Identifying Malignant Melanoma

We all remember the hockey fan story from October 2021 of Vancouver Canucks equipment manager Brian Hamilton. The fan behind the bench got his attention during the game with a very important observation about the mole on the back of his neck.

“The message you showed me on your cell phone will forever be etched into my brain and has made a truly life-changing difference for me and my family,” 

“Your instincts were right and that mole on the back of my neck was a malignant melanoma and thanks to your persistence and the quick work of doctors, it is now gone.”

— Hamilton

The difference between skin cancer and melanoma

Skin cancer is common but often survivable. Basal and squamous cell carcinomas, by far the most common types of skin cancer, can be extraordinarily disfiguring but are rarely fatal.

Melanoma is a different story. It accounts for just about 1 percent of all diagnosed skin cancers but causes the vast majority of deaths. In 2021, the American Cancer Society estimated that doctors would diagnose about 106,110 new melanomas in the United States and that about 7,180 people would die of the disease. The risk increases with age.

Melanoma is the most serious type of skin cancer. It develops when skin cells multiply rapidly as a consequence of mutations in their DNA caused by UV exposure. Melanomas originate in the pigment-producing melanocytes in the basal layer of the epidermis; they often resemble moles and are generally black or dark brown.

Early detection can lead to effective treatment.

The most important warning sign of melanoma is a new spot on the skin or a spot that is changing in size, shape, or color.

The Skin Cancer Foundation, founded in 1979, has long recommended an “ABCDE” test for worrisome lesions. It is a mnemonic device to check what to look for:
A for asymmetry, when one half doesn’t match the other

B for an irregular border

C for colors that might be different from one another

D for large diameter, or anything approaching the size of a Cheerio or a pencil eraser

E for evolving, meaning that it changes over time.

The five-year survival rate for “thin melanoma,” Stage 1, when the cancer is less than one millimeter thick, is 99 percent, according to the American Cancer Society. Once it has spread to distant organs, in Stage 4, the survival drops to 27 percent.

The American Cancer Society’s estimates for melanoma in the United States for 2022 are:

• About 99,780 new melanomas will be diagnosed (about 57,180 in men and 42,600 in women).

• About 7,650 people are expected to die of melanoma (about 5,080 men and 2,570 women).

• The rates of melanoma have been rising rapidly over the past few decades, but this has varied by age.

If you find a mole or spot that was not there before or is changing in size, please contact Feinstein Dermatology at 561-498-4407, email us at [email protected], or schedule a skin check at

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