ABCDE to detect skin cancer

Checking for asymmetry, border, colour, diameter and elevation in a mole can help one detect first signs of it

Endometrial (Uterine) Cancer Endometrial cancer is rare in India. The American Cancer Society recommends that at the time of menopause, all women should be informed about the risks and symptoms of endometrial cancer, and strongly encouraged to report any unexpected bleeding or spotting to their doctors. For women with or at high risk for hereditary non-polyposis colon cancer (HNPCC), annual screening should be offered for endometrial cancer with endometrial biopsy beginning at age 35.

Prostate Cancer Prostate cancer is not uncommon in India. It is only that we are not used to looking for it in our population. Factors such as family history, age and race play a part in the risk of prostate cancer. The National Cancer Institute, the American Cancer Society, the U.S. preventive Services Task Force and the American Academy of Family Physicians recommend that men talk to their doctors about the pros and cons of screening.

This discussion should include an offer for testing with the prostate-specific antigen (PSA) blood test and digital rectal exam (DRE) yearly, beginning at age 50, to men who are at average risk of prostate cancer and have at least a 10-year life expectancy. Following this discussion, those men who favour testing should be tested. This discussion should take place starting at age 45 for men at high risk of developing prostate cancer.

This includes African American men and men who have a first-degree relative (father, brother, or son) diagnosed with prostate cancer at an early age (younger than age 65). This discussion should take place at age 40 for men at even higher risk (those with several first-degree relatives who had prostate cancer at an early age). If, after this discussion, a man asks his health care professional to make the decision for him, he should be tested (unless there is a specific reason not to test).

Oral cavity cancer Early detection (as distinct from organised screening) of oral cancer using visual inspection of the mouth is being considered in our country where the incidence is high.

The oral cavity is easily accessible for routine examination, and can readily detect lesions that are the precursors of oral cancers. Furthermore, there are indications that precursor lesions may regress if tobacco use ceases and that surgical treatment of early oral cancer is very effective.

Some programmes have also encouraged early detection of oral cancer by self examination using a mirror.

SKIN CANCER: The best way to find skin cancer early is to keep an eye on the skin, especially moles. The ABCDE rule ( see below ) can help us remember what to look for when you are checking any moles on your skin.

Signs of skin cancer: The ABCDE rule

A For asymmetry: A mole that, when divided in half, does not look the same on both sides. B for border: A mole with edges that is blurry or jagged. C for colour: changes in the colour of a mole, including darkening or loss of colour. D for diameter: A mole larger than A� inch in diameter. E for elevation: A mole that is raised above the skin and has an uneven surface. Several ongoing studies are currently evaluating low cost approaches to screening that can be implemented and sustained in low-resource settings. For example visual inspection with acetic acid may prove to be an effective screening method for cervical cancer in the near future.

(The doctor is MS (Gen), DNB (Surg), Mch (Surg, Onco), FRCS (Edin) Diploma in lap Surg (France)A Chief Surgical OncologistA Vamsy1964@gmail.comA 9848011421)