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After a scary experience with melanoma, a British journalist is encouraging people to pay attention to changes in their skin.
In a BBC News essay, Sarah Lee wrote that she didn’t notice the mole on her head until July 2021. She took a photo of her scalp to see how her hair dye had faded and found a dark spot instead.
The 29-year-old expressed her concern with a doctor who told her it was just a "fungus" and nothing to worry about.
Lee continued to observe the spot and noticed "satellite" moles within a few months. When she saw her doctor again, she was told it was "impossible" to get skin cancer on the scalp because hair blocks the sun’s ultraviolet rays. Lee was also told she was too young to have skin cancer.
Frustrated, Lee got a second opinion which revealed the mole was melanoma, the deadliest form of skin cancer. She was later diagnosed with stage three malignant nodular melanoma.
Dr. Harvey Lui, a dermatological oncologist at BC Cancer, says that although melanoma on the scalp is uncommon, it confirms that skin cancer can develop anywhere.
"It can occur on the soles of your feet, it can occur inside your mouth, and that's not an area that gets a lot of sunlight," Lui, who's also professor of dermatology and skin science at the University of British Columbia, told Yahoo Canada. "Wherever you have skin, there's a possibility that melanoma could develop at that site."
What is melanoma?
According to the Canadian Cancer Society, melanoma is a cancer that starts in melanocyte cells of the skin. Melanocytes make melanin, which gives your skin, hair, and eyes their colour. There are four types of melanoma, including superficial spreading melanoma (the most common) and nodular melanoma.
"When those cells become cancerous, they seem to have a higher chance of spreading locally or spreading through the bloodstream or spreading through the lymphatics to other parts of the body so it's for that reason that we consider melanoma to be the most serious of all skin cancers," Lui explains.
"Wherever you have skin, there's a possibility that melanoma could develop at that site."Dr. Harvey Lui
Typically, changes in the size or shape of a mole is the first sign of melanoma skin cancer.
"Most melanomas initially show up as flat spots on the skin and they expand, they grow from side to side and they often have an irregular pattern of pigmentation," Lui says. "But nodular melanomas, they tend to be thick right at the beginning, and they tend to be much more aggressive when patients develop nodular melanoma."
Who's at risk of developing melanoma?
Melanoma can affect anyone regardless of sex, age, or race.
There are risk factors that can increase a person’s likelihood of developing the disease, including a personal or family history, excessive sun exposure, and having light-coloured skin, eyes and hair.
The Melanoma Network of Canada notes the leading cause of melanoma is too much exposure to ultraviolet radiation, either from the sun or tanning beds.
Lui adds that those who have had blistering sunburns are also at risk.
Pay attention to new moles and changes in existing moles
As with most cancers, the earlier melanoma is detected, the better chance of treatment and survival.
In Lee’s case, the melanoma had spread down her skull by the time she was diagnosed. The journalist had to get 24 lymph nodes removed and endure two types of targeted therapies to prevent a recurrence.
According to Lui, an important takeaway from Lee's story is that she monitored the original mole, noticed changes to it, and continued to seek medical attention.
"The key is that if you know you go see a health care professional, and it looks okay, if there's further change, then it probably warrants a re-evaluation," Lui says.
Lui adds that melanoma on the scalp can be difficult to diagnose because unlike other parts of the body, it’s not one we often examine. It's often a hairdresser or family member who notices it first.
Wear sunscreen when going outside
To reduce your risk of getting skin cancer it’s important to protect yourself from the sun’s UV rays.
Cover up: Protect your skin as much as possible when you’re out in the sun. Wear hats, long sleeves and light-coloured clothing, as well as sunglasses with both UVA and UVB ray protection.
Wear sunscreen: Experts recommend wearing sunscreen when outdoors with at least SPF 30 or higher.
Minimize time outdoors between 11 a.m. and 3 p.m.: This is when the sun is the most intense. If possible, try to do outdoor activities outside of these times.
Seek shade: If you must be outdoors on a hot day, try to avoid the direct sun and seek shade instead.