Close and Personal
Last updated: March 2023
Since I was first aware of melanoma it has always been my moles that I have viewed as the enemy. Watching and scrutinizing them for any change. Whilst many people’s melanoma do come from pre-existing moles, a whopping 71% of melanoma come from new moles or more importantly new lesions on the skin.
Knowing your skin is harder than it sounds
The message that needs to be shared widely is that we shouldn’t just concentrate on the previous message of looking just for the ABCDE rules on moles – we need to just get close and personal with ourselves. We need to know our skin completely.
Knowing your skin isn’t as easy as it sounds though. It’s hard when like me you have so many moles to keep track of – new ones can often get missed. Other patients I talk to mention their own concerns with being unable to look at their own backs, or becoming like a contortionist to view moles in hard to reach places.
So, us skin cancer patients get frequent appointments for “skin checks”. In all honesty, as a skin cancer patient, the fact that there is another set of eyes – trained eyes to check over my 100 plus moles is nothing short of a relief.
Skin cancer check anxiety with a dermatologist
For all patients any appointment – no matter how insignificant it might first appear – comes with anxiety. We plan for and prepare for the worst. Pre-empting every possibility in the run-up to it. Perhaps a sinister lymph node get’s detected, or we may need to change plans we have made to schedule in an immediate surgery or biopsy.
It’s completely impossible to become blasé and that is without the non-mental preparation involved in most appointments.
No need to be nervous
I remember once attending a melanoma conference in Sweden and I was sat at dinner on a table with 3 dermatologists and another patient. The patient and I were discussing with humor our nerves, and the processes we would go through to become “ready” for a skin cancer check with a dermatologist. The dermatologists were aghast at the idea that as patients we might have been dreading the meeting – relieved and yet bemused by our responses.
The simple act of a skin check involves inspection – scrutiny – of your skin. To perform this examination the patient needs to be in a state of near or in some cases, complete undress. This topic has come up frequently in discussions on our online support forum and many of the male patients laugh at the steps taken by their female counterparts. Yet they themselves acknowledge that a skin check isn’t just a simple across the table conversation with a doctor.
Dressing up for the dermatologist to check for skin cancer
How women perceive our own bodies and how we believe others view us varies greatly. Yet most female skin cancer patients I know take great care before a skin appointment to bathe, remove hair, moisturize, and then dress in suitable “skin check appropriate” underwear.
Matching bra and knickers set purchased solely for, and only ever worn to, skin check appointments. The psychological impact of being both on display and seemingly under review or inspection taking on a world of its own.
Yet, if you ask the dermatologist (or any other doctor or nurse involved) they would be mortified at the lengths some of us patients go to for our appointments. One medical professional I spoke to said she was grateful when her patients had washed. I’m generally so clean by the time I get to the appointment that I could have used as an antibacterial wipe! My only mistake was when I once combined a hospital trip with a work meeting and was wearing what I deemed to be non-hospital appropriate underwear. I was quite frankly mortified!
It's thoroughness that matters
When I began the process of routine skin and lymph checks just over 4 years ago I would stand or lie on display in just my underwear on for examination. Body confidence apparently a pre-requisite - or just leave your fears and inhibitions at the door. Since then, my team has changed their systems and I have the top half of my body checked first, replace those items of clothing, and then check the bottom half.
My consultant will then discretely check under the underwear. Melanoma not being particularly selective with where it might appear one would be foolish to assume that where the sun doesn’t shine is safe.
There are of course common sites for melanoma. Most skin cancer appearing on the trunk or legs.2 Yet even despite our knowledge as patients and our vigilance with checking our skin we often forget particular areas such as our scalp or the backs of our ears. Just because we can’t see there doesn’t mean the sun didn’t!
Starting regular skin checks
The act of examining your skin should become routine. Set one day every month on the calendar. On that day, check over your body and markdown on a chart or take a photograph of anything that has changed. For myself and many others, it’s the 1st day of the month. Our “Skin and Lymph Check” day.
So go ahead and get up close and personal with your skin and the skin of your loved ones. Your survival really could depend on it!
Do you sunscreen in the fall?