymph nodes under jaw

Causes

  • Acquired genetic mutations

These mutations may evolve at any time of a person’s life. These may occur randomly or maybe as a result of exposure to UV rays. UV rays affect the skin cells damaging them and affecting their ability to grow within a proper limit. The cells thus show enormous growth and become cancerous cells.

  • Family tendency

If we look at the family history of the patients suffering from melanoma, most of them have a family member who was previously affected by melanoma. Such patients have an abnormal tumour suppressor gene that is crucial to check the growth of cancerous cells. 

  • UV rays exposure

Ultraviolet rays are a major cause of skin cancer. The exposure to UV rays may be under the sun or artificial light sources like tanning beds. According to a study, out of 63 women diagnosed with melanoma, 60 used tanning beds. This ratio adequately explains the adverse effects of UV rays on your skin.

Other risk factors of melanoma

  • Risk increases with age.
  • Fair skin due to lack of melanin
  • Location. If someone lives near the equator or at high altitudes, they are at higher risk of developing melanoma.
  • Weak immune system or if someone is on immune suppressant drugs
  • People who have had melanoma recently have a higher risk of getting another if proper treatment is not assured.
  • Having more than 50 moles on your body or several freckles 
  • Damaged skin from sunburn or radiotherapy
  • A type of birthmark called congenital melanocytic naevus can turn into melanoma.

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How is melanoma diagnosed on examination?

So far, I  have listed some of the causes of melanomas. Let me tell you in a rather precise manner how to diagnose melanoma. You may get a clear identification of melanoma by following the ABCDE principle:

  • A stands for asymmetrical shape. Check for any uneven or irregular moles.
  • B stands for border irregularities. There can be fades or blurred segments. 
  • C stands for a colour change. These can range from black, blue and brown to pink and red. Also, these colours are irregularly distributed.
  • D stands for diameter. Normal moles have a diameter of 6 millimetres or less. Melanomas are larger than 6mm.
  • E stands for evolving as the melanomas keep on changing. Diagnosis of melanomas is based upon their ever-changing nature. They may look oval or square, unpaved or smooth, unicolored or multicoloured from time to time.

If your doctor suspects the mole to be cancerous on examination, you will have to get a biopsy done to confirm this.

‘I am enjoying a cancer-free life’- Melanoma Survivor Story

“With my lifestyle, I was pretty sure I will get melanoma one day. I am a farmer, and playing hide and seek with the sun is part of the job. People in my village often complained about melanomas.

 One day, my wife noticed an asymmetrical mole on my ear lobe. Assuming it to be a regular one, I didn’t pay heed until it started itching under the scorching sun. Lack of time made me reluctant to go to the hospital. So, my wife recommended me the Your Doctors Online platform to know about the actuality of this mole. I connected with Dr. Morrison, who asked me for pictures of the mole and had an in-depth conversation with me regarding all the signs and symptoms. She diagnosed me with melanoma.

Luckily, the matter was in my hands as cancer had not yet spread to lymph nodes. On the advice of Dr. Morrison, I went to a local dermatologist by her reference. The dermatologist had my biopsy done and melanoma removed. The immunotherapy medicines after my surgery made me uncomfortable with their itching effects. However, with the support of Dr. Morrison and my local dermatologist, I managed to overcome those side effects as well. Now, I am enjoying a cancer-free life of a lively farmer.” – Derek F.

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Types of melanomas

There are four types of melanomas:

  • Superficial melanoma

Superfical melanoma

This melanoma rests on the superficial layer of skin and does not penetrate inward. It accounts for 70% of all melanomas and may occur at any age. However, people who are exposed to ultraviolet radiation have a higher risk of melanomas.

  • Nodular melanoma

Nodular Melanoma

Source: Nodular Melanoma. Retrieved on 2020-02-25. StatPearls Publishing LLC, Contributed by DermNetNZ – “Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/)

Nodular melanoma accounts for 15% of the total cases of melanoma. It can be diagnosed by a lump that grows outside the skin. It shows exponential growth and invades the deeper layers of skin as well.

  • Lentigo maligna melanoma 

lentigo maligna melanoma

Source: Omar Bari, Philip R. Cohen, CC BY 3.0 <https://creativecommons.org/licenses/by/3.0>, via Wikimedia Commons

It is found on the skin with severe sunburns and expresses itself as a freckle called Hutchinson’s freckle. In addition, it grows slowly and can be treated timely.

  • Acral lentiginous melanoma

Acral lentiginous melanoma

This is observed in dark people who are not susceptible to the other types of melanoma. It occurs in palms, under the nails, and soles.

Treatments

  • By far, the only available treatment for melanoma is surgery. The type of surgery depends upon the extent to which cancerous cells have invaded your skin.
  • You may have a sentinel lymph node biopsy to check whether the melanoma has invaded lymph nodes or not.
  • Similarly, excision of the damaged lymph nodes(lymphoedema) is the only available procedure to prevent the further spread of cancer.
  • Immunotherapy and radiotherapy are used after the surgical procedure to eliminate the remaining traces of cancer cells.

How to prevention melanoma?

Here are some preventive measures you can take to decrease your chances of getting melanoma:

Sunscreen

  1. Use sunscreen when going outside
  2. Wear clothes that cover your body entirely
  3. Avoid tanning beds.
  4. Visit a dermatologist for skin examination regularly if you have a family history of melanomas.

“My mother, who has recently gone through a successful recovery, escorted me to the doctor’s clinic for a sentinel biopsy” – Melanoma Survivor Story.

“I was about to leave for a family trip when I noticed an irregular mole near my groin region. I was well aware of melanoma as my mother had recently gone through stage 3 melanoma surgery.

Within no time, I logged in to Your Doctors Online. Dr. Davis listened to me with rapt attention after viewing pictures of my mole. As it had different colours and uneven borders, she asked me to go for a biopsy. She referred me to a nearby dermatologist who validated the presence of melanoma. This news just bombarded as a missile onto my head as I had never expected such an uncertain moment of my life. My mother, who had recently gone through a successful recovery, escorted me to the doctor’s clinic for a sentinel node biopsy. An air of relief passed by when the biopsy was negative.

My telemedicine doctor was in contact with me and my dermatologist. Both of them ensured complete medical and emotional support for me from the very beginning of surgery to the course of medications. Now, I am enjoying a healthy and sound life just because of the proper counselling and subsequent treatment.” – Nichole O.

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If you have an irregular suspicious-looking mole, take pictures and chat with our board-certified doctors. Remember, in melanoma, early detection can save lives. 

 

References

Melanoma: Stages, types, causes, and pictures. (n.d.)., from https://www.medicalnewstoday.com/articles/154322

Melanoma. (2020, March 10)., from https://www.mayoclinic.org/diseases-conditions/melanoma/symptoms-causes/syc-20374884

Tanning. (2021, January 04)., from https://www.skincancer.org/risk-factors/tanning/

Nhs choices. (n.d.)., from https://www.nhs.uk/conditions/melanoma-skin-cancer/causes/

 

Disclaimer: This article provides general information and is not intended to diagnose, treat or cure any disease or medical condition. If you require specific advice, please consult one of our medical professionals through the app. However, in case of an emergency, please call 911.

About Dr. Amna



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