Peace of Mind During Pandemic
May is Melanoma Awareness Month, and while you don’t need another thing to worry about these days, it’s important to learn about melanoma and understand its risks. Approximately 200,000 melanoma cases will be diagnosed in the U.S. in 2020 and it’s estimated that the number of new melanoma cases diagnosed will increase by almost 2 percent this year. Men age 49 and under have a higher chance of developing melanoma than any other cancer, and women age 49 and under are more likely to develop melanoma than any other cancer except breast and thyroid cancers.
The good news is that the vast number are curable, especially when diagnosed in the earliest stages. The estimated five-year survival rate for patients whose melanoma is detected early is about 99 percent.
How to Check Your Skin for Cancer
You can stop worrying about melanoma by taking a good look at your skin once a month. Look for anything new, changing or unusual on both sun-exposed and sun-protected areas of the body. Melanomas commonly appear on the legs of women, and the number one place they develop on men is the trunk. Keep in mind, though, that melanomas can arise anywhere on the skin, even in areas where the sun doesn’t shine, including the groin, genitalia, the bottom of your feet and in or around your nails.
What to Look for During Skin Screening
I recommend comparing a suspicious spot to surrounding moles to determine if it looks different from its neighbors. These “ugly ducklings,” or outlier lesions, can be larger, smaller, lighter or darker compared to surrounding moles. A solitary lesion without any surrounding moles for comparison are also considered ugly ducklings. About 20 to 30 percent of melanomas develop in existing moles, while 70 to 80 percent arise on seemingly normal skin.
Not every melanoma is dark or pigmented. Amelanotic melanomas are missing the dark pigment melanin that gives most moles their color. These melanomas may be pinkish, reddish, white, the color of your skin or even clear and colorless, making them difficult to spot.
Look out for any new moles or freckles that arise on your skin, a sore or spot that does not heal, a change in any existing mole (growing, swelling, itching) or any spot, mole or lesion that looks unusual.
You might find lots of things that suggest a lesion of concern, but another encouraging bit of information is that many lesions that meet these criteria are benign, and can be diagnosed while you are in the comfort of your own living room.
Non-invasive Biopsy from Home
Through telemedicine, I see many dark spots that are actually benign. Seborrheic keratoses, benign sun spots, and even ticks can look like melanoma. During this past month I am gratified to be able to reassure patients who are concerned about new lumps and bumps. Only on a few occasions have I determined that a spot needs further evaluation. What happens then? Does that mean you need to come into the office? Not necessarily.
Technology has advanced to a degree that we can assess a pigmented mole through an innovative genomic test that can be done by you at home. The DermTech Pigmented Lesion Assay (PLA), which comes in a kit sent to a patient’s home, can determine if a mole is benign or if it has the genomic risk factors of melanoma and needs to be biopsied. The PLA has an adhesive patch that sticks to a mole like tape and is peeled off painlessly to collect skin cells. When administering the test, you draw a circle on the tape to highlight the location of the lesion (as seen in the picture). Skin cells that stick to the adhesive patch are analyzed in a specialized laboratory where the cells are examined for two genes that can indicate the presence of melanoma. This gene expression analysis enables DermTech to accurately distinguish between melanoma and non-melanoma.
With the PLA, there is a less than 1% chance of missing melanoma. It results in fewer unnecessary biopsies, and allows us to limit in-office visits. Plus, it’s painless and doesn’t leave a scar.
What’s the process?
Schedule a telehealth appointment to discuss your skin cancer concerns. If it’s advised that you need to have any lesions further evaluated, we may suggest the DermTech PLA. A kit is sent to your home and we supervise the application of the adhesive sticker via a telehealth visit. Results are available in approximately one week, which means that peace of mind, a rare commodity these days, might just be a week away.