Skin cancer expert Dr Deepak Rallan offers some myth busting to help you keep a check on moles during lockdown.
“I’m worried about skin cancer, but I can’t get to my doctor.”
This has been a frequent worry heard on the Diamond Skin Care phone lines from March onwards. Since the beginning of the lockdown, just under 5,000 patients in Norfolk would normally have visited a GP with concerns about skin cancer.
Advice on the Cancer Research UK website says: “You should see your GP if you notice a change in your skin that isn’t normal for you. Even if you’re worried, you shouldn’t delay seeing them. Your worry is unlikely to go away if you don’t make an appointment. The symptom might not be due to cancer. But if it is, the earlier you pick cancer up, the easier it is to treat. You won’t be wasting your doctor’s time.”
However, Dr Deepak Rallan, director and chief consultant at Diamond Skin Care, which runs the Diamond Skin Care Mole Check clinics in Norwich and Great Yarmouth, says the recent lockdown has eroded many liberties. “Among them is access to routine healthcare, making it difficult to follow Cancer Research’s advice,” he says. “It is ironic that a public health intervention to minimise harm from one condition, can cause anxiety and harm due to other conditions.”
Fortunately, some help is at hand from Diamond Skin Care, which has not stopped its essential services during the recent tough months. Here, Dr Rallan discusses the myths and facts of skin cancer to help you during lockdown.
Myth 1: A cancerous mole becomes itchy, crusty, oozes or causes redness.
Fact: Skin cancer generally causes no discomfort at all. The changes in appearance can be completely silent and knowing to look out for ‘silent’ changes could save a life.
Dr Rallan says: “It is important to remember that the vast majority of itch or crust symptoms come from benign growths. So such symptoms are worth noting, but should not cause undue concern.”
Myth 2: Most melanoma arises from a mole which undergoes changes.
Fact: Just over half of all of new melanomas arise on normal-looking skin. Less than 50pc arise from pre-existing moles which undergo asymptomatic changes.
For this reason, Dr Rallan agrees with the Cancer Research UK recommendation to get to know your skin. But this can be a daunting task for someone with a lot of moles.
“Many of our patients point to stable, longstanding moles (during their annual mole checks) as cause for concern, because they look a little different from the other moles,” he says. “The spectrum of normal is large and longstanding stable lesions that change over years or decades are not a reason to worry.”
But what colour should a mole be? And what if it changes colour?
Moles can range in colour from flesh coloured through the whole spectrum of light to dark brown. They can be flat or raised, smooth or rough, and some have hair growing from them.
Myth 3: A changing mole always suggests skin cancer.
Fact: All moles can change over time. They start off flat and dark and over years become raised and lighter. This is normal evolution for a mole and some types of moles disappear completely over time.
“The key to self monitoring without worry is knowing what change is normal and what is abnormal,” suggests Dr Rallan. “A mole which becomes progressively darker over a few months is an abnormal change, while a mole becoming raised and lighter over years is a normal type of change and not a worrying feature.”
Myth 4: Melanoma is only suspected if you notice a mole is changing shape, or if it has an uneven or ragged edge.
Fact: While this rule (also called ABCD criteria) can be helpful, not all melanomas fit these criteria.
Diamond Skin Care Mole Check patients are coached in what to look out for by the examiner. Dr Rallan has developed an easy to remember mantra to avoid confusion. He says: “New, black and changing, is far easier for the eye to spot than trying to decide if a lesion is asymmetrical, irregular and may have different shades of brown, beyond the biological norm.
“I advise my patients to monitor, but not in detail. Detail is my job! Studying one’s moles in detail is the root cause of unnecessary anxiety.”
Myth 5: Skin cancer can’t be cured.
Fact: Some skin cancer types, such as melanoma and squamous cell carcinomas, are confined to the skin in the early stages. This situation is not so serious and the skin cancer is effectively cured by removal.
However, if left to grow, they spread, via the blood, to other internal parts of the body. This situation is more serious and can result in loss of limb or life.
The solution is simple: If you notice a new or changing very dark mole, seek medical attention immediately. A dermatologist with experience in a technique called dermoscopy can tell you if the mole is cancerous or not.
Myth 6: If it’s black, it must be cancerous.
Fact: Black colour on its own can represent a blood blister or, in darker skin types, dark moles are normal. Not all dark lesions are cancerous!