The most serious form of skin cancer is melanoma. They constitute less than 5%
of skin cancers but cause an estimated 75% of skin cancer deaths.221 Melanoma
are usually pigmented lesions. Any skin change, including those to a wart, mole,
or freckle that changes color, size, or shape, or that loses its sharp border may be a
melanoma and should be evaluated by a health care provider, preferably a dermatologist.
If found early and it has not grown deep into the skin, melanoma can be
treated successfully. The five-year survival rate (percentage of people who live at
least five years after diagnosis) at this stage is around 97%. After melanoma has
metastasized, the five-year survival rate is less than 20%.

According to the American Cancer Society, 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.222 Another important sign is a spot that looks different from all of the other
spots on your skin (known as the ugly duckling sign). If you have one of these
warning signs, have your skin checked by a dermatologist.

The ABCDE rule is another guide to the usual signs of melanoma. Be on the lookout
and tell your doctor about spots that have any of the following features:
• A is for Asymmetry: One half of a mole or birthmark does not match the
• B is for Border: The edges are irregular, ragged, notched, or blurred.
• C is for Color: The color is not the same all over and may include different
shades of brown or black, or sometimes with patches of pink, red, white, or
• D is for Diameter: The spot is larger than 6 millimeters across (about ¼ inch—
the size of a pencil eraser), although melanomas can sometimes be smaller
than this.
• E is for Evolving: The mole is changing in size, shape, or color.

Some melanomas don’t fit these rules. It’s important to tell your doctor about any
changes or new spots on the skin, or growths that look different from the rest of
your moles.
Other warning signs are:
• A sore that doesn’t heal
• The spread of pigment from the border of a spot into the surrounding skin
• Redness or a new swelling beyond the border of the mole
• Change in sensation, such as itchiness, tenderness, or pain
• Change in the surface of a mole, such as scaliness, oozing, bleeding, or the
appearance of a lump or bump
Although attention to visual signs of skin cancer has been recommended, there is
doubt about the value of visual inspection for screening for skin cancer. The U.S.
Preventive Services Task Force (USPSTF) found that evidence to assess the net
benefit of screening for skin cancer with a visual skin examination is limited.
Even doctors find it difficult to tell the difference between melanoma and an ordinary
mole. The lack of clear cut evidence of the value of skin inspection suggests
that it is important to consult a dermatologist to evaluate any areas of skin that
concern you, to inspect areas that may be hard for an individual to see, and when
indicated, to biopsy lesions to make definitive diagnoses.
To see examples of normal moles and melanomas, visit the Skin Cancer Image
Gallery at:

This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel.