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Dermatologists encourage people to screen the one you love for skin cancer


Science Centric
4 May 2009 18:52 GMT

Treating moms and dads to brunch or backyard barbecues is a great way to honour them on Mother's Day and Father's Day, but the American Academy of Dermatology (Academy) hopes more families will start another annual tradition - screening their loved ones for skin cancer. To help detect the warning signs of skin cancer, especially melanoma (the deadliest form of skin cancer), the Academy is adopting the revised ABCDs of Melanoma Detection by adding an 'E' for evolving.

Based on current estimates, more than 1 million cases of skin cancer will be diagnosed in the United States in 2009. When detected early, most skin cancers can be successfully treated. Performing regular skin self-examinations is an easy way to detect suspicious moles that could be cancerous, and research shows that involving a partner in the self-examination process can improve the early detection of skin cancer.

'People who check their skin regularly for any changes in existing moles or new moles are taking an important first step in detecting the early warning signs of skin cancer,' said dermatologist David M. Pariser, MD, FAAD, president of the Academy. 'Asking a partner to help monitor your skin for any changes or to assist in examining hard-to-reach areas can be very beneficial in spotting skin cancer.'

To enhance a patient's ability to detect skin cancer, the Academy has adopted the revised ABCDs of Melanoma Detection, which include an 'E' for Evolving. A mole or skin lesion that is 'Evolving' or changing in size, shape or colour should be brought to the attention of a dermatologist. This is in addition to other characteristics of moles for which individuals should check their skin - Asymmetry (one half unlike the other half), Border (irregular, scalloped or poorly defined), Colour (varies from one area to another; shades of tan and brown, black; sometimes white, red or blue), and Diameter (the size of a pencil eraser or larger). A mole with any of these characteristics, or one that is an 'ugly duckling,' meaning it looks different from the rest, should be brought to a dermatologist's attention.

A new study published in Cancer examining changes in melanomas diagnosed over 35 years found that melanomas were frequently described by patients as evolving lesions. In this collaborative study conducted at the NYU Langone Medical Centre, dermatologist David Polsky, MD, PhD, FAAD, associate professor of dermatology and pathology and director of the Pigmented Lesion Clinic in the Ronald O. Perlman Department of Dermatology, and colleagues studied 1,684 prospectively enrolled patients diagnosed with 1,734 melanomas. They observed important differences in the clinical behaviour of nodular melanomas (very rapidly growing melanomas) compared to superficial spreading melanomas (the most common type of melanoma).

Among the key findings, Dr Polsky reported that more than 90 percent of patients with nodular melanoma reported a history of change in the lesion and these patients were more likely to be diagnosed with thicker, more dangerous tumours. By comparison, 80 percent of patients with superficial spreading melanoma indicated a slower pace of change in the lesion, and over time these lesions were diagnosed earlier in their evolution, as thinner, less problematic, tumours.

'Nodular melanomas typically do not have the classic ABCD features that one might expect to find when doing a skin self-exam, as they can be one colour and have smooth borders,' said Dr Polsky. 'But what's important to note is that nodular melanomas do change over a few months time, especially in colour or height, such as a bump on the skin. So, I think by modifying our detection criteria to include 'evolving,' the ABCDEs of Melanoma Detection will better encompass the characteristics of aggressive nodular melanomas and help patients better assess a dangerous mole.'

In addition, the Academy offers a Body Mole Map, a tool individuals can use to track their moles. The map provides information on how to perform a skin exam, images of the ABCDEs of melanoma and space for people to track their moles to determine any changes over time. Popular holidays, such as Mother's Day (10 May), Father's Day (21 June) and Grandparents Day (13 September) are reminders for people to check their loved ones' skin for suspicious moles using the Academy's Body Mole Map. The mole map is available at www.melanomamonday.org.

To minimise your risk of skin cancer, the Academy recommends that everyone Be Sun SmartSM:

- Generously apply a broad-spectrum water-resistant sunscreen with a Sun Protection Factor (SPF) of at least 15 to all exposed skin. 'Broad-spectrum' provides protection from both ultraviolet A (UVA) and ultraviolet B (UVB) rays. Re-apply every two hours, even on cloudy days, and after swimming or sweating. Look for the AAD SEAL OF RECOGNITION(R) on products that meet these criteria.

- Wear protective clothing, such as a long-sleeved shirt, pants, a wide-brimmed hat and sunglasses, where possible.

- Seek shade when appropriate, remembering that the sun's rays are strongest between 10 a.m. and 4 p.m. If your shadow is shorter than you are, seek shade.

- Protect children from sun exposure by playing in the shade, using protective clothing, and applying sunscreen.

- Use extra caution near water, snow and sand as they reflect the damaging rays of the sun which can increase your chance of sunburn.

- Get vitamin D safely through a healthy diet that may include vitamin supplements. Don't seek the sun.

- Avoid tanning beds. Ultraviolet light from the sun and tanning beds can cause skin cancer and wrinkling. If you want to look like you've been in the sun, consider using a sunless self-tanning product, but continue to use sunscreen with it.

- Check your birthday suit on your birthday. If you notice anything changing, growing, or bleeding on your skin, see a dermatologist. Skin cancer is very treatable when caught early.

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