Most of us are familiar with the ABCDs of skin cancer.  We have long been told to look for moles that are “asymmetrical”, have irregular “borders,” display a dark brown or black “color” and have a “diameter” of more than ¼ inch.

But a new study in the Archives of Dermatology says that the most deadly subset of melanoma cancer, nodular melanoma, may claim more lives because it is often hiding in plain sight before it is discovered. In short, it just doesn’t look like the melanoma we’ve been told to look for.

While the survival rate for other forms of melanoma has risen sine 1978, the nodular melanoma survival rate has not budged in 30 years.  Nodular melanoma only makes up 14 percent of the diagnosed melanomas but is responsible for 37 percent of all melanoma fatalities.

Nodular melanomas do not typically spread across the skin’s surface.  Instead, they often form on or slightly under the skin and quickly grow deeper vertically.

This is is at the heart of why nodular melanoma is so problematic.  The depth of skin cancer cells at diagnosis is the best predictor of life or death. If a cancerous mole reaches a depth of 3.5-4 millimeters before it is found, only 60 percent of those patients will survive beyond 5 years.

Patients should be especially vigilant about looking for nodular melanoma because it grows so much more quickly than other types of melanomas.  One doctor reported clearing a patient after a skin cancer screening only to have her return two months later with nodular melanoma.  Therefore, YOU are your own best defense.

I hear what you’re saying – alright, alright already.  Tell us what to look for!

I’ve posted a photo above of one incidence of modular melanoma.  But it wouldn’t hurt to do your own Google Images search for “nodular melanoma” to see it in many different forms.  Here’s a checklist:

  • Color – Nodular melanoma can be any color from brown to black to purple to pink.  But it is most often pink.
  • Size – Can be smaller than a pencil eraser.
  • Texture – Look for firm bumps on or under your skin.
  • Change – Nodular melanoma grows very quickly.  Any bump or mole that is changing at a fairly rapid rate should be examined by a doctor immediately.

Melanoma can be a scary thing to think about, especially because we’re all wishing we could take some of those long days in the sun back.  But the up side is that with caution and vigilance, skin cancer can be caught early and treated very successfully.


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