Misdiagnosis of melanoma poses significant challenges in the field of dermatology and impacts patient outcomes.
Melanoma, a type of skin cancer, is a serious and potentially fatal condition.
First, let’s discuss skin cancer in general, including nonmelanoma.
Skin Cancer Statistics
Skin cancer is the most common type of cancer worldwide, and 1 in 5 Americans will develop skin cancer by age 70. Skin cancer can be broken down into two types: nonmelanoma and melanoma.
Nonmelanoma
Nonmelanoma consists of multiple different types of cancer, but it can mostly be divided up into three categories.
Basal cell carcinoma is the most common type of skin cancer. It forms on the top layer of skin. It can look like a waxy bump, a scar, a white or pink patch, an open sore, an elevated growth with raised edges, or a growth that crusts, oozes, itches, or bleeds. Luckily, despite being the most common type, Basal cell carcinoma rarely spreads and is easily treatable. However, delaying treatment can cause complications (Moffitt Cancer Center).
Squamous cell carcinoma is different from basal cell carcinoma. It can also form on areas of the skin that aren’t often exposed to light, like genitals. Squamous cell carcinoma appears on the skin as a wart, a raised growth with a depression, a scaly red patch, or a tough and thickened patch of skin. It is usually very treatable. But it can spread if it is not treated quickly (Moffitt Cancer Center).
The last main type of nonmelanoma cancer is Merkel cell carcinoma. This is a rare, very aggressive type of cancer. It presents itself as a shiny pink, red, or bluish lump on the skin. With early detection, it is usually treatable. But it is important to catch it as early as possible (Moffitt Cancer Center).
Melanoma
Melanoma skin cancer begins in the malanocytes, which are the pigment-producing cells located on the top layer of the skin. While exposure to ultraviolet rays from the sun and tanning beds are often the cause of melanoma, it can also occur on areas of the skin that are not often exposed to light.
Warning Signs of Melanoma
Warning signs of melanoma include a mole that:
- gradually changes color or shape
- has a border that is not a perfect circle
- has multiple shades of brown, black, or tan
- is a different size, shape, or color than other moles on your body
Melanoma is a very serious type of cancer. It is important to have suspicious looking moles checked out by a professional. Early detection is key for the cancer treatments’ success (Moffitt Cancer Center). If you notice any of the symptoms listed above, please see a medical professional, as it is always better to be safe than sorry.
While the number of new cases of melanoma are estimated to fall by 5.6%, the amount of deaths caused by melanoma are expected to increase by 4.4% in 2023 (Skin Cancer Foundation). Men are the most likely to develop melanoma. However while melanoma is more common in White men, Black men are 26% more likely to die from the disease. This is mostly due to late-stage diagnosis, since the majority of melanoma in Black men appears under their toenails, on their toes or the soles of their feet, or on the fingernail beds or palms. Therefore, it is important to often check these places for any abnormalities and to see a medical professional for any abnormalities that may appear on your skin.
Melanoma Statistics in South Carolina
It is estimated that there will be 1,800 new cases of melanoma skin cancer in South Carolina in 2023, and as summer launches into full swing and more and more residents are increasing their time outside, it is critical to wear sunscreen and avoid sunburn whenever possible (American Cancer Society).
Early detection and accurate diagnosis are crucial for successful treatment and improved patient outcomes. However, there is a growing concern surrounding the misdiagnosis of melanoma cases, which can lead to delays in proper treatment and unnecessary anxiety for patients.
The Challenge of Accurate Diagnosis
Melanoma can mimic benign skin conditions, making it challenging for medical professionals to accurately diagnose. Factors such as atypical moles, variations in appearance, and the absence of standardized diagnostic criteria contribute to the complexity of differentiating melanoma from other skin abnormalities. Moreover, human error, limited access to specialized expertise, and time constraints in busy clinical settings can further contribute to misdiagnoses.
Consequences and Impact of Misdiagnosis
Misdiagnosis of melanoma can have serious consequences. Patients may face unnecessary surgical procedures, potentially leading to physical scarring and emotional distress. Delayed treatment due to misdiagnosis can allow the cancer to progress, making successful treatment more difficult and reducing survival rates. Additionally, misdiagnosed patients might not receive appropriate counseling and support, leading to a lack of necessary preventive measures, such as regular skin exams and sun protection.
A South Carolina 28-year-old hairstylist won a $1 million settlement (the doctor’s insurance policy limit) after a mole her doctor had told her was benign grew into stage 3B melanoma.
The woman went to her doctor, concerned about a mole on her calf. Her doctor performed a biopsy. The results showed that the mole was atypical and needed to be removed. “The pathologist did not judge the mole as cancerous, but recommended removing it as a conservative, precautionary measure.” (SCLawyersWeekly)
The doctor did not remove the mole, nor recommend her to a specialist. The patient says her doctor just told her it was benign.
“A little more than a year later, the patient returned to her doctor, again concerned about the mole. A second biopsy and examination revealed that the mole had progressed into a stage 3B melanoma.” (SCLawyersWeekly)
After this diagnosis, the doctor removed a tennis-ball-sized portion of the woman’s calf, along with lymph nodes from her pelvic region. She then had to undergo a course of interferon treatment. Her medical bills ended up being close to $120,000.
After the surgery and treatment, the patient was cancer-free. But “her oncologist estimated a 50% chance of her cancer recurring within five years.” (SCLawyersWeekly)
Strategies to Combat Misdiagnosis
To combat the misdiagnosis of melanoma, healthcare systems should focus on several key strategies:
- Improving medical education and training for healthcare professionals regarding melanoma detection and diagnosis
- Encouraging interdisciplinary collaboration among dermatologists, pathologists, and other specialists to enhance accuracy through comprehensive evaluations
- Leveraging technology, such as advanced imaging techniques and computer-aided diagnosis systems
The misdiagnosis of melanoma poses significant challenges in the field of dermatology and impacts patient outcomes. Increased awareness, improved training, and the integration of technological advancements are critical steps toward minimizing misdiagnosis rates. By addressing this issue, we can strive to ensure that individuals at risk for melanoma receive timely and accurate diagnoses. This will allow for prompt treatment and better chances of successful outcomes.
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