May is Skin Cancer Awareness Month and summer months are approaching, which means its time that you make that annual trip to the dermatologist’s office and get a skin cancer screening. According to the American Academy of Dermatology (AAD), skin cancer is the most common cancer in the U.S.—it’s estimated that more than 8,500 Americans are diagnosed with it every day and one in five will develop it in their lifetime. The scariest stat? One person dies from melanoma, the deadliest form of skin cancer, every hour!
But, when caught early, skin cancer is highly treatable. So go get yourself checked out! I had my first mole removed this year at the age of 28, and now I’m more aware than ever—I keep track of changes in my skin and make sure to get regular screenings. Here’s an inside look at my experience.
It all started with a visit to my primary physician, who noticed a mole on my upper thigh during a routine exam. She suggested I have it looked at by a dermatologist sooner rather than later, as her gut instinct was that it was a bit atypical. I made an appointment with a derm who said the mole was indeed dark, but that it was symmetrical and looked OK and they would document its size and appearance in my chart and take another look in six months.
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When that time rolled around, my insurance had changed and I put off the check-up screening that was recommended because I was busy and didn’t want to deal with the new paperwork, etc, that came with switching to a new derm. But, as the months went by, I took a peek at the mole from time to time and noticed it had gotten a bit bigger and darker—it was a pretty ugly thing. Even so, I didn’t think too much of it.
A full year had passed before I decided it was time to revisit the dermatologist. After reviewing my charts and performing a screening, my doctor acknowledged the fact that my mole was growing, and faster than she had liked. It looked darker than almost every other spot on my body and had morphed a bit so that it now had a slightly irregular border. “We should test it to make sure it’s OK,” she said.
The surprising thing to me was the location of the mole. High on my upper thigh, it was not an area that was exposed to the sun regularly, if ever. It’s important for me to point this out because it taught me that I shouldn’t write something off just because it doesn’t fit the standard. If you see something unusual or your gut is telling you something might be off, see a doctor sooner rather than later, and at the very least, you’ll get peace of mind.
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When I arrived for my appointment to “test” my mole, I had assumed the doctor would just scrape off a tiny bit of it and send to a lab. Boy was I wrong. As someone who is scared of needles and has managed to avoid them for most of her life, I was totally caught off guard when the doctor said they would actually need to excise the entire mole, which required stitches. “When we remove a suspicious mole, we need to remove the entire thing, as only part of it could be cancerous and we wouldn’t want to miss anything,” says Boca Raton, FL, dermatologist Robyn Siperstein, MD. “If we are concerned about a lesion, we must remove it in its entirety to make sure, as skin cancers start with just one cell that turns bad either in normal skin or in a mole, and that one cell starts changing and rapidly multiplying. A mole just starting to turn cancerous will have most of the cells normal and healthy with only a few rapidly expanding cancerous ones taking over. As it progresses, the cancerous ones outnumber the healthy ones, but we want to catch these things as early as possible, which is why we test the entire lesion.” She asked me if I wanted to go through with it and I knew I didn’t really have a choice. Health trumps all.
The doctor proceeded to tell me that there are two options when removing a mole. “One is to shave it off, which can leave a circular scar, and the other option is to cut or excise it (sometimes called a punch if it is small enough to use an instrument that has a circular blade attached to a handle),” says Dr. Siperstein. The latter is the method that the doctor suggested would be best to remove my mole and leave me with the best possible scar. The “punch” tool looked like a tiny circular cookie cutter—there were different size circles depending on the size of the mole needing to be “punched” out. I put my brave face on.
The whole thing was over in just a few minutes (I felt really proud of myself!) and I didn’t feel the actual procedure at all thanks to a local anesthetic—I was actually grateful for the location of the mole in this moment because the thigh has more fatty tissue than other parts and therefore I hardly felt the numbing injection. “With cutting or excising a lesion, we then need to use stitches [I had mine in for 10 days] to bring the wound together to heal quicker. Because of this, the procedure usually results in a scar that is a thin line, though it can stretch wider over time if it is an area with tension.” For me, that’s exactly what happened (the legs always experience tension of sorts due to walking, exercising, etc), although it’s still a very small scar.
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Some people hesitate to have a mole removed because they’re worried about scarring, which is understandable, but not worth the risk in my opinion. Look for a doctor with experience in mole removal and skin cancer procedures so that you know you’re in good hands and won’t get a botched scar. Some dermatologists and plastic surgeons specialize in these treatments and may be able to provide a higher level of care. Take your time and select someone who you feel comfortable with.
Once the mole is removed, it’s sent to a lab (Siperstein Dermatology has its own in-house lab, but offices that don’t will send the specimen out to another company to process it). “In our lab, we slice the tissue into thin strips and embed them onto glass slides,” says Dr. Siperstein. “These slides are then dipped in different chemicals in order to give the tissue color so the pathologist can easily visualize what is going on in the skin under the microscope.”
When I got the call with my results, I breathed a deep sigh of relief. Not cancerous! However, I won’t stop being aware and paying attention to my skin with a close eye. Especially living in Florida—I’m exposed to harmful UV rays even when I think I’m not. The sun is a powerful and dangerous thing. Being diligent about wearing broad-spectrum sunscreen (apply at least an SPF of 30 every day) and taking care of your skin can help lower your risk.
When examining your skin for atypical moles and lesions, you can refer to this helpful guide, provided by the AAD:
A is for Asymmetry: One half doesn’t match the other.
B is for Border irregularity: The edges are ragged, notched or blurred.
C is for Color that varies from one area to another.
D is for Diameter: Melanomas are usually greater than 6 millimeters (the size of a pencil eraser) when diagnosed, but they can be smaller.
E is for Evolving: Look for a mole or skin lesion that looks different from the rest or is changing in size, shape or color.
Visit SpotSkinCancer.org for more information on prevention and detection.
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