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skin cancer

melanoma: catching it early can mean the difference between life and death

a stage 3 melanoma diagnosis came soon after maureen meehan noticed that a mole on her arm had changed shape, felt different and had become itchy.

by karen hawthorne

jul 6 2023

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5 minute read

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1200 canadians died of melanoma in 2022

when caught early, the cure rates for melanoma can get as high as 90 per cent, but untreated, melanoma spreads to the bloodstream or lymphatic system, damaging other body parts and causing death. getty

is checking your skin for new moles, or moles that have changed in size, shape or colour something you do regularly? maybe not. but what if it could save your life?

“once every one to three months, when you step out of the shower, take a glance at yourself, take about a minute or two and just to go from head to toe and make sure you get your back and the back of the body,” says dr. maxwell sauder, onco-dermatologist at princess margaret cancer centre in toronto. “performing regular skin exams doesn’t need to be a long process.”

sauder, who is also an assistant professor of dermatology at the university of toronto, is speaking out to raise awareness of the very real risk of melanoma , a less common but dangerous form of skin cancer that has the potential to spread to other parts of the body.

the number of canadians diagnosed with melanoma has more than tripled in the past 30 years, according to the canadian dermatology association — concerning numbers have seen a number of companies involved in awareness campaigns to increase education about prevention. one of these is pharmaceutical company merck canada which launched practice skintimacy , a website aimed at teaching people how to spot the signs of melanoma.

early identification of a suspect mole is critical.

“when caught early, melanoma is very manageable,” says sauder, who was motivated to pursue a career in dermatology — specifically onco-dermatology — after a close family friend died of melanoma. “it’s when we let things go, that’s when most people get into trouble.”

in fact, cure rates can reach 90 per cent — one of the highest cure rates of all cancers — but when untreated, melanoma invades your skin, reaching your bloodstream or lymphatic system, damaging other body parts and often causing death. the canadian cancer society reports that an estimated 9,000 canadians were diagnosed with melanoma in 2022 and 1,200 died from it. of note, the number of people diagnosed has increased from 8,700 in 2021 which is an 8.5 per cent jump from 2020.

“once you get a diagnosis of cancer, you never really get over it”

maureen meehan of london, ont. considers herself one of the lucky ones. her cancer was caught early enough to save her life, but she’s been through a lot since a diagnosis of stage 3 malignant melanoma in 2017.

“when you have a diagnosis of cancer, you never really get over it,” says meehan, who has been remission for one year. “it’s always in the back of my mind.

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meehan, 63, was a marketing professional with the london health sciences foundation in august 2017 when she noticed that a mole on her forearm had become bigger, was asymmetrical and also itchy.

“i’d been watching it, but then i noticed that it had changed,” she says.

it prompted a visit to her doctor who referred meehan to a tissue specialist in london. the specialist performed a punch biopsy of the mole, where, after freezing the area, skin is removed and sent to a lab for analysis. the procedure happened on a friday and the specialist called her the following tuesday with the diagnosis of melanoma and a referral to the regional cancer program.

no family history of melanoma

“it was a shock and very disturbing,” she says. “i have no history of this kind of cancer in my family at all. and my entire life, i have been very diligent about wearing sunscreen and being out of the sun. i was never a person who sunbathed, although i like being outdoors.”

she was advised that surgery was necessary as soon as possible. but first, there were mris to check whether or not the melanoma had spread. unfortunately, the scans shows that it had likely spread to the lymph nodes in her right armpit. the surgery in october removed the cancerous tissue on her forearm, leaving a large scar as a constant reminder of life’s uncertainty. part of the suspect lymph nodes was also removed for monitoring. meehan’s oncologist later confirmed that the two lymph nodes tested positive for small deposits of scattered melanoma cells, meaning the cancer had metastasized.

the next steps included followup monitoring appointments for five years, with ultrasounds of her right armpit every four months, physical exams to check any suspicious looking moles, as well as scans.

“people think, ‘oh, well, you just have [the mole] removed in your doctor’s office and you’re on your way,’” meehan says. “that’s a misconception. melanoma is the most invasive type of skin cancer with the highest risk of death. i don’t think people are aware of that.”

indoor tanning is like smoking for your skin

sauder sees patients of all ages and says that everyone is at risk of developing melanoma because of a “perfect storm” of factors, including stronger radiation rays from the sun because of the ozone breakdown, and the proliferation of indoor tanning which he equates with smoking for your skin. even using indoor tanning once increases your chances of developing melanoma. other top risk factors include having fair skin that burns rather than tans, a family history of melanoma or a history of severe sunburns.

“we know that blistering sunburns before the age of 18 increases your risk of developing melanoma in your lifetime,” sauder says, adding that while he’s not against spending time outdoors, he recommends being safe around the sun. this includes applying sunscreen liberally and frequently (especially during rigorous activity), taking advantage of shade, and wearing sun protective clothing like hats and rash guards. “the ultimate goal ideally is that your skin is uniform in colour, so you really want to try and avoid that t-shirt tan.”

how to spot skin cancer

pay close attention to the size, shape and colour of moles, recommends sauder, who uses the “abcde” guide: asymmetry (is the shape of one part of the mole different than the other?); borders (are the edges irregular or ragged?); colour (is the mole an unusual shade of brown, tan, black, or more than one colour?); diameter (is it bigger than 6mm or the size of a pencil eraser head); and evolution (has it changed, become itchy, scaly or does it bleed)?

“you’re really looking for something that you spot in the mirror and it makes you think, ‘oh my gosh, i don’t remember that looking like that,’” he says. “it’s that kind of traumatic difference.”

for more information on melanoma and other skin cancers or to connect with others, visit melanoma canada and save your skin foundation.

karen hawthorne is a toronto-based writer.

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karen hawthorne

karen hawthorne worked for six years as a digital editor for the national post, contributing articles on health, business, culture and travel for affiliated newspapers across canada. she now writes from her home office in toronto as a freelancer, and takes breaks to bounce with her son on the backyard trampoline and walk bingo, her bull terrier.

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