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Is This Skin Cancer?

Pretty much everybody will eventually get a “thing” on their skin that might cause them worry.

You can “google” a search for “do I have skin cancer”… and invariably, you will be directed to “go see your Doctor”.

This is certainly reasonable advice, but you probably want more than that.

So here is a simple guideline:

1) If it bleeds easily without provocation – it may be a cancer. Sometimes it may be an early cancer. Almost all moles that bleed spontaneously are are a cancer.

2) Most people have at least one mole. A mole is simply pigmented skin, and you can’t often feel a mole when you run your finger over it. If you CAN feel a mole, it is probably an “intradermal naevus”. An Intradermal naevus – even if pigmented – rarely becomes cancerous.

3) Any mole that has more than 2 of the following 5 criteria could be a cancer:

A = Asymmetry. Is the mole asymmetric? That’s a point against it being normal.B = Border. Does the mole have an irregular and indistinct border? If so another point against “normal”C = Colour. Is the mole more than one colour with multiple colours and even some redness? 1 point against normal again.D = Diameter. Any mole more than 7mm in maximum dimension is suspicious.E = Evolving. Any mole that “gets worse” over time may be a cancer – independent of the other criteria.

If a mole has at least 2-3/5 of the above criteria – it should come off and be analyzed. Most Physicians have the ability to do that for you.

4) Any “nodular” or “raised” skin lesion with a centrally ulcerated area or a “rolled border” is suspicious for a basal cell carcinoma. Pretty much all of these should be biopsied.

5) If you are taking an immunosuppressant like prednisone or anti-rejection or anti-rheumatoid arthritis drugs or drugs to suppress the immune system to control Crohn’s disease, multiple sclerosis, rheumatoid arthritis, cancer or lupus. ANY skin lesion under these circumstances has a higher chance of being a cancer.

Over the years, I cannot count the number of times I have been astonished when something that I took off a patient that looked “a bit odd” came back as a skin cancer.

Erring on the side of caution is probably the best way to go.

It sounds redundant, but it is very good advice:  If you are concerned about a “thing” on your skin, don’t waste time googling.  Talk to your Doctor.  It could save your life!



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