Who Needs Mole Removal?
Mole removal is necessary if a mole becomes cancerous. This can happen to any mole on the skin and is classed as a type of cancer known as malignant melanoma. Skin cancer of all types has become far more common in the last 40 years or so, particularly in people who spend a lot of time sunbathing or use sunbeds to get a tan.
How Does The Sun Cause Skin Cancer?In fair skinned people, exposure to the ultraviolet light in sunlight, particularly ultraviolet B, causes the skin cells to produce more of a protein called melanin. This is a protective response to skin damage. The melanin is a brown pigment that stops more of the ultraviolet light penetrating into the layers of skin that are actively growing. This reduces the chance that their DNA will be damaged and that cancer will develop.
Melanocytes produce more of this pigment than any other skin cell, and collect together in small groups that are commonly called moles. Moles are particularly sensitive to damage by sunlight, and when the skin is exposed repeatedly to high levels of sun, they can start to show pre-cancerous changes.
Types Of Skin CancerMalignant melanoma is the type of skin cancer that arises in melanocytes. It is not the most common cause of skin cancer, but it is the most deadly, as it can more easily spread to other sites around the body. A mole that becomes cancerous must therefore be removed as quickly as possible to stop the cancer cells breaking off and travelling to other tissues and organs, to then set up secondary tumours.
Other types of skin cancer are known as non-melanoma skin cancer. One of these, basal cell carcinoma, is the most common form of this type of cancer – over 100,000 people need to be treated for this in the UK every year. The other is squamous cell carcinoma, which is less common but, like malignant melanoma, is more likely to metastasise to other body sites.
Checking On MolesFair skinned people usually have many moles on the skin all over the body. Usually, these develop during the first few months of life but some new ones can continue to appear. The danger signals to watch out for are new moles that appear and then grow very quickly, or pre-existing moles that start to change. They may become bigger suddenly, they may change colour, or they might start to take on a roughened texture or a ragged-edged appearance.
This is particularly dangerous if it happens to a mole on part of the body that you don’t normally see, such as the back of the neck. Some people who have already had mole removal because they have been diagnosed with malignant melanoma, or who are at risk from developing skin cancer, have their moles checked regularly at a mole clinic.
This involves having detailed photographs taken of the skin on all different parts of the body to produce a mole map. This is then compared each time you attend for a check-up. These can be done annually, or more or less often, depending on your risk. Moles that have changed in size or appearance, or that have suddenly appeared, can then be examined by a mole specialist to see if there is any cause for concern.
Why Is Mole Removal Necessary?Moles are superficial structures in the skin, so if a mole does show signs of changes that could possibly be cancerous, the best way to find out what is happening is to remove the mole and then have it examined. A histologist will take the mole and the skin tissue that has been excised, and will take sections of it to look carefully at the type of cells present. It is possible to find out if the skin cells are showing pre-cancerous changes, or if they have become cancerous.
The tests will also show if the operation to remove the mole has taken enough healthy tissue underneath that the doctors can be reasonably sure that no cancer cells are left. If this is not the case, a second operation may be necessary to remove deeper layers of skin. If the cancer has become more extensive, by spreading through the skin, and is in danger of affecting other parts of the body, the surgery may then be followed up by chemotherapy to kill any remaining stray cancer cells.