Not all Melanomas Come from Moles

The MetaOptima Team | Mar 22, 2017 | Tips Melanoma Moles

Not all Melanomas Come from Moles

We’ve all heard about the importance of checking our skin for cancer. We do our self skin examinations, go to the doctor for checkups, avoid too much sun, and that’s it. Right?

Wrong! Did you know that not all cases of skin cancer have symptoms that most skin guides tell you to look for? Many times there isn’t even a mole to check! In fact, only 20-30%¹ of melanoma cases grow from moles or are mole-associated. This study found that melanoma often grows from normal skin. This can be very tricky, since these cases can appear very quickly, and might not be recognized during your regular skin check routine.

Although not entirely understood why, it seems that these non-mole cases (known as de novo melanoma) are more aggressive than mole-associated melanomas. Researchers found that patients with de novo melanomas were more likely to have aggressive characteristics. Compared to patients whose moles transformed into melanoma, de novo melanoma patients were twice as likely to have thick tumours, and 1.6 times more likely to have broken/uneven skin. Since some skin cancers grow very quickly, it’s always important to look for new lesions or spots, no matter how small!

The good news is that there are still signs that you can look out for. To help you out, here are three specific non-mole related signs⁶ that can be associated with cancer:

• Bumps/warts/scratches that bleed easily or won’t heal- squamous cell carcinoma (SCC) cancers often appear as wart or scab-like bumps that bleed or crust easily. If the abrasion hasn’t healed after 4-6 weeks, it’s time to visit your doctor.
• A change in your nails- be wary of different colours, texture, or tenderness both on and underneath your nail, as this could be a form of SCC
• Changes inside your eye- people who are genetically predisposed or already have lots of moles need to remember that your eyes can get moles too. These are too small to see, so make sure you go to your optometrist for your yearly checkup

Now that we’ve established that not all skin cancers have moles, it’s important to also talk about the fact that even when skin cancers ARE associated with moles, some don’t always follow the rules of what the moles should look like.

An important skin cancer to be aware of is nodular melanoma. The reason that this particular subtype of melanoma is so important is because it grows vertically. When most people think about skin cancer, they imagine a spot that slowly spreads outwards across the skin (epidermis). However, nodular melanoma forms a small bump and spreads downward into your skin, becoming more dangerous as it grows. Even 3.5-4² millimeters makes a huge difference. Since nodular melanoma grows quickly (spreading internally in as little as three months³), it’s important that it’s caught early on. But how can this be done if it’s so hard to spot?

Most infographics and websites tell us to look for moles that are asymmetrical in shape, have an irregular border, multiple colors, or have a diameter of over 6mm. So what happens when a mole is cancerous but doesn’t fit this category? Not to worry! There are useful rules out there for helping you identify these strains of cancer. Do you remember your ABCDs? (If not, click here.⁴) Well, now it’s time to expand the ABCDs to EFGs to account for cancers like nodular melanoma!

The extra steps that you can take to help identify high-risk skin lesions are:

Evolving- changing in shape, colour or size over time, it’s time to get it checked. Take measurements when you perform your monthly skin check, or take pictures to make comparisons on apps like MoleScope.⁵

Firm- oddly firm or tender to the touch, this can be an important warning sign.

Growing- similar to evolving, if you notice that a new lesion is growing, it’s time to see a specialist.

It can be scary not knowing what to expect, especially when it comes to cancer. However, with a little bit of research, vigilant skin checks, and taking care of your skin, you can be prepared. It’s always better to be safe than sorry! What’s even better is you can share your knowledge with your family and friends so they can know what to look for during their skin checks too! Tender, sore, or changing bumps on your skin shouldn’t be ignored, regardless of if they don’t look like a mole! Remember, when in doubt, see a doctor, dermatologist or specialist, and get the support of your friends, family, and cancer communities in your area. Prevention and awareness is a team effort that we’re all a part of! Skin cancer can be tricky, but that doesn’t have to stop us from being prepared!

The MetaOptima Team

Now that you're the master of non-mole cases, check out other types of melanomas here!