Screening for Cancer - Early Detection

Ms. Angelina Jolie’s recent decision to prophylactically have a double mastectomy reminds us of the high level of concern regarding breast cancer.

In part, implicit in her decision is the accurate understanding that screening mammograms may not be efficient at identifying the most virulent breast cancers when they are potentially curable.  Mammograms are best at identifying breast cancer tissue types where later diagnosis would only minimally affect prognosis.

Malignant melanomas are quite different from the above scenario; early diagnosis almost uniformly dictates long term cure.  In the case of melanomas (and also colonoscopy diagnoses which also save lives) we can identify early signs in pigmented growths which allows us to remove them in a curative stage. Yearly full cutaneous exams with your dermatologist are a smart thing to do.

Screening for Cancer.

Doctors are trained in the art and science of treating symptoms.  Symptoms are our bodies ways of announcing disease.  In short, internally we are often a day late and a dollar short.

Dermatology is beautifully different: we can see evidence of early pathology by examining the organ (skin) directly.  The average dermatologist by recognizing and removing abnormal moles saves 2-3 patients' lives per month since these moles would evolve into uniformly fatal malignant melanomas ("mole cancers") with the patient dying within a few years.

Risk factors include fair skin, fair hair, blue eyes, and to a lesser degree excessive sun exposure.  Evolving tumors, when removed early, are 100% curable; 100% fatal when removed late.  

A yearly full cutaneous exam on all patients would essentially prevent this fatal disease (the fastest increasing cancer in the U.S) from exacting its toll.