Reflections At St. Luke's: Skin Cancer Prevention

How many times have you worried about a mole or dark spot on your skin? According to David Sable, MD, Ph.D., dermatologist at Reflections at St. Luke's, it's a good idea to be proactive and keep an eye out for visible changes in your freckles or moles -- often the first signs of skin cancer.

 "If you have a personal or family history of skin cancer linked to moles, you can't be too careful," says Dr. Sable. "It’s best to limit your exposure to sunlight and to always use sunblock, preferably with an SPF of 50. Although most moles are benign, be sure to examine your body -- even the bottoms of your feet and between your toes -- to check for changes in your skin and any existing moles once a month."

If you discover a new mole or notice changes in moles you may have had all your life, make an appointment with a dermatologist to rule out melanoma, the deadliest form of skin cancer. "If you notice changes in a mole's color or size, it’s very important to have a dermatologist evaluate it,” says Dr. Sable. "You also should have any moles checked if they bleed, ooze, itch, appear scaly or become tender or painful."

Examine your skin closely using a mirror, especially those areas often exposed to the sun. Use a full length mirror if you have one and keep track of any changes in your moles over time. Ask a family member or friend to examine your scalp and neck. The most common location for melanoma in men is on the back; in women, it is on the lower legs. See a dermatologist who is experienced in diagnosing and treating skin cancer if you have a mole that meets any of these “A-B-C-D-E” descriptions:

• Asymmetry: One half of the mole does not match the other half
• Border: The border or edges of the mole are ragged, blurred, or irregular
• Color: The mole has different colors or it has shades of tan, brown, black, blue, white, or red
• Diameter: The diameter of the mole is larger than the eraser of a pencil
• Evolving: The mole appears different from others and/or is changing in size, color, shape

 Most often, there is no cause for alarm.

 “If you do have skin cancer, surgery can be performed by a trained dermatologist to treat most common types of skin cancer,” says Dr. Sable. “We use a special type of surgery, called Mohs surgery in cases of non-melanoma skin cancer. We remove a microscopically thin layer of skin in the affected area. After each removal of tissue, we examine the tissue specimen for cancer cells, and that examination informs us if, or where, we need to remove additional tissue.”

 “Mohs surgery is one of the most precise methods we have for removing non-melanoma skin cancer,” says Dr. Sable. “It allows for the removal of a skin cancer with very narrow surgical margin and a high cure rate.”

 “Sometimes skin cancer is found to have spread unnoticed beneath the top layer of skin,” says Dr. Sable. “In those cases when we’ve had to remove a more significant amount of tissue, our team also can do immediate reconstructive surgery. That makes our patients very happy.”