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Medical Forum / General / General / September 2005Questions about mole diagnosis and treatment.
I have a lot of moles (hundreds, maybe over 1000) and I have light skin, but avoid sunlight and use sunscreen. I'm just wondering what the goal should be with regard to a doctor's decision to remove any of my moles. I want to verify that a dermatologist should REALLY be removing moles that aren't actually suspected of currently being actual cancer. If a dermatologist should really be removing moles not suspected of currently being actual cancer, then under what circumstances should a mole removed? My impression is that dermatologists will remove moles that are suspected of being "potential precursors to cancer" without actually currently being cancer. Is this a valid precautionary treatment? Today, for example, a new dermatologist removed 2 of my moles but, based on the diagnosis codes he wrote, he suspects them to be "benign neoplasms" What I'm getting at here is that it would seem that the doctor does NOT suspect they are currently cancer if his opinion as that they are benign. Therefore, I assume the removal is strictly for preventative purposes. Is removal for preventative purposes a valid treatment or not? In the past, I have had moles removed that turned out to be "dysplastic nevi" otherwise known as "clarks type". No other information was given by the lab other than this. I have a few questions about this type of mole: 1) Has it been conclusively been proven that "dysplastic nevus or Clarks type" moles are REALLY precursors to cancer. AND WHAT I MEAN BY THIS IS CAN THE MOLES THEMSELVES REALLY DEVELOP INTO CANCER? 2) If yes to above, then is this a 100% risk that these moles themselves will become cancer, or, if not, then what is the risk factor? 3) Should every mole suspected of being "dysplastic otherwise known as clarks" be removed? 4) what other types of moles are proven to potentially "develop into cancer" and need to be removed? 5) Any tips on how I can determine for myself whether a doctor is REALLY removing a mole out of necessity vs. simply being overly aggressive? Thanks. J. JAY, YOU"VE COME TO THE WRONG PLACE. The dorks in this newsgroup are just parrots for stuff you can alrezdy find on the internet. SAVE YERSELF THE TROUBLE AND DO YOUR OWN RESEARCH. DON'T SAY I DIDN"T WARN YOU!!!!! ------- Original Message -------- Subject: Re: Questions about mole diagnosis and treatment. Date: 8 Sep 2005 18:39:08 -0700 From: "J" <burglar_of_turds@yahoo.com> Organization: http://groups.google.com Newsgroups: sci.med,sci.med.diseases.cancer References: <tq4Ue.536$Ef2.390@trndny04> > JAY, YOU"VE COME TO THE WRONG PLACE. > [quoted text clipped - 3 lines] > > DON'T SAY I DIDN"T WARN YOU!!!!! Looks (to me) that you're the dork. J ~~~~~~~~~~~~~~~~~~~~~~~ Jake, There is no such thing as a "benign neoplasm." You are thinking of "benign tumor." A neoplasm is a malignancy or a cancer. All the other lumps and swellings are called tumors. As for moles, I don't know the answer either. David H ~~~~~~~~ > ~~~~~~~~~~~~~~~~~~~~~~~ > Jake, [quoted text clipped - 6 lines] > David H > ~~~~~~~~ Humbug. Neoplasm = tumor, malignant or not. As for moles, recent research has shown that moles are skin tumors which have been stopped in their growth. The mechanism by which the body does this has not been fully elucidated and may give us insight into further ways of treating cancer (oncogene senescence as opposed to apoptosis). Sometimes this "brake" on tumor growth is lost and the mole becomes a melanoma.  Signaturemadiba > I have a lot of moles (hundreds, maybe over 1000) and I have light skin, but > avoid sunlight and use sunscreen. I'm just wondering what the goal should [quoted text clipped - 3 lines] > should really be removing moles not suspected of currently being actual > cancer, then under what circumstances should a mole removed? Where I come from (Canada) they remove them if they're suspicious looking, they remove them if they're troublesome (irritated by clothing and/or bleeding). Some will remove some that are cosmetically "disfiguring", but they sure won't remove 100's in our health system. (unless I suppose someone goes outside our system to a cosmetic surgeon) > My impression is that dermatologists will remove moles that are suspected of > being "potential precursors to cancer" without actually currently being [quoted text clipped - 20 lines] > 3) Should every mole suspected of being "dysplastic otherwise known as > clarks" be removed? Well I found pictures of clark's type http://www.skinsite.com/info_atypical_moles.htm If I had those, I'd have them removed and ask for each pathology report and continue to closely monitor for others. I don't know that removing moles guarantees no future melanoma (we all live with risks every day anyway), but perhaps removing the clark's types reduces the risks of melanoma for that specific location? Why don't you ask your primary care physician these questions? J >I have a lot of moles (hundreds, maybe over 1000) and I have light skin, >but avoid sunlight and use sunscreen. I'm just wondering what the goal [quoted text clipped - 36 lines] > > Thanks. If you have suspicions that your doctor is being overly aggressive, I suggest getting a second opinion when removals are advised, or even check back with your GP. The dermatologist should only remove moles that are suspicious (which is a difficult line to draw - we all make mistakes) or dysplastic. In patients like you it can be difficult to pick up changes in any mole, or any newly appearing ones, and ordinary clinical follow-up is probably very hit and miss. It is possible that photographic surveillance is better but I have not been follwing the literature on this. The dysplastic naevi put you at some risk. Peter Moran > J. >I have a lot of moles (hundreds, maybe over 1000) and I have light skin, but >avoid sunlight and use sunscreen. I'm just wondering what the goal should [quoted text clipped - 7 lines] >being "potential precursors to cancer" without actually currently being >cancer. Is this a valid precautionary treatment? Moles can develop into melanoma, which is a really bad cancer. Unlike most other skin cancers, melanomas usually metastasize very early, and once they do, the chances of effective treatment are very poor. So by the time a mole can be identified as a true cancer, it may be too late. Melanomas, unlike most cancers, often occur in relatively young people and are all too often fatal. That's why 'suspicious' moles, ones that have shown visible changes, are usually removed -- the consequences of not doing so can be terrible, and often the only way to determine whether it's benign, precancerous or already an early stage of cancer is to remove it and examine the tissue. I'm not a doctor, and I don't know the rate or probability of progression of dysplastic moles into melanomas, but since a simple office procedure can prevent a disastrous outcome, I don't think it's unreasonable to err far on the side of caution when deciding whether a mole should be removed. For a patient who has already had many dysplastic or precancerous moles, I would think that even more caution (i.e. aggressive treatment, removal) would be a good idea. I can appreciate that you aren't happy about all these procedures to remove moles that are developing abnormalities, but they may be saving your life. I suggest you search for information about melanoma on the net, especially reliable sites like the National Cancer Institute. You could also search PubMed with the key "dysplastic nevus", which brings up almost 1000 papers. You should also discuss the matter with your doctor. (Note that the skin cancers older people get on exposed skin like face and hands from excess sunlight are a totally different kind. They can grow in place slowly for many years, sometimes forming large eroded sores, before they metastasize, so they are seldom life threatening. Melanoma, on the other hand is a fast growing, very aggressive cancer, and very difficult to treat once it spreads, and it spreads very early.)
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