The Phantom Menace: How to Monitor Moles and Should They Be Removed 

DIFFERENT MYTHS AND FEARS ARE RELATED TO MOTHERLANDS AND PIGMENT SPOTS. Some say that it is better not to touch them, others – that you need to remove and as soon as possible. At the same time, a typical inhabitant of central Russia has more than a dozen moles and does not have a clear understanding of how to monitor them and what risks they pose. We talked with oncologist Dmitry Kravchenko and found out what to look for, how to suspect melanoma, and when and how to get rid of moles.

What’s the problem with moles?

The problem is that sometimes moles, or, scientifically, pigmented nevi, turn into melanoma. Melanoma is a very dangerous tumor that spreads quickly and leads to death in a short (several months) period. More recently, new drugs have emerged that are effective in melanoma; True, they help only some patients, and it is too early to talk about a complete cure: even if all the symptoms of the disease have disappeared and the person remains healthy for several years, it is not known whether a relapse will occur. In any case, this is an extremely dangerous disease, which, nevertheless, can be prevented or detected at a very early stage, when the treatment has a good prognosis.

It is believed that everyone has a risk of melanoma, although it is increased in fair-skinned people with a large number of nevi (moles). The genetic factor also plays a role, so you need to be especially careful if a relative has melanoma. The most important risk factor is exposure to sunlight, primarily sunburn. It is believed that the risk of melanoma is especially increased if a person had sunburn as a child. It turns out that the main prevention is protection from the sun’s rays in all its manifestations: you need to use effective sunscreen, be in the shade if possible, do not use a solarium and avoid sunburn. And the condition of moles should be monitored regularly.

How to examine moles and on what to look for?

English-speaking authors often come up with abbreviations that are easy to remember – and in the case of examining moles, these are ABCDE: Asymmetry, Border, Color, Diameter, Evolution, that is, asymmetry, contour, color, diameter and changes. What does it mean? Any birthmark with an asymmetric shape should be suspicious, just like any mole with an uneven or indistinct outline or an uneven color. Particular attention should be paid to moles larger than 5 millimeters and to any changes in them: shape, color, size, itching or other unpleasant symptoms.

These signs are independent of each other, and often with early melanoma, only one of them is visible to the naked eye. Therefore, it is very important not to wait for multiple changes, but to go to the doctor immediately as soon as you notice any of these five signs, for example, a blurred outline or asymmetry. It is better to examine not only moles, but also the entire surface of the skin, especially if you have recently sunbathed; other types of skin cancer, so-called non – melanoma, do not develop from pigment cells, but are also associated with exposure to sunlight. Therefore, if new strange or unusual elements appear, it is better to consult a doctor.

Where and how can you get diagnosed?

Of course, it makes sense to regularly examine moles yourself and consult a doctor if you suspect any changes. This can be a dermatologist or oncologist, or a therapist who will refer you to the right specialist. In different countries and cities, days of early diagnosis of melanoma are regularly held, where you can get a check-up free of charge. In Russia, many clinics in 100 cities take part in this action, and the next such day will take place on May 22. Of course, if you are really worried about one of the moles, it is better not to wait for any action, but to see a doctor immediately.

Traditionally, it is believed that special attention should be paid to moles by those who have at least fifty of them all over their body. But in 2016, one study found that many patients with melanoma had much fewer moles, so you can’t rely solely on their number. The risk of a large number of nevi is rather that it is difficult to examine them on your own, memorizing and fixing all the changes. If you want to systematically track the condition of all moles on your body, you can use the FotoFinder system , which is available in some clinics. During the examination, the doctor will photograph all areas of the body, highlight on the screen those moles that seem suspicious, and then take microscopic photographs of each of them. All images are saved in the database, and on the next visit (after six months or a year), you will be able to see any changes, if any.

What if the doctor suspects something is wrong?

If you suspect an unfavorable process, the doctor will recommend removing the mole and be sure to do its histological examination, that is, to study the structure of cells under a microscope. Although beauty salons often offer laser removal of moles, it is a very dangerous procedure; under the influence of the laser, the tissue of the mole seems to evaporate, that is, it completely disappears, and as a result, the material for microscopy is lost. For the same reason, you should not try to “remove” moles with strong chemicals sold in pharmacies. Unfortunately, every year thousands of people die of melanoma due to not being diagnosed on time. It happens that a mole was removed with a laser, its malignancy was not revealed, and soon the patient has metastases – and it is no longer possible to save him.

Therefore, it is better not to risk and remove moles, if recommended, surgically. This procedure is not more complicated and much faster than the placement of a filling: local anesthesia, careful removal with a scalpel, application of a bandage. Then the place of the mini-operation may hurt a little, but in general it is not worse, for example, taking blood for a general analysis. However, none of the side effects of mole removal or the inconvenience of frequent sunscreen applications are as dangerous as the risk of melanoma; to protect ourselves as much as possible is in our power.

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