You can do some testing for skin cancer at home, by checking your skin monthly for new growths or changes. Your doctor should also check your skin once a year, and may choose to biopsy suspicious marks.
Everyone, even if dark-skinned, should examine his or her own skin every month. Do a complete skin exam every month in front of a mirror, in privacy, and fully undressed (such as before or after a bath) in bright, natural sunlight or a good light.
- Start with your head, scalp, and face, and continue in an orderly fashion down the entire length of your body, both front and back. It is important to look for any new growths or changes including pink patches or spots, scaly growths, bleeding areas, or changing moles. A friend can help you examine your back and scalp.
- Bend your elbows, and look carefully at your palms; forearms, including the undersides; and upper arms.
- Examine the back and front of your legs. Also look between your buttocks and around your genital area.
- Sit and closely examine your feet, including the soles and the spaces between the toes.
If you have already had skin cancers:
- Feel both sides of your neck, armpits, and groin crease for any new lumps or bumps that may be enlarged lymph nodes, which could indicate that the cancer has spread.
When examining your skin, keep the ABCDEFs of moles in mind:
- Asymmetry: Does half of the mole (or other pigmented skin spot) look different from the other half?
- Border: Is the border of the mole irregular or ill defined?
- Color: Is the color uneven (shades of one or more colors), or has it changed over time?
- Diameter: Is the mole larger than a pencil eraser?
- Elevation: Has the surface of the mole changed? If it was smooth and flat before, is it now elevated (raised)?
- Feeling: Has the sensation (feeling) around the mole changed? Does it itch? Is it painful?
Everyone should get a full skin examination by a doctor or nurse every year, to look for moles, birthmarks, or other pigmented areas that look abnormal in color, size, shape, or texture.
Your full skin exam usually includes a visual examination of the skin. Further evaluation of moles or other pigmented areas will most likely be done using a dermascope, a magnifying light instrument used by dermatologists to assist in the diagnosis of malignant skin lesions.
If you have had skin cancer before, you should schedule a skin examination more frequently than once a year. Dermatologists and dermatologic surgeons, who are skin cancer specialists, can often diagnose and treat many skin cancers at an early stage. Ask your doctor how often you should have these skin examinations.
Skin cancer can't be diagnosed merely by looking at it. If a mole or pigmented area of the skin changes or looks abnormal, your doctor may choose to biopsy the mark, taking a tissue sample for a pathologist to examine. Suspicious areas should not simply be shaved off or cauterized (destroyed with a hot instrument, an electrical current, or a caustic substance). A biopsy should be performed first to determine if the area is malignant.
Several techniques are used to perform skin biopsies. For skin cancer, your doctor will most likely use a technique known as local excision, in which the entire suspicious area is removed with a scalpel under local anesthetic. Depending on the size and location of the suspicious area on your body, you may have this type of biopsy done in a doctor's office or possibly as an outpatient at a hospital. Your doctor will put in stitches to close the excision and cover the area with a bandage.
Some doctors use other biopsy techniques called punch biopsies or shave biopsies. In a punch biopsy, the doctor uses a tool to punch through the suspicious area and extract a round cylinder of tissue. In a shave biopsy, the doctor simply shaves off a piece of the growth. Both of these types of biopsies are usually done in a doctor's office. If the tissue is malignant, further excision will be necessary.
The sample of skin is sent to a pathologist, who looks at the tissue under a microscope to check for cancer cells. Your tissue may be judged normal or abnormal. Abnormal results may include benign growths such as moles, warts, and benign skin tumors or may mean a diagnosis of squamous cell carcinoma, basal cell carcinoma, or melanoma. Because melanoma can be hard to diagnose, patients should consider having their biopsy sample checked by a second pathologist.
As with any time the skin is cut, there is a small risk of infection after a biopsy. You should call your doctor if you have a fever, an increase in pain, reddening, or swelling at the infection site, or continued bleeding. If your skin usually scars when injured, the biopsy may leave a scar. For this reason, a biopsy on the face might be better performed by a plastic surgeon or dermatologist who specializes in techniques that reduce scarring. If a large area is biopsied, a skin graft may be required to cover it.
Before you have a skin biopsy, you should tell your doctor what medications you are taking, including anti-inflammatories, which may make your biopsy look different to the pathologist, or blood thinners like Coumadin or aspirin, which could cause bleeding problems.
Last reviewed on 7/21/09
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