21.02.2024

Six bizarre signs of skin cancer revealed after radio legend Chris Evans’ diagnosis

Broadcaster Chris Evans today revealed he has skin cancer — after his masseuse urged him to have a suspicious freckle checked out. The 57-year-old today told listeners on his Virgin Radio show that his melanoma was found in the extremely early stages and he is hoping to make a full recovery.

He said: ‘It’s been caught so early, just so you know, that it should be completely treatable. Treatment will happen on September 14.’

It comes after a previous cancer scare in 2020 when he spotted concerning marks on his skin. But doctors told him he had ‘nothing to worry about’. Before that, he was given the ‘all-clear’ in 2015 after fearing he had prostate cancer symptoms.

Here, dermatologists explain the early warning signs of skin cancer and how to protect yourself.

The broadcaster Chris Evans announced on his Virgin Radio show on Monday that he has skin cancer

Signs of skin cancer range from the innocuous to obvious, but experts warn that treating cases early is key to making sure they do not spread or further develop

Signs of skin cancer range from the innocuous to obvious, but experts warn that treating cases early is key to making sure they do not spread or further develop

Asymmetrical moles

Dermatologists follow the ABCDEs when diagnosing melanoma; that is, asymmetry, border, colour, diameter and evolving.

Most melanomas — the rarest but most dangerous form of skin cancer that is most likely to spread — present as moles that have uneven edges.

They look different from common moles — the round, brown or tan spots on the skin caused by growing clusters of cells in the skin called melanocytes.

Dr Nayoung Lee, a dermatologist at NYU Langone Health, said: ‘If you can’t fold the mole in half, if edges don’t line up’ it could be melanoma.

Irregular borders of a mole, the ‘B’ in ABCDEs, can also indicate melanoma. The edges of a normal mole are uniform and smooth.

The Skin Cancer Foundation advises people to look out for ‘ugly ducklings’ — unsightly moles that very clearly stick out from the pack all over the body.

The foundation says: ‘This recognition strategy is based on the concept that most normal moles on your body resemble one another, while melanomas stand out like ugly ducklings in comparison.’

Moles of uneven colours

Colour, the ‘C’ in ABCDEs, is a strong indicator of dangerous melanoma. Healthy moles are typically a single colour, from dark and light brown to pink and flesh-toned.

Some moles become cancerous and change colours gradually. Roughly 20 to 30 per cent of melanoma cases develop in existing moles.

The other 70 to 80 per cent of the time, cancerous moles arise on otherwise healthy-looking skin.

But a suspicious mole often contains several shades of brown, black, or tan, as well as spots of pink, red or purple.

It becomes more colorful as cancer progresses, so early action is crucial. In fact, 99 per cent of patients who detect and begin treating their melanoma early survive five years or more after their diagnosis.

Dr Zaineb Makhzoumi, a dermatologist at the University of Maryland who specialises in a type of surgery to remove cancerous moles, said: ‘Once you start to get two, three, four colors fused within one mole, that should be a warning sign and you should have that mole evaluated by a board-certified dermatologist.’

Chris Evans shares three sons and one daughter with the professional golfer and part-time model Natasha, 38

Chris Evans shares three sons and one daughter with the professional golfer and part-time model Natasha, 38

Moles larger than a pea

Size matters when it comes to suspicious moles. Melanomas typically present a bit bigger than a pea or a pencil eraser, about six millimeters or a quarter inch.

Dr Makhzoumi said: ‘Most moles, if they’re benign, are smaller than a pencil eraser.

‘If you have a mole that’s bigger than a pencil eraser that is not in and of itself a warning sign and concerning. But rather when taken with the other constellation of signs, that’s something that you want evaluated by a dermatologist.’

Not all melanomas subscribe to the ‘D’ in ABCDEs where D means a diameter of at least six millimeters. In 2013, doctors in Queensland, Australia, treated a 38-year-old woman with invasive melanoma on her arm that measured just 1.6 mm in diameter.

The small cancerous mole also did not appear asymmetrical, meaning doctors must still keep an eye out for moles that appear darker than those around it, as was the case in the Australian woman.

Doctors must also monitor how a mole evolves over time. This is the ‘E’ in ABCDEs. Changes in the size, shape, color, or elevation of a spot or any new symptom such as bleeding, itching, or crusting, may be a warning sign of melanoma.

Dr Makhzoumi said: ‘Moles tend to go through an evolution, but the evolution of moles tends to be that that they shrink, or they disappear.

‘If you have a mole that’s evolving in that it’s growing, it’s getting darker, it’s elevated, that’s really, really key for melanoma,’

Melanoma grows in two phases, horizontal and vertical. The horizontal phase can last years before the mole becomes dangerous and invasive, meaning it spreads to lymph nodes and organs. But in a later phase, the lesion grows vertically, at which point it becomes a tumor with the ability to spread elsewhere in the body, potentially proving fatal.

Dr Makhzoumi added: ‘Once melanoma enters that vertical growth phase, they actually accelerate very rapidly. So if you have a spot that all of a sudden starts to develop a lump to it, that is highly concerning for malignant melanoma.’

Bleeding or scaly patches

These will often appear on areas of the skin most often exposed to sunlight, such as the face and the top of the head.

Precancerous squamous cell carcinoma — the second most common form of skin cancer — leads to actinic keratosis leads to a skin disorder that causes rough, scaly patches. The patches can sometimes bleed and become ulcerous.

Dr Lee said: ‘They just feel scaly so you can feel them more than see them.’

People that have a history of heavy sun exposure are most likely to experience this type of skin cancer.

With every bad, blistering sunburn comes a heightened risk of squamous cell carcinoma.

Fair-skinned people and those with light eyes who are more prone to sunburn are also more vulnerable to SCC.

More often than not, though, squamous cell carcinoma is curable when treated early. In fact, the survival rate is as high as 98 per cent.

Dr Nayoung Lee (left), a dermatologist at New York University, said that moles with multiple different colors within them can be a warning sign. Dr Zaineb Makhzoumi (right), a dermatologist at the University of Maryland, warned that multi-coloured moles are a sign of cancer

A sore that bleeds may indicate another type of non-melanoma skin cancer called basal cell carcinoma which, like SCC, has a high survival rate. Still, people should treat it aggressively once it’s detected.

Dr Lee said: ‘Depending on location they can grow deeper in muscle and bone, so they do become problematic if left to grow for a long period of time.’

Basal cell carcinoma is the most common type of cancer overall and the most common type of skin cancer more specifically.

Dr Lee added: ‘Basal cell carcinomas, we don’t even stage them because survival rates are good.’

Dark patches on genitals

Melanoma can present as dark lesions on the mucous membranes, meaning the inside of the nose, mouth, vagina, or anus, or the fingers and toes.

This subtype of aggressive cancer is exceedingly rare and accounts for less than two per cent of all melanoma cases.

Unlike other types of melanoma, mucosal melanoma is not affected by sun exposure. About half of the mucosal melanomas start in the head and neck, typically the nose, mouth, windpipe, or esophagus. Smoking, ill-fitting dentures, and ingesting or inhaling carcinogens all greatly compound the risk of sarcomas in the mouth.

Most of the remaining 50 per cent of melanomas begin in the anus or rectal region and the female genitals. Spots on mucosal areas might not be melanomas but rather squamous cell carcinomas.

Dr Lee said: ‘Initially when it’s early it kind of looks like a whitish bump or ridge on the mucosal surface. So as it grows it starts to look more like an ulcer, it can look fungated [like a fungal infection in appearance], or other things.’

While doctors have not pinpointed the exact cause of mucosal membrane melanomas and non-melanoma cancers, some believe they are linked to a viral strain of human papillomavirus (HPV).

HPV strains 16 and 18 are those deemed high risk and cause the vast majority of cervical cancers. But strains six and 11, lower risk varieties, are more commonly associated with non-UV-linked skin cancers inside our bodies’ orifices.

Dr Makhzoumi said: ‘The subtypes that are causing a cervical cancer are not the same subtypes that are causing skin cancer.’

Patients can sometimes mistake nonmelanoma cancers in the genital region with a sexually transmitted infection, but doctors want to drive home the fact that this type of cancer is not a sexually transmitted disease.

Waxy, pearly bumps on skin

Basal cell carcinoma, which typically appears on sun-exposed parts of the body like hands, neck, arms, and legs, often present as a waxy lump or a small, smooth, shiny, or pale growth.

It does not always appear raised, though, and could resemble a flat scar.

Dr Makhzoumi said: ‘You really want to look for a basal cell skin cancer, one of the really specific signs is that when you stretch the edges, it looks pearly. There’s an opalescence to it, there’s an opalescence to basal cells, they do really look like shiny or pearl-like.’

Melanoma: The most dangerous form of skin cancer

Melanoma is the most dangerous form of skin cancer. It happens after the DNA in skin cells is damaged (typically due to harmful UV rays) and then not repaired so it triggers mutations that can form malignant tumours.

Causes

  • Sun exposure: UV and UVB rays from the sun and tanning beds are harmful to the skin
  • Moles: The more moles you have, the greater the risk for getting melanoma
  • Skin type: Fairer skin has a higher risk for getting melanoma
  • Hair colour: Red heads are more at risk than others
  • Personal history: If you’ve had melanoma once, then you are more likely to get it again
  • Family history: If previous relatives have been diagnosed, then that increases your risk

Treatment

  • Removal of the melanoma:

This can be done by removing the entire section of the tumor or by the surgeon removing the skin layer by layer. When a surgeon removes it layer by layer, this helps them figure out exactly where the cancer stops so they don’t have to remove more skin than is necessary.

  • Skin grafting:

The patient can decide to use a skin graft if the surgery has left behind discoloration or an indent.

  • Immunotherapy, radiation treatment or chemotherapy:

This is needed if the cancer reaches stage III or IV. That means that the cancerous cells have spread to the lymph nodes or other organs in the body.

Prevention

  • Use sunscreen and do not burn
  • Avoid tanning outside and in beds
  • Apply sunscreen 30 minutes before going outside
  • Keep newborns out of the sun
  • Examine your skin every month
  • See your physician every year for a skin exam

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