How to spot a Melanoma

Melanoma signs, by Dr Toby Nelson
Written by
Toby Nelson
Published on
June 8, 2023

Melanoma is the deadliest form of skin cancer, so catching it as early as possible offers the best prognosis.

Melanoma forms from a cancerous change in a cell called the melanocyte. Melanocytes are found primarily in the skin but can be found in the back of the eye, and mucosal surfaces such as the genitals, the mouth, and the gut. When a melanocyte develops damage within its normal DNA it can replicate out of control forming a melanoma. For this to happen the area of the skin will change in appearance.

All cancers grow, when a cancer forms internally you may not know about it until you develop symptoms such as a cough or bleeding from the back passage,lethargy weight loss etc.

Skin cancer declares itself through a visible (but sometimes subtle) change in appearance. When my patients ask me what to look out for, I tend to use the analogy of nature. Things in nature such as trees, birds, flowers and even people have some form of symmetry.

When there is disease in nature symmetry is lost. The tree may lose a few branches,the flower may grow more on one side and die on the other. Moles on our skin should be symmetrical, like the flower both in shape and colour. Some people have naturally asymmetrical moles, but all their moles will be of a similar appearance and therefore retain symmetry for that individual.

Melanoma will not respect the rules of nature. It will grow in a way that becomes noticeable. Colours may change or there may be more than one colour. The shape may become odd and out of keeping with your other moles. Sometimes, rarely melanoma forms as a new pink nodule or even a mole that seems to be disappearing. In these situations, one should think about getting a mole check.

Melanoma. can be treated if it is found quickly.

The recommended approach is to follow the ABCDE rule. The checklist explains what to look for when checking moles or other skin changes.

A – Asymmetry

Most melanomas are likely to be uneven or irregular in shape (asymmetrical). Ordinary moles are usually more even and both halves look mostly the same (symmetrical).

B – Border

The edges around a melanoma (border) are more likely to be uneven, irregular or jagged. Ordinary moles usually have a clear,smooth-edged border.

C – Colour

Melanomas are usually more than one colour. They may have different shades, such as brown mixed with a black, red, pink, white or blue tint. Normal moles usually only have shades of brown.

If you have red or fair hair and pale skin,the melanoma may only be red or pink with no brown. This is called amelanotic melanoma.It is much less common.

D – Diameter (width)

Melanomas are usually more than 6mm wide. Normal moles are usually about the size of the blunt end of a pencil or smaller.

If you have lots of large moles, some of them may be larger than 5mm in diameter.

E - Evolving (changing)

Look for changes in the size, shape or colour of a mole. The change in shape can include the area becoming raised or dome-shaped. Or, if the mole is flat, it may stay that way but become wider.

Of all of these it is the E that I find most useful as a diagnostic, as cancer can not grow without evolving and evolving means a change that can be seen. Unlike other forms of cancer skin cancer is on the surface so doesn't require specialist tests or blood tests.

Regularly checking your skin is crucial for early detection of melanoma and other types of skin cancer. By becoming familiar with your skin and the appearance of your moles, birthmarks, and other marks, you can easily notice any changes or new signs or symptoms that may indicate a problem.

If you have any possible signs or symptoms of melanoma or a mole you are concerned about, please get a mole check or visit your GP as soon as possible.

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