With the fierce Australian sun, frequent checks for skin cancer are essential. Exactly how often you should be checked will be dependent on your risk of cancer, something that should be discussed with your general practitioner.
As a general rule, those who are deemed to be at high risk should conduct a self-examination every three months and get a full body examination with a doctor every six to twelve months. If you are regarded as medium risk, a self-examination should be performed every three to six months and a full body examination conducted by a doctor should be done every two to five years. Here at the Neighbourhood Clinic, within our General Practice, we have doctors that conduct full-body skin cancer checks in Fitzroy, Melbourne.
During the skin check, what will the doctors be looking for?
The first thing that you should always do during your check is to point out any areas that may be of concern to you. Although the doctor will perform a thorough inspection, it helps to put your mind at ease from the outset. The doctor will be looking for any new skin lesions or lesions that have perhaps changed since your previous visit. You will be asked about:
- Any freckles or moles that have altered how they feel, especially itchiness or irritation
- Freckles or moles that have changed in appearance, such as becoming larger or have changed in colour or shape.
- Any existing lesions that have started bleeding or “crusting”
Melanoma – Adults
During your examination, your doctor will want to establish what is a mole and what is a potential melanoma. They will follow the standard A, B, C, D, E practice to determine this.
- Asymmetry– the objective is to determine if the lesion has an abnormal shape or pattern
- Border– the doctor will be looking to establish if the lesion has a regular or irregular border
- Colour– any lesion that exhibits different colourings is a cause for concern and needs further examination
- Diameter– most melanomas are larger than 6mm in diameter. However, any that cause concern with your doctor should be examined further
- Evolving– any lesion that changes in terms of its shape, size or colour should be further investigated
Some forms of melanoma, such as the nodular melanoma, can be visibly different to the naked eye. Lesions that grow quickly, for example, those that have noticeably increased in size in the space of a month need to be investigated urgently.
Melanoma – Children
Melanomas in children generally present themselves differently to those in adults. As a result, a different set of A, B, C, D criteria are used.
- Amelanotic – this means that the lesion will usually be red or pink in colour as it doesn’t contain the pigment melanin
- Bleeding and uneven– melanomas in children frequently bleed and are typically raised
- Colour– melanomas in children are harder to detect as they are usually uniform in colour
- Diameter– again, melanomas in children are harder to detect as; generally, they are less than 6mm in diameter
What does the physical check involve?
Naturally, the physical check is an extensive assessment of the skin to identify skin cancer and potential skin cancer. The check will also give medical professionals the opportunity to:
- Ascertain your overall risk of skin cancer
- Teach the individual how to perform self-examination
- Warn of the dangers of exposure to the sun and suggest preventative methods
The tools of the trade
The Dermatoscopy, which is often referred to as a dermoscopy, is essentially a handheld microscope that will allow the doctor to perform a more detailed examination of the skin. Often liquid is applied to the skin as this will help to present a clearer image. Generally, a dermatoscopy is only used by more experienced physicians.
With modern photography equipment becoming increasingly sophisticated, medical photos play a role in ensuring that nothing is missed. They can also be used in discussions with other doctors who are not present during the physical examination. The images can also be used on a compare and contrast basis for “before and after” pictures. They can also be used to help educate individuals about what they should be looking for.
It is crucial to balance this argument with the fact that there are some negatives. Photographs can provide a false sense of security and can lead to delays in treatment if a “wait and see” approach is adopted.
What happens if a suspicious lesion is detected?
If a suspicious lesion is detected, there are several courses of action that your doctor may wish to take. The two main options are:
- Biopsy– the lesion will be removed under local anaesthetic and sent to a lab to establish whether it is cancerous
- Referral to a specialist– the patient may be referred to an oncologist (a doctor specialising in cancer) or a surgeon. This option is normally taken when the lesion is either difficult to remove or a second opinion is required.