Make a mountain of this mole

The mole, which was a mere 2mm in size, turned out to be malignant. If he had delayed seeking medical attention even a little, maybe by just 6 months, he would have needed additional investigation and treatment, including sampling his lymph nodes, chemotherapy, radiation, and, of course, plastic surgery to cover the surgical scar.

In most people, moles change all through life, growing darker or lighter, getting bigger or simply disappearing. Some moles mature over a lifetime, while others are attacked by the body’s immune system. A few others can mutate to become cancerous. It is not possible to pinpoint one specific reason for this change as these can include genetic predisposition, environment, hormones, exposure to sunlight, oxidative stress, metabolism, and pollution.

It is therefore important to keep track of your moles and find out which ones are new, which ones are growing, and which ones are a cause for concern. The best way to find out if any mole could be problematic is through a regular body scan, which can easily be done at home.

Use a mirror and study each part of your body. Keep track of the moles all over your body and ask a friend or family member to help you check your back and even the back of your head. If you find any moles anywhere on your body, schedule an annual total body mapping and mole analysis at the hospital. 

Body mapping involves the taking of 20 pictures of your entire body from head to toe. Each section is then checked for atypical moles with a dermoscope. This is recorded and cross-checked every year during the annual body mapping exercise. With this, not only new moles are tracked, but also existing ones that are changing in shape, size, or colour. This is especially important if you have many moles, photoaging, or a history of melanoma. People with more than 100 moles have seven times higher risk of developing melanoma than people with fewer moles.

It is recommended that you follow the ABCDE rule of moles. In this rule, A stands for asymmetry. A symmetrical mole is usually safe; however, if your mole is asymmetrical, consult a doctor immediately. B is for border. If the border of the mole is clear, then you need not worry. A jagged or wavy border, however, spells trouble. C is for colour. The colour of your mole should be uniform. A mole with two or more colours needs a doctor’s attention. D is for diameter. Any mole larger than 6 mm in diameter needs to be checked by a skin specialist. E is for evolution. Any new mole or any changing mole is a sign of possible danger. If you have any moles that are flaking, oozing, itching, bleeding, or leaking, see a doctor.

As with all cancers, the earlier a melanoma is detected, the easier it is to treat it. The best time to detect a melanoma is when it is small and doesn’t go beyond the epidermis. 

Not all moles are melanomas and not all melanomas are moles. However, considering that melanoma is responsible for the greatest number of deaths related to skin cancer, we recommend that you stay safe with regular check-ups.

Melanomas are a malignant version of the melanocyte cells. Melanocytes are found in the top-most layer of the skin and produce melanin which normally protects your skin from the sun’s harmful rays. Sometimes, however, these melanocytes mutate and that is when they become dangerous.

That’s why it’s important to protect yourself from the sun. Wear light clothes to protect your skin from direct sunlight. Use sunscreen with sun-protection factor (SPF) to shield your face and hands. Schedule and attend check-ups diligently so that you can diagnose the problem early. If your body mapping raises any red flags, opt for a biopsy. The pathologist will tell you if the cells are malignant. 

Melanomas are classified in stages 0 to 4. A stage 0 melanoma is easy to treat and to remove. A melanoma is classified as stage 4 if it has spread to other parts of the body, usually through the lymph nodes. In this case, an oncologist will recommend a programme of radiation therapy or chemotherapy. A melanoma is usually removed along with some healthy skin around it. 

An old Asian saying claims that our moles decide our fortune. There may just be an element of truth in this superstition. 

 

 

Dr Saroj Suvanasuthi is a dermatologist at Samitivej Sukhumvit Hospital. Call (02) 711 8700-2.