PARDON ME FOR BEING THE SKUNK at your summer picnic, but as you’re enjoying the sun on your face, remember that overexposure to ultraviolet-B waves accounts for about half of all diagnosed cases of cancer each year. That’s one million cases of basal cell, squamous cell, and melanoma malignancies, and Texas, for obvious reasons, routinely ranks among the top three states (with California and Florida) in incidence of these. The most lethal, melanoma, took the lives of nearly eight thousand Americans and more than four hundred Texans last year and is only increasing in prevalence. This is too bad: Most skin cancers can be successfully prevented and self-monitored. You’ve just got to know a mole from a melanoma. Here’s your last-chance guide before the dog days set in.
Know your ABCD’s—and E’s. Most of your moles are going to develop in your first two decades of life; treat any that appear after that with suspicion. Think like a five-year-old and employ what the American Cancer Society calls the ABCD’s of mole examination: A stands for a melanoma’s asymmetry; B for its borders, which tend to be irregular rather than smooth; C for its variegated color; and D for a diameter greater than six millimeters (one-fourth inch), larger than the average mole. Moreover, says Ronald Rapini, the chairman of dermatology at M. D. Anderson Cancer Center, in Houston, you should add an E for evolution: While regular old moles don’t grow, melanomas do—first horizontally and then vertically, up from the skin and down into it, which is how the cancer becomes systemic and lethal.
An equal-opportunity cancer. Unlike most cancers, melanoma develops in adults in their twenties, thirties, and forties just as often as it does in the elderly; in fact, it is a leading killer cancer in the younger age groups. And only an estimated 10 percent of the cases are hereditary.
Sometimes a mole is just