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How to Spot Skin Cancer and Melanoma

Heard the old joke that a doctor is “practicing” medicine? Sometimes it seems just like that! My misspent youth caught up with me in my 30s and is still causing problems in my late 50s.

Do You Trust Your Doctor?

Twenty years ago I noticed a large freckle on the back of my calf. I hadn’t always had it. It was larger than a pencil eraser and it worried me. I pointed it out to my dermatologist who said it was nothing to worry about it. Three years later a new dermatologist assured me it looked fine. Two years later, when we moved back east, a new dermatologist said it was harmless.

Eighteen months later we moved back to California, and you guessed it, another dermatologist said it was fine. I told him it bothered me and I wanted it removed, then biopsied. This doctor literally said,  “You’re being a silly woman. If I remove that, I’ll butcher your leg and it’ll look horrible.” That bedside manner fell flat on me.

I found a Plastic Surgeon who removed it, then biopsied it.

I remember lying on the table, face down, leg numbed, while he cut it out. He said, “This doesn’t look suspicious to me, but you’ll feel more comfortable with it removed.” Ten days later his nurse phoned. The biopsy had come back showing melanoma. They needed to take a larger, deeper, part of my calf to be sure they got it all. I didn’t panic, but I was furious. How could 5 specialists miss my skin cancer? It didn’t fit the criteria for them to be concerned.

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This freckle hadn’t darkened or changed during all those years. But my gut told me it wasn’t right. I’m here because I trusted my instincts and was insistent.

Some possible signs of skin cancer:

  • The most important warning sign for melanoma is a new spot, or a spot that is changing in size, shape, or color. Another important sign is a spot that looks different from other spots on your skin (known as the ugly duckling sign). If you have any of these warning signs, have your skin checked by a doctor.
  • The ABCDE rule is another guide to the usual signs of melanoma.

A is for Asymmetry

One half of a mole or birthmark does not match the other.

B is for Border

The edges are irregular, ragged, notched, or blurred.

C is for Color

The color is not the same all over and may include shades of brown or black, or sometimes with patches of pink, red, white, or blue.

D is for Diameter

The spot is larger than 6 millimeters across (about ¼ inch – the size of a pencil eraser), although melanomas can sometimes be smaller than this.

E is for Evolving

The mole is changing in size, shape, or color.

__________

How to protect your skin:

I wear hats almost everyday and have 3 sun umbrellas. I wear very strong sunscreen everyday. I slather all exposed parts of me, rain or shine. When the salespeople tell me there’s no benefit to using anything higher than an SPF 30, I ignore them.

If I’m in a very sunny place or will be outside a long time, I layer sunscreens. I start with a chemical sunscreen, which goes on bare skin, soaks in and changes how your skin reacts to the sun. Then, I layer a physical block on top which reflects the suns rays. I can’t be too careful.

Look for full spectrum sunscreens that protect against UVA and UVB. Wear UV protective sunglasses, clothing, hats and stay out of the sun. I do all of these and still have spots pop up. They’re from damage caused many years ago.

UVA: A stands for Aging.

This radiation penetrates deep into the skin and is responsible for premature aging of the skin and skin cancer. Tanning beds can emit 2 to 5 times more UVA radiation than the sun. People actually still use these!

UVB: B stands for Burning.

This radiation is stronger than UVA radiation. It mainly affects the outer layers of the skin, causing sunburns, premature aging of the skin, and skin cancer. These rays are strongest during the summer months – especially between 11 am and 4 pm.

You need to be your own advocate when it comes to your health. And skin cancer is serious business. If anything seems off to you, trust your instinct and go the extra mile to be sure. Skin Cancer is deadly.

What type of sunscreen do you use?

 

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65 Comments

    1. Sometimes it seemed like arrogance. Other times it felt like apathy, which really pissed me off. Yes, we have to advocate for our own bodies.

  1. I mostly just stay out of the sun and never have been fond of “laying out” though we all did it as teen-agers in the 70’s (and I lived in the tropics!).

    I just don’t like the feel and inconvenience of applying and re-applying sunscreen. Are there decent sprays or powders? Wondering this, too, about tinted moisturizer – every summer it’s the same thing … I want to apply some tint, esp on my legs and arms but the thought of putting lotion on when I emerge from a cooling shower is just – not attractive. Jergens and its generics (Walmart) dry pretty fast, but – I still want to look that up… Powdered semi-permanent skin tints. I guess it’s called “gradual tanner”.

    Also be great if sunscreen included some tanner. Looks like some do…

    1. It’s really important to find a sunscreen that feels good on your skin!! So you will use it consistently. I try a lot of new sunscreens but basically stick to a physical block (Sheseido) for my face and neck. Then a chemical one for the rest of me.
      I use and like the Jergens light self tanner for my legs in the summer. It just takes the “pasty factor” off my legs and helps disguise some veins.

  2. Great post! Timely too as a friend of mine from high school died last year from melanoma. She was only 49. I’ve not tanned in over 25 years and am rocking my paleness. I’ve had tremendous difficulty finding sunscreen that didn’t irritate my face but finally lucked out with CoTZ Face Natural Skin Tone SPF 40 Sunscreen 1.5 oz that I discovered on Coolibar. I love this stuff! At first I thought that the tint would be way too dark for my porcelain skin tone but once rubbed in it’s fine. I’m wearing this instead of foundation as it makes my skin look poreless. Now I need to start wearing sunscreen on the rest of my body. I also have a great hat, 2 pairs of pants and 1 top from Coolibar and I love all of them. Think I’ll make an appt with my doctor for a skin check now…

    1. I’m sorry to hear about your friend. That’s so tragic.
      Thanks for the sunscreen recommendation Kim! I’ll check out the CoTZ. I’m so fair I usually can’t wear tinted sunscreens. In fact, pure zinc usually disappears into my skin tone.
      YES…protect the rest of your body. Apparently melanoma doesn’t always show up where your skin has had the most exposure. Mine was the back of my leg. I’ve got a large package coming from Coolibar. They have great products. Thanks so much for sharing Kim!!

  3. I tanned all the time when I was young. I was so naive. I thought I’d be dead by the time I was 30 so I didn’t care how it was damaging my blond blue eyed sensitive skin. Flash forward 30 years and I am paying with age spots and wrinkles.

    If you’ve read my blog for longer than 2 years you will know that I suffered tremendously at the hands of a bad Dr. during what should have been a simple operation that turned into a nightmare of pain. I had a fear of hospitals before I went for my operation but I can tell you that my most recent catastrophe cemented my thoughts that hospitals are places we go to die, not get better.

    bisous
    Suzanne

    1. I’ve only recently found you Suzanne, so I didn’t hear about your horrible problem. It sounds awful! I agree hospitals are where people go to die. And that’s another issue I will take to my soap box. It shouldn’t be that way. Glad you’re OK now.

  4. I had a similar story. I had a small spot on the end of my nose which my Doctor kept telling me was harmless. It was the chemist in France who told me to got to a specialist as soon as possible when I asked for something to get rid of the pesky spot. By this stage it was bleeding. It was still difficult to get a referral and it was wrongly treated. I finally had an operation and a skin graft on the end of my nose to fill in the hole. Not a good story. I was lucky apart from the appearance it was not the dangerous type.

    1. I’m so sorry to hear this!! You’re so lucky. The problem is, those Basil and Squamous cell, pre cancers turn into more serious problems if left untreated. I’m really glad you caught it.

    1. Hi Michele! I like a variety of sunscreens and use different ones, depending on how strong the sun is. I just tried a new “gee wizz”, invisible zinc sunscreen, that was crappy. I’ll write post on what I look for, why and the winners I’ve found.

  5. Ouch. This really hits home. My mother was a sun worshipper who raised a sun worshipper. I am so trying to listen to you, Jennifer. Must disclose that tomorrow’s post might put you off. As far as doctors go, I agree with you 100%. We must advocate for ourselves and our loved ones. Sometimes you just have to say no, doctor, you’re wrong. We live inside our body, not them.

    Anita

    1. Your post didn’t upset me at all Anita!! You may have totally different skin and melanin content than mine. Growing up in the era of “tan is chic”, was tough for my ghost white complexion. I’m now paying for the ignorance of my youth, but cringe when I see people ignoring what we do know now.

  6. I haven’t had the luxury of having the same doctors for years at a time. With changing health plans it seems like you have to tell the same story over and over. Communication between doctors is sometimes non-existent. It’s great that you demanded to have a biopsy and found out before it’s too late. We have to step up to the plate to make sure we get the care we and our loved ones need.

  7. Thank you for this, Jennifer. As someone who baked in the sun in my teens (didn’t we all in the 70s?) with little more than baby oil – I’m living with the damage now, as well. Glad you were tenacious in your gut feeling.

    1. Baby oil and iodine was my cocktail of destruction! For some reason I assumed it would make me tan like my friends who tanned easily. I can only claim ignorance of the time.

  8. I’ve had similar experiences with doctors over different medical issues. You were right to trust your intuition, and to continually press medical professionals to listen! You have to take charge of your own health and show doctors that you aren’t stupid and the last word in any diagnosis is yours!
    Glad you caught this. Skin cancer is no joke!

    Alicia
    spashionista.com

    1. Thanks Alicia! It is not a joke. I hated being treated as a moron or “a silly woman”, as the last Dermatologist referred to me. It’s what spurred me to action. I suppose I should be grateful to him.

  9. I must say that I feel VERY fortunate and confident with my dermatologist. She has recommended and I have used TIZO for years.

  10. Jennifer, thank you for a much needed educational post on the dangers of skin cancer. The information is valuable and you covered so many important issues. My father died of melanoma. It’s not the way you want to go.
    Kimberly
    http://FiftyJewels.com

  11. wow, now I’m going to be freaking out about every freckle! I think you are so right about following your instincts. How can they all miss that? Thank goodness you are ok now. I always say follow your guts!

  12. Jennifer, my gosh, I, too, had a similar experience with a freckle on my nose. Two dermatologists said it was just a freckle. I’ve had freckles all my life so I believed them. But I couldn’t shake this feeling that something wasn’t right. I made an appointment with my PCP. As soon as she looked at me she said, “That’s a basal cell carcinoma.” Whaaat? She set me up with a surgeon who she called immediately, arranged for me to skip the preliminary biopsy, and the next day it was removed along with areas around it until they found cancer-free tissue. Yikes! I’m slathered in Burt’s Bees Sunscreen every day, stay in shade, and wear hats, too.

    1. You’re lucky Sandy! Our stories are so similar! Luckily there are great hats ans sunscreens out there.

  13. Jennifer,
    I feel very strongly about being our own advocate when it comes to our health. Good for you for trusting your gut!

    Thank you for breaking down the ABCDE’s of skin cancer and the difference between UVA and UVB. This is one of the best articles I have read on the subject and I plan to share it!

  14. Holy cow, melanoma is NO joke! I’m so glad you trusted your instincts, my grandfather died from melanoma. I too am queen of the cover up and sunscreen. To this day people still say that I need a tan but I ignore them. I would love to hear more of your sun protection clothing recommendations. Oh and I use Neutrogena UltraSheer Dry-Touch SPF 45 on body and Oil of Olay Regenerist SPF 50 on my face.

    1. I like the Neutrogena Ultra Touch too, but the liquid, not the spray. For my hands I always carry the Neutrogenia Baby stick in my purse and car, which I reapply regularly. I like the Sheisedo sunscreens. I know they are expensive, but I find they soak in well, work nicely under my tinted moisturizer don’t look ghostly!

  15. I see both sides of this coin. As a retired dentist, the fact remains, we are all human and only know what we know (that being what we are taught or have experienced). That being said, it’s always important to be your own advocate in any situation. So bravo to you for deciding to get the freckle out! Did you ever read “Cancer, Schmancer” by Fran Drescher? She had to see 7 or 8 different doctors before getting an answer! jodie
    http://www.jtouchofstyle.com
    ps…Love the hat, I wear one often too!

    1. I did not read that book! I’ll have to look for it. So true about us doing what we can with the knowledge we have. That’s why using our instinct is so important. It’s the concept Malcolm Gladwell illustrated in his book “Blink”. Great book, if you haven’t read it!

  16. Jennifer unfortunately YOUR STORY IS ALL TOO COMMON. You are so right that we must all be our own advocates. I have heard so many so many stories of misdiagnoses and botched surgeries where one has very little recourse. You are doing so much to take care of yourself, I applaud you!

    xoxo
    Karena
    The Arts by Karena

  17. Great article, my friend, as well as a good reminder at this time of year. I’m passing this on to all my young friends (in there 20-30’s) so they don’t make some of the stupid mistakes I did. Isn’t it funny now days, we never leave home without a hat and sunscreen.

    1. Now we know! I’ve drilled it into my fair skinned daughter’s consciousness, and she’s very careful too!

  18. How long do you wait before applying another lotion?
    NO fun…………checking the skin going to docs who wave their hands…….and say all is good.
    Honestly,do we have to pay and then tell them how to do their job?I guess so!!!
    Good you were persistent!!
    Hats suit you………I WILLNOT ASK HOW MANY YOU OWN!!!

    1. As soon as the chemical one is dry, I layer the physical one. Physical gives instant protection. Chemical takes 30 minutes to interact with your skin before becoming effective.
      Well if I count my hats, so do you!!
      xox

  19. I do not trust doctors easily because I am a doctor’s daughter. In fact, a dear friend was just taken to emergency this morning because her doctor screwed up. timely post…

  20. Such an important post! I am so glad you listened to your gut! I watch for things like this constantly as I am so fair and I hat and lather, too. Am looking for good lightweight gardening shirt today to replace old one! Thanks Jennifer!

    1. Check some of the online clothing shops for gardening shirts with SPF built in! They may not be chic…but you’re gardening:))

  21. Hi Jennifer. Great post on such an important subject. The UK isn’t as hot and sunny as parts of the US but skin cancers are increasing because in the 70s holidays abroad took off and everyone wanted a tan! I’ve got that very pale Scottish skin courtesy of my parents (bless them) but when I was young I sunbathed at every opportunity going bright red first and only after the redness would my skin go a brown colour – you never thought this is actually a burn!!!

    Now I wear Factor 50, and this is because ever since I turned 60 I have an annual skin check where my entire body gets checked over by a specialised skin nurse and several small basal cell and squamous cell cancers have been found. And I’m really pleased they’ve been found as the docs just use a quick ‘freezing’ technique which burns them off. Left without checking they would’ve grown much further and needed a proper op. So I’m hyper skin and sun aware now. If I could tell my younger self anything I’d say don’t do this sunbathing thing – not worth it!

    1. Same with me! I had no idea the damage I was doing. I think a lot of us have the same problem and made the same mistake!

  22. PS when we go to the Mauna Kea…..(we have been going for 40 years! One daughter was married there in 1984! I look like a nun. I swear. Under the umbrella…covered with black caliber! Now they have colors !!!

    Such great advice that will save lives!!!!

  23. Jennifer great post. Thanks again for the reminder and sharing. I am also very careful as skin cancer is big in my dad’s family. Living in California too- I don’t think we realize how much sun we get daily. So glad you insisted on a removal!! That scares me and reminds me I’m due for a check too. Let’s get together. Miss you .xo

  24. EEEEEEEEEK!!!!!!!!!!

    This happened to my husband! He has had a lot of sun; and we lost a really close friend to melanoma……(he baked) .we lost him when he was 59!!!!
    but…I studied all the pictures….and , thank God…my husband goes to the dermatologist every three months….he has played tennis at noon for 40 years…..and he was 73!

    His dermatologist said..”this doesn’t look like anything….but we will biopsy it”! Yes! Melanoma! the kind of skin cancer that can kill you! I took him to my genius dermatologist in Santa Monica…(no offense Santa Barbara dermatologist who diagnosed) and she sprang into action!
    (Dr.Karyn Grossman….best dermatologist in the world if you ask me….primarily cosmetic…..and the best of the best;) but when it came to my husband…she is “dialed in”! The pathology went to the “best” pathologists ; Harvard….and a certain person….then…we had to see if it had spread….(key); and we went to the guy in Santa Monica who does the “sentinel node test”; He is also the “best” (this is scary stuff!!) fortunately…..that was negative.

    this is scary stuff. I say again !….and in your case; it is frightening that this was not diagnosed by all those doctors!

    Adam, my husband’,s was an “atypical” melanoma…(it looked like a big freckle “! He has had two more melanomas….(not related….”in situ” which are not as dangerous…but my doctor said….RED ALERT!!!

    Notify all your children and blood relatives! They have a 50% greater chance of melanoma now!!! That is a LOT!!

    At any age! And my husband’s have all been “atypical” meaning all those years I spent studying those pics of melanomas; when it comes to Adam’s….useless. His are all “atypical”; so the doctor….said…any skin change….get right in here!

    The price he is paying..all those years of playing tennis five days a week at noon!

    And being in the office the rest of the day….and having skin that came from northern Italy and Northern France…….the sun didn’t come out!

    Sunscreen wasn’t considered important when he was growing up!

    Thank you so much for writing this blog post!

    Never trust any single doctor if you have a bad feeling! Go to another and another! Especially about your skin! It is your body’s biggest organ!!!!

    What an important and wonderfully giving post!

    Penelope
    Brava and Thank you!!!!

    1. Very scary for him! I burned and peel as a kid too so that’s where all my damage came from. I have told my children and my siblings, because they have a 50% higher risk of getting it too!!

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