Did you know that only 10 percent of all skin cancer cases involve the dangerous melanoma? And that the survival rate of melanoma is 80 percent? Seven Striking Facts About ‘Suspicious Birthmarks’.
A mole is nothing more and nothing less than an accumulation of pigment cells in the skin. It is unclear why such a build-up occurs, but it is a very normal phenomenon. The more time you spent in the sun (unprotected) as a child, the greater the number of moles. Heredity also plays a role. A few moles are congenital, but most appear between the 3rd and 20th year.
If you get new moles at a later age, they are by definition ‘suspicious’. After the age of 50, the number of moles often decreases. It is not known why that happens. Note: Malignant moles do not disappear with age. Reason to be extra alert to suspicious spots from the age of 50.
Any change in a mole is suspicious
Ordinary moles – round, soft and even in color – rarely become cancerous. The chances of that happening are less than one in a million. But there are also restless – in medical terms ‘atypical’ – moles. These can develop into a dangerous form of skin cancer, also called melanoma. If a mole changes shape, or if it starts to itch or bleed, there may be development in a malignant direction. Such a troubled mole looks different from an ordinary mole. It is asymmetrical – not neatly round or oval – and very flat. Unlike a normal mole, which has a clear, clean outline, the contours of an atypical mole are vague. Often he has different colors: light brown, dark brown, black, gray. A suspicious mole is more than 5 millimeters in size, a melanoma usually more than 10 millimeters. Because a melanoma can metastasize quickly, it is by far the most dangerous form of skin cancer. Melanoma literally means ‘black growth’.
No melanoma without sun
Under the influence of UV rays in the sunlight, the pigment cells in the skin can divide uncontrollably. Since the body is naturally capable of repairing damaged cells, that process usually stops on its own. But in some cases this does not happen and a malignant skin tumor forms: a melanoma. The vast majority of melanomas develop from a mole. By far the biggest risk factor for developing melanoma is the sun; only hereditary forms (about 10 percent of the total) can develop without exposure to sunlight. Periods of short, but intense exposure to the sun – such as under a sunbed or while baking on the beach – are especially dangerous. Other factors that increase the risk of developing a melanoma (mild) are:
- fair skin that is difficult to tan and burns easily;
- more than fifty ordinary or more than three troubled moles;
- two or more first-degree relatives with melanoma.
Compared to other European countries, melanomas are relatively common in the Netherlands; melanoma ranks five in the top ten of most common cancers in women, eight in men. The number of cases has been steadily rising for years. This is probably because the Dutch are avid sunbathers. Moreover, together with the Swedes, we are the least concerned about skin cancer of all Europeans. As a result, we go to the doctor too late with a suspicious mole.
Check your back and legs in particular, as they are more prone to melanomas
It is estimated that about 30,000 people are diagnosed with skin cancer each year. The vast majority of these are cancers of the epidermis (a basal cell carcinoma or squamous cell carcinoma). These cancers are caused by the sun, but not from a birthmark. Melanoma is present in less than 10 percent of all skin cancers. Melanoma mainly affects people over the age of 50. If someone gets a melanoma at a younger age, it is often a hereditary variant of the disease. Melanomas can appear anywhere on the body, even under the scalp. However, some body parts are more ‘sensitive’ to it than others. In men this is mainly the back, in women it is the back and legs.
GPs only see a melanoma once every two years
In total, about 2500 melanomas are discovered every year. This means that a general practitioner sees a patient with a melanoma at his consultation hour on average once every two years. With so few ‘examples’ it can be difficult to make the correct diagnosis. That is why a suspicious mole is in principle always removed. Depending on the type of mole and his own expertise, a general practitioner does this himself or refers it to a dermatologist. A dermatologist does have a lot of experience in assessing suspicious moles. In addition, he can use aids that the general practitioner does not have, such as a dermatoscope. This is an instrument that magnifies the mole ten times. In this way, deviations in shape or color become more visible. Until a few years ago there were long waiting lists for the dermatologist, but nowadays you can get there within a few weeks. With very suspicious moles, this is even within a few days. Moreover, more and more hospitals have a special ‘birthmark consultation hour’. The dermatologist, surgeon and oncologist are there at the same time to help people with suspicious moles as well and as quickly as possible.
More than 80 percent of patients survive a melanoma
A doctor will always remove a suspicious mole. This is done by cutting the spot under local anaesthetic. The removed tissue is sent to the laboratory for further examination. If it turns out that there is a melanoma, the same spot will be operated on again. Depending on the thickness of the tumor, 1 to 2 centimeters of extra tissue is removed. Then the doctor examines the nearest lymph nodes with his hands for metastases. If he feels anything suspicious, he will have an ultrasound or possibly a CT scan of that area. The sutures are removed from the wound seven to fourteen days after the second operation. In the case of thin melanomas (of 1 millimeter or less), in principle no further checks are necessary. In the case of thicker melanomas, the patient is followed for a number of years. Metastatic melanoma is very dangerous, but fortunately the tumor is usually discovered and removed before it can spread. In most cases, people with melanoma have a very good prognosis: more than 80 percent of them survive the first five years. With early detection, that percentage even rises to 90 percent. The vast majority of patients never have new complaints after removal.
Self-monitoring pays off
It is wise to regularly check your body for changing or new moles. For example, do that on the first day of each quarter. More often does not make sense, because then changes are no longer noticeable. A mole that you want to keep a special eye on can be photographed with a centimeter next to it. That makes it easy to see after three months whether it has changed in size, shape or color. Do you have three or more troubled moles, or two or more first-degree relatives with melanoma? Have your moles inspected annually by a dermatologist.
When to the doctor?
• If the mole gets bigger or thicker.
• If the birthmark changes color.
• If the mole changes shape and/or outlines, and the edge becomes irregular.
• If the mole starts to itch.
• If the mole starts to bleed.
• If there is an ulcer or scab on the mole.
Sources):
- Plus Magazine
