Identifying Skin Cancer

The skin is the largest organ of the body, and it has numerous important functions. It’s resistant outer surface (epidermis) keeps bacteria and toxins from entering our body while also preventing moisture from within our body from escaping. It is also a durable and flexible structure that offers protection for our delicate internal organs from solar radiation, abrasion, and other traumas.

But, the skin is not perfect, though. Like all superheroes, it has a weakness. It can tolerate perfumes, tattoos, piercings, chemical-laden lotions, dramatic temperature shifts, drought, and the ravages of time. It will stretch and contract. It will even heal itself when cut. However, it is vulnerable to the power of sunlight. Sunburns are bad enough, but the major danger is skin cancer.

Most skin cancers remain local diseases. Examples of these include squamous cell cancer and basal cell cancer. While not pleasant to have, if caught early, they are treatable by excision and typically cured. Other skin cancers can become deadly. These are melanomas and are named after the skin’s pigment, called melanin. Melanoma skin cancer starts local but may travel (metastasize) to other parts of the body. It can require dramatic treatment and can be fatal, despite best efforts. Researchers are working hard to find a cure for melanoma but have not discovered it yet. So, prevention remains the primary goal.

Melanoma often appears as an unusual mole or freckle on the skin. While it is occasionally difficult to tell a skin cancer from a normal freckle or mole, there usually are predictable signs. Doctors judge skin spots using the “ABCDE” method.

A is for appearance. A spot that appears symmetrical is less likely to be cancerous than one that is asymmetric or uneven. If you draw a line through the middle of the freckle and confirm that one side appears exactly like the other, that is a good sign.

B is for border. A sharp border between the mole and surrounding skin is much less worrisome than if the pigmented spot seems to blend in or send tendrils out into the nearby tissue.

C is for color. An even light-to-medium brown color, termed “café au lait” for being the same color as “coffee with milk” is rarely worrisome. But spots with a mix of colors or that are all black, blue, or purple need to be checked out without delay.

D is for diameter. Any lesion with a diameter greater than a quarter inch (6 mm) or about the size of a standard pencil eraser is of concern and should be examined by a doctor.

E is for evolving. If a freckle or mole starts to evolve or change, it could be a warning sign of cancer and must be brought to the attention of a physician without delay.

Indeed, the sun is magnificent, the giver of life, and the symbol of hope and happiness. Unfortunately, we all need to understand the sun’s dangers, as well, especially as it relates to our skin. With the few simple precautions and some know-how discussed above, we can protect ourselves and increase our chances of more healthy years to bask in its wondrous warmth.

Patrice Thornton, MD, is an internal medicine physician at SVMC Northshire Campus in Manchester Center, VT. It is part of Southwestern Vermont Medical Center and Southwestern Vermont Health Care in Bennington. For additional information, visit svhealthcare.org/locations/northshire-campus.