When Should I Call My Doctor
You should have a skin examination by a doctor if you have any of the following:
- A personal history of skin cancer or atypical moles .
- A family history of skin cancer.
- A history of intense sun exposure as a young person and painful or blistering sunburns.
- New or numerous large moles.
- A mole that changes in size, color or shape.
- Any mole that itches, bleeds or is tender.
A note from Cleveland Clinic
Receiving a diagnosis of melanoma can be scary. Watch your skin and moles for any changes and seeing your doctor regularly for skin examinations, especially if youre fair-skinned, will give you the best chances for catching melanoma early when its most treatable.
Last reviewed by a Cleveland Clinic medical professional on 06/21/2021.
Signs Of Squamous Cell Carcinoma
Behind Basal cell carcinoma, Squamous cell carcinoma is the second most commonly diagnosed type of skin cancer. Unlike Basal cell carcinoma, it does pose the risk of spreading to local lymph nodes if left untreated for too long. Here are the signs of Squamous cell carcinoma to look for:
- Rough or scaly patches that may crust or bleed
- Raised skin growths or lumps that may have a lowered center
- Open sores that never heal, or heal and come back
- Skin growths that resemble warts
How Are Moles Evaluated
If you find a mole or spot that has any ABCDE’s of melanoma — or one that’s tender, itching, oozing, scaly, doesn’t heal or has redness or swelling beyond the mole — see a doctor. Your doctor may want to remove a tissue sample from the mole and biopsy it. If found to be cancerous, the entire mole and a rim of normal skin around it will be removed and the wound stitched closed. Additional treatment may be needed.
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Know The Facts About Skin Cancer
Every year, doctors diagnose more than 4 million cases of nonmelanoma skin cancers in the US, and it’s estimated that nearly 200,000 people will receive a melanoma diagnosis in 2019.;
Basal and squamous cell skin cancers develop on the outer layers of the skin and are more common, though less harmful, than melanoma.;
Melanoma is the deadliest form of skin cancer. It forms in the cells responsible for skin pigmentation, called melanocytes. It’s an aggressive form of cancer and accounts for nearly 10,000 deaths each year. Even with early detection, it can be fatal.
Symptoms of all types of skin cancers include:
- Change in the size or color of a mole or other spot on the skin
- A new growth on the skin
- Odd skin sensations, such as persistent itchiness or tenderness
- Spread of pigmentation outside the border of a mole
Skin cancer may develop due to a variety of factors, including genetics and exposure to toxic chemicals, but the clearest connection is that of skin cancer and UV exposure.;
Screening Information For Non
Early detection and recognition of skin cancer are very important. More than 75% of non-melanoma skin cancers are diagnosed by patients or their families. Recognizing the early warning signs of skin cancer and doing regular self-examinations of your skin can help find skin cancer early, when the disease is more likely to be cured.
Self-examinations should be performed in front of a full-length mirror in a brightly lit room. It helps to have another person check the scalp and back of the neck. For people with fair skin, non-melanoma skin cancer most often begins in places that are frequently exposed to the sun. For people with darker skin, squamous cell carcinoma often occurs in areas that are not as frequently exposed to the sun, such as the lower legs.
Include the following steps in a skin self-examination:
Examine the front and back of the entire body in a mirror, then the right and left sides, with arms raised.
Bend the elbows and look carefully at the outer and inner forearms, upper arms , and hands.
Look at the front, sides, and back of the legs and feet, including the soles and the spaces between the toes.
Part the hair to lift it and examine the back of the neck and scalp with a hand mirror.
Check the back, genital area, and buttocks with a hand mirror.
Talk with your doctor if your hairdresser or barber has noticed a suspicious lesion on your scalp or under your beard, or if you find any of the following during self-examination:
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How Is Scalp Cancer Diagnosed
You might go to your doctor if you notice a suspicious spot on your scalp, or a doctor might notice it during a skin check. No matter how the spot is found, skin cancer diagnosis will happen roughly the same way.
First, your doctor will ask you about your family history of cancer, if you spend a lot of time in the sun, use protection in the sun, and if you use tanning beds. If you noticed the lesion, your doctor may ask if youve noticed any changes over time or if its a new growth.
Then your doctor will do a skin exam to look more closely at the lesion and determine if you need further testing. Theyll look at its size, color, shape, and other features.
If your doctor thinks it might be skin cancer on your scalp, theyll take a biopsy, or small sample, of the growth for testing. This testing can tell your doctor if you have cancer, and if you do, what type. A biopsy might be enough to completely remove a small cancerous growth, especially basal cell carcinoma.
If the spot is cancerous but not basal cell carcinoma, your doctor might recommend more testing to see if it has spread. This will usually include imaging tests of lymph nodes in your head and neck.
What Is My Skin Type
Skin types that are more sensitive to ultraviolet radiation burn more quickly and are at a greater risk of;skin cancer.
All skin types can be damaged by too much UV radiation. Skin types that are more sensitive to UV radiation burn more quickly and are at a greater risk of skin cancer.
People with naturally very dark skin still need to take care in the sun even though they may rarely, if ever, get sunburnt. The larger amount of melanin in very dark skin provides natural protection from UV radiation. This means the risk of skin cancer is lower.
Eye damage can occur regardless of skin type. High levels of UV radiation have also been linked to harmful effects on the immune system.
Vitamin D deficiency may be a greater health concern for people with naturally very dark skin, as it is more difficult for people with this skin type to make vitamin D.;
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How Is Skin Cancer Diagnosed
A skin biopsy is needed to diagnose skin cancer. Your doctor removes a sample of skin tissue, which is sent to a laboratory. In the laboratory, a pathologist studies the sample under a microscope. The pathologist looks for abnormal cells that indicate cancer. If it is cancer, the biopsy sample provides important information about the cancer stage.
Lymph node biopsy is done when there are signs of advanced melanoma, such as:
- Swollen, hard, and enlarged lymph nodes.
- Mid-thickness tumor , even without lymph node symptoms.9
Imaging tests are done for advanced melanoma. The purpose is to see whether the cancer has spread to distant parts of the body. Melanoma is most likely to spread to distant lymph nodes, lungs, liver, brain, and bones.10 These areas may be evaluated using:
- Computed tomography , alone or with positron emission tomography
- Chest x-ray
- Magnetic resonance imaging
- If distant metastases are found, a blood test may be done to check your lactate dehydrogenase levels. LDH is an enzyme found in the blood. The results of this test are used to classify Stage IV cancer. High LDH is a sign of cancer that is harder to treat.5
The Importance Of Annual Exams
The easiest and most effective way to detect skin cancer is to self-check your skin and go to a dermatologist regularly for a check-up.;
Experts disagree on what groups of people should get annual exams: Some say you only need a screening if you have suspicious moles or risk factors for melanoma; others say everyone should get an annual skin check.;
A few factors increase your risk of skin cancer, and if you have any of these, you would benefit from a yearly check-up:;
- Fair skin, light eyes and blonde or red hair
- Skin that burns or freckles easily
- A family history of any type of skin cancer
- History of tanning bed use
- History of severe sunburns
- Unusual moles or more than 50 moles on your body
For now, even though these apps may be helpful in some ways, your best bet is to seek the professional opinion of a dermatologist or doctor if you notice any suspicious moles or other warning signs of skin cancer. ;
The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.
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Surgical Lymph Node Biopsy
This procedure can be used to remove an enlarged lymph node through a small incision in the skin. A local anesthetic is generally used if the lymph node is just under the skin, but the person may need to be sedated or even asleep if the lymph node is deeper in the body.
This type of biopsy is often done if a lymph nodes size suggests the melanoma has spread there but an FNA biopsy of the node wasnt done or didnt find any melanoma cells.
The Big See: How To Detect Skin Cancer
May is Skin Cancer Awareness Month, so were sharing the Skin Cancer Foundations 2020 campaign called The Big See. Skin cancer can happen to anyone, no matter their skin tone or age, and on any part of the body. The good news? Skin cancer is very treatable when you and your dermatologist find it early.
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When You Might Need An Imaging Test
You doctor should not order any imaging tests unless theres a good reason to think the skin cancer has spread.
If there are signs that the cancer has spread to your lymph nodes or beyond, then you may need an imaging test.
This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
What Newer Tools Are Available To Diagnose Skin Cancer
Some newer devices allow doctors to spot problematic skin lesions.
One approach, called reflectance confocal microscopy , uses a low-power laser to scan skin lesions and provide important clues about whether theyre cancerous or not. RCM is sometimes used in combination with another method called optical coherence tomography , notes the Memorial Sloan Kettering Cancer Center.
3D total body photography is another new technology thats used to track changes in the appearance of moles or lesions in people at risk for melanoma. Dozens of digital cameras snap pictures of patients simultaneously. Then a computer creates a 3D avatar to show all the lesions on an individuals body, so doctors can inspect them further.
Skin cancer apps are also becoming popular detection devices. These apps, available via most smartphones, claim to assess skin changes and help people decide whether they should see their dermatologist. While they can be helpful at promoting awareness, the accuracy of these programs is questionable. One recent study found the most accurate skin cancer detection app missed nearly 30 percent of melanomas, per the Roswell Park Comprehensive Cancer Center.
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Look Out For An Ugly Duckling
The Ugly Duckling is another warning sign of melanoma. This recognition strategy is based on the concept that most normal moles on your body resemble one another, while melanomas stand out like ugly ducklings in comparison. This highlights the importance of not just checking for irregularities, but also comparing any suspicious spot to surrounding moles to determine whether it looks different from its neighbors. These ugly duckling lesions or outlier lesions can be larger, smaller, lighter or darker, compared to surrounding moles. Also, isolated lesions without any surrounding moles for comparison are considered ugly ducklings.
Odors And Basal Cell Carcinoma
Basal Cell Carcinoma or BSC is the most commonly occurring skin cancer from among six types of skin cancer known in the 21st century. The Mayo Clinic asserts that BSC is the most easily treatable of the skin cancers and usually appears as one of two phenomena:
Anything that looks like either of these should be seen by a doctor immediately.
In related research, the American Chemical Society worked with US National Institutes of Health funding and found that chemicals are emitted by BSC into the area above the cancerous skin area.
Volatile in this scenario does not mean explosive. “Volatile” means readily evaporating at room temperature. The chemicals are exuded in different proportions by BSC and by non-cancerous skin and this difference is the marker for BSC.
Some physicians can detect the difference between the odors mentioned above by smell or chemo-sensory irritant.
Back in the 1990s, I first thought that a medical device of some sort would be helpful in this task – like the Breathalyzer for detecting alcohol fumes. In 2016, it was reported that a scientist in Israel, Hossam Haick1,3, began working on just such a device in 2006 and named it the âelectronic nose.â I expect it to show up soon as a smartphone app.
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What You Can Do
Check yourself: No matter your risk, examine your skin;head-to-toe once a month to identify potential skin cancers early. Take note of existing moles or lesions that grow or change. Learn how to check your skin here.
When in doubt, check it out. Because melanoma can be so dangerous once it advances, follow your instincts and visit your doctor if you see a spot that just doesnt seem right.
Keep in mind that while important, monthly self-exams are not enough. See your dermatologist at least once a year;for a professional skin exam.
If youve had a melanoma, follow up regularly with your doctor once treatment is complete. Stick to the schedule your doctor recommends so that you will find any recurrence as early as possible.
What Happens During A Skin Cancer Screening
Skin cancer screenings may be done by yourself, your primary care provider, or a dermatologist. A dermatologist is a doctor who specializes in disorders of the skin.
If you are screening yourself, you will need to do a head-to-toe exam of your skin. The exam should be done in a well-lit room in front of a full-length mirror. You’ll also need a hand mirror to check areas that are hard to see. The exam should include the following steps:
- Stand in front of the mirror and look at your face, neck, and stomach.
- Women should look under their breasts.
- Raise your arms and look at your left and right sides.
- Look at the front and back of your forearms.
- Look at your hands, including between your fingers and under your fingernails.
- Look at the front, back, and sides of your legs.
- Sit down and examine your feet, checking the soles and the spaces between the toes. Also check the nail beds of each toe.
- Check your back, buttocks, and genitals with the hand mirror.
- Part your hair and examine your scalp. Use a comb along with a hand mirror to help you see better. It may also help to use a blow dryer to move your hair as you look.
If you are getting screened by a dermatologist or other health care provider, it may include the follow steps:
The exam should take 10-15 minutes.
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Testing For Gene Changes
For some people with melanoma, biopsy samples may be tested to see if the cells have mutations in certain genes, such as the BRAF gene. About half of melanomas have BRAF mutations. Some drugs used to treat advanced melanomas are only likely to work if the cells have BRAF mutations , so this test is important in helping to determine treatment options. Tests for changes in other genes, such as C-KIT, might be done as well.
A newer lab test known as looks at certain gene expression patterns in melanoma cells to help show if early-stage melanomas are likely to spread. This might be used to help determine treatment options. To learn more, see Whats New in Melanoma Skin Cancer Research?
Excisional And Incisional Biopsies
To examine a tumor that might have grown into deeper layers of the skin, the doctor may use an excisional biopsy.
- An excisional biopsy removes the entire tumor . This is usually the preferred method of biopsy for suspected melanomas if it can be done, although this isnt always possible.
- An incisional biopsy removes only a portion of the tumor.
For these types of biopsies, a surgical knife is used to cut through the full thickness of skin. A wedge or sliver of skin is removed for examination, and the edges of the cut are usually stitched together.
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