Skin Cancer Screening - Questions to Consider

Why come to the Clinic?

If you are concerned about skin cancer and melanoma, or just want peace of mind and a thorough check of all your moles, then seek an opinion with an expert.

Early detection remains the most important factor in improving the survival of people diagnosed with melanoma.

Dr Bowling is an internationally recognized expert in skin cancer diagnosis with Clinics in London & Oxford.

Will I see a skin cancer expert?

Yes - Dr Bowling performs all consultations and examinations personally, guaranteeing an expert opinion and total confidence in you skin cancer assessment.

This is important as many high street clinics, offering ‘skin cancer screening’ or ‘mole checks’, have non-medically qualified staff offering opinions.

For something as important as melanoma always seek an expert opinion and check the qualifications of the person performing the examination.

Consultations can be booked directly with the clinics ensuring fast and direct access to expert care.

Will I be charged per mole examined?

No - All moles and skin lesions are examined routinely as part of the examination.

Furthermore charging for each mole examined is unethical in Dr Bowling’s opinion.

Additionally as Dr Bowling is a Dermatologist, any other skin concerns can also be discussed as part of the consultation.

What is dermoscopy?

Dermoscopy is a diagnostic technique using devices to illuminate and magnify structures within the skin, which would otherwise be invisible to the naked eye.

Expertise in dermoscopy improves accuracy for detecting melanoma. Furthermore expertise in dermoscopy results in fewer unnecessary skin excisions.

Dr Bowling is the UK dermoscopy expert.

Who would benefit from skin cancer screening?

People with risk factors for melanoma and skin cancer include those who have one or more of the following:

- a history of childhood sunburn
- fair skin
- high UV exposure
    + lived overseas
    + work outdoors
    + outdoor hobbies
    + sun-seeker / history of sunbathing
    + sun bed use
- multiple moles
- multiple atypical moles
- a previous history of skin cancer
- a previous history of melanoma
- a family history of melanoma
- a history of immunosuppression

Those with multiple risk factors may benefit from regular skin cancer screening.

What does the appointment involve?

Consultation: A detailed medical consultation will take place and risk factors for skin cancers including melanoma will be discussed.

Examination: All areas of the skin will be examined except for the scalp, breast, buttock and genital areas. Patients are strongly advised to check these areas before undergoing the examination and advise Dr Bowling of any moles present at these sites. This is very important as melanoma can occur at any skin site.

What should I wear to my skin cancer examination?

Female patients should wear separates and if possible avoid wearing make-up, nail polish and avoid skin-staining preparations (e.g. self-tanning products) for at least 2 weeks prior to examination.

Recent sun exposure should be avoided as this causes changes to be seen in moles.

How often should I have a skin cancer check?

This will depend upon your risk factors and findings on examination.

When will I get the results?

By seeking an expert opinion the results are available immediately.

What happens if a skin cancer is detected?

If a skin cancer is detected treatment can be arranged directly at the Clinics.

Treatment can also be arranged for any areas that have the potential to become skin cancers (pre-malignant lesions) during the consultation.

What about cosmetic mole removal?

Treatment for any mole or skin lesion causing symptoms or cosmetic concern can also be arranged.

Self Skin Checks - ABCDE check for Moles

All moles have the potential to change. Most changes are entirely innocent however it is important to examine any changing mole to exclude features of melanoma. Therefore if a mole changes and develops any the following features it should be checked by a doctor:

A = Asymmetry: Moles are usually round or oval.
B = Border: If the edge of a mole becomes blurred / smudged.
C = Colour: If the mole develops more than one colour.
D = Diameter: If the mole increases in size >6mm.
E = Extra features: Erythema (redness), elevation, itch, irritation.

Skin Cancer Diagnosis

The presentation of skin cancers can be variable and diagnosis may be a challenge for clinicians. Accurate diagnosis is essential for effective treatment. A number of diagnostic tools exist to aid diagnosis including:

Dermoscopy

Dermoscopy is a technique which uses devices to illuminate and magnify structures within the skin, including the blood vessels seen in certain skin cancers. Dermoscopy has been proven to improve accuracy when diagnosing melanoma allowing earlier detection of melanoma and other skin cancers and a reduction in unnecessary skin excisions.

Pathology

The diagnosis of skin cancer can usually be achieved clinically by experts, however sometimes a diagnostic biopsy is required to confirm the diagnosis before definitive treatment is undertaken

Skin Cancer Treatment

The treatment of skin cancer is complex and will depend upon a number of factors including: the type of skin cancer, the site affected and the potential of the tumour to spread. Therefore an expert opinion is recommended to ensure the best choice of treatment is made. Treatment for skin cancers include:

Topical

A number of creams can treat the less aggressive skin cancers particularly on low risk skin sites such as the trunk and limbs. They can also be used to treat pre-malignant skin lesions.

Cryotherapy

Local destruction of the tumour can be achieved with liquid nitrogen therapy. This should only be considered for less aggressive skin cancers particularly on low risk skin sites such as the trunk and limbs. It can also be used to treat pre-malignant and some benign skin lesions.

Surgery

Surgical excision should be considered for any skin tumour at high risk anatomical sites. This can usually be achieved under local anaesthetic. A safety margin of normal skin is required.

Mohs’ micrographic surgery

The tumour is examined under a microscope at the time of surgery to ensure tumour free margins are achieved before the wound is closed. This can be a very useful treatment of high risk tumours at difficult anatomical sites.

Photodynamic therapy

The skin tumour is gently scraped away and a topical cream is applied. The cream is absorbed by any remaining tumour cells which then can be treated with a bright light. This should be reserved for less aggressive skin cancers particularly on low risk skin sites such as the trunk and limbs. It can also be used to treat pre-malignant skin lesions.

Radiotherapy

Radiotherapy should be considered for tumours which have recurred or where surgery can be difficult. The treatment will usually involve a course of outpatient appointments in a hospital where radiotherapy is available.

Skin Cancer Information

For information on skin cancer please visit: http://www.cancerhelp.org.uk