The
first step to medical detection of skin cancer is a simple medical history
report. We will will ask your age and about past exposures to known causes
of skin cancer and if you or anyone in your family has had skin cancer.
During your physical exam, we will note the size, shape, color, and texture
of any areas in question, and if there is bleeding or scaling. The rest
of your body may be checked for spots and moles that may be related to
skin cancer.
We may also check lymph nodes (bean-sized collections of immune system
cells that fight infections) near the suspicious area. Some skin cancers
may spread to lymph nodes. Affected lymph nodes may become larger and
firmer than usual.
We often use dermoscopy (also known as epiluminescence microscopy (ELM),
surface microscopy, or dermatoscopy) to help determine if a spot might
be a melanoma. This involves the use of a dermatoscope, which is a special
magnifying lens and light source held near the skin. Sometimes we will
use a thin layer of oil with this instrument. A digital or photographic
image of the spot may be taken. The use of these tests can improve accuracy
in finding skin cancers early. It can also often reassure you that a lesion
is benign (non-cancerous) without the need for a biopsy.
If we think that an area of skin might be cancerous, we will take a sample
of skin from that area to look at under a microscope. This is called a
skin biopsy. Different methods can be used for a skin biopsy. The choice
of method depends on the possible type of skin cancer, where it is on
the body, and the size of the affected area.
If a spot is found to be cancerous or pre-cancerous, we may recommend
further tests or treatment. If the spot is small and localized, a more
extensive biopsy or some type of surgery may be needed. For cancers that
might be more extensive (especially melanomas), imaging tests might be
done, and treatment might include chemotherapy or radiation.
With thanks to the American Cancer Society.