› Forums › General Melanoma Community › What is a “good” skin exam?
- This topic has 21 replies, 5 voices, and was last updated 10 years, 6 months ago by
JC.
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- October 21, 2013 at 2:45 am
What exactly IS a good skin exam supposed to involve? I mean a REAL full body skin check, keeping in mind the patient has a history of melanoma.
I'm on my 2nd dermatologist whose idea of a skin exam is "here's a gown, leave your bra & panties on" and after few questions and a cursory skin exam is out the door in 3-5 minutes. Then they ask on the way out the door "So, when do you think I need to see you again? Six months or a year?" Ummmm… You're the doctor. Isn't that one of the things I'm paying you to tell me? What do I think? I think I need a new dermatologist. THAT'S what I think.
I "fired" the first dermatologist (after several years) because I suspected his skin exam was incomplete. Now I'm on my 2nd – and his was even WORSE. (At least the first made an attempt to move my bra and panties aside to see what was underneath – the 2nd didn't even touch me. I guess I shouldn't have been surprised – my oncologist's referral consisted of "He's a good guy – we go to the same church together". Gotta love the South.) BUT now I've had TWO dermatologist do skin exams the same way, and I've started to wonder if my expectations are off.
Background – I'm a stage III melanoma survivor, NED for 4 years now. I still visit my oncologist bi-annually for PET scans and bloodwork. Other than the nurse taking my BP & weight, these visits do not include ANY sort of physical exam. He seems to rely on the bloodwork & PET scan to tell him everything he needs to know. He is not a melanoma specialist. (Yes, if the beast returns, I intend to find a specialist.)
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- October 21, 2013 at 3:09 am
You're a stage III survivor and concerned because you don't think that either your oncologist or your dermatologist is knowledgeable enough about melanoma and/or is not taking your case seriously enough. So you are going to wait until the sh*t hits the fan to hook up with a melanoma Center of Excellence where you can find really good, informed medical care. Why are you waiting? I don't understand.
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- October 21, 2013 at 3:09 am
You're a stage III survivor and concerned because you don't think that either your oncologist or your dermatologist is knowledgeable enough about melanoma and/or is not taking your case seriously enough. So you are going to wait until the sh*t hits the fan to hook up with a melanoma Center of Excellence where you can find really good, informed medical care. Why are you waiting? I don't understand.
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- October 21, 2013 at 3:09 am
You're a stage III survivor and concerned because you don't think that either your oncologist or your dermatologist is knowledgeable enough about melanoma and/or is not taking your case seriously enough. So you are going to wait until the sh*t hits the fan to hook up with a melanoma Center of Excellence where you can find really good, informed medical care. Why are you waiting? I don't understand.
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- October 21, 2013 at 3:44 am
Your risk of a recurrence is much higher than your risk of another primary so your derm appointments are probably less pressing than the onc appts. Even a good skin exam doesn't last all that long. As long as all parts of the body are being looked at… remember – docs are looking for an ugly duckling or something that looks different from everything else. In general, those usually stand out. For myself, I really rely on my derm to do a good back exam since that area is much harder for me to monitor. I monitor everything on the front. I also have pictures that I can use for comparison purposes. But honestly, I don't expect my derm to find anything I haven't already found myself. (I found all my 3 primaries – they changed). So I guess it's all what you expect. And maybe if you want more, you should just tell this doctor what you expect. If he won't go along with it, move on again. Sometimes I think just airing your expectations can make all the difference. I actually prefer a doctor I can work with than someone who tells me how things are.
Best wishes,
Janner
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- October 21, 2013 at 10:03 pm
The best skin exam is the one you do yourself! Know your skin. Try this two minute video to teach you how:http://melanomainternational.org/melanoma-facts/examine-your-skin/#.UmWkTWbD_84
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- October 22, 2013 at 12:46 am
A doc who specializes in mole mapping answered this very question at a seminar I attended. "New" and like everything else is fine. "New and different" is worth a biopsy. I don't have a ton of moles, but this is the criteria I use when I see something new.
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- October 22, 2013 at 12:46 am
A doc who specializes in mole mapping answered this very question at a seminar I attended. "New" and like everything else is fine. "New and different" is worth a biopsy. I don't have a ton of moles, but this is the criteria I use when I see something new.
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- October 22, 2013 at 12:46 am
A doc who specializes in mole mapping answered this very question at a seminar I attended. "New" and like everything else is fine. "New and different" is worth a biopsy. I don't have a ton of moles, but this is the criteria I use when I see something new.
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- October 21, 2013 at 10:03 pm
The best skin exam is the one you do yourself! Know your skin. Try this two minute video to teach you how:http://melanomainternational.org/melanoma-facts/examine-your-skin/#.UmWkTWbD_84
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- October 21, 2013 at 10:03 pm
The best skin exam is the one you do yourself! Know your skin. Try this two minute video to teach you how:http://melanomainternational.org/melanoma-facts/examine-your-skin/#.UmWkTWbD_84
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- October 21, 2013 at 3:44 am
Your risk of a recurrence is much higher than your risk of another primary so your derm appointments are probably less pressing than the onc appts. Even a good skin exam doesn't last all that long. As long as all parts of the body are being looked at… remember – docs are looking for an ugly duckling or something that looks different from everything else. In general, those usually stand out. For myself, I really rely on my derm to do a good back exam since that area is much harder for me to monitor. I monitor everything on the front. I also have pictures that I can use for comparison purposes. But honestly, I don't expect my derm to find anything I haven't already found myself. (I found all my 3 primaries – they changed). So I guess it's all what you expect. And maybe if you want more, you should just tell this doctor what you expect. If he won't go along with it, move on again. Sometimes I think just airing your expectations can make all the difference. I actually prefer a doctor I can work with than someone who tells me how things are.
Best wishes,
Janner
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- October 21, 2013 at 3:44 am
Your risk of a recurrence is much higher than your risk of another primary so your derm appointments are probably less pressing than the onc appts. Even a good skin exam doesn't last all that long. As long as all parts of the body are being looked at… remember – docs are looking for an ugly duckling or something that looks different from everything else. In general, those usually stand out. For myself, I really rely on my derm to do a good back exam since that area is much harder for me to monitor. I monitor everything on the front. I also have pictures that I can use for comparison purposes. But honestly, I don't expect my derm to find anything I haven't already found myself. (I found all my 3 primaries – they changed). So I guess it's all what you expect. And maybe if you want more, you should just tell this doctor what you expect. If he won't go along with it, move on again. Sometimes I think just airing your expectations can make all the difference. I actually prefer a doctor I can work with than someone who tells me how things are.
Best wishes,
Janner
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- October 22, 2013 at 6:22 am
A lady I respect very much, after learning of my case and then a few ladies cases told me she jumped her female Dermatologist "because she never had me remove my panties nor bra". (You are welcome to look at my profile on the MPIP).
If your primary was not in the anal nor genital areas and you have not had additional primaries, the odds on having a new primary in one of these areas is extremely low. (My Oncologist checks my butt about once a year. I have found all that was there before I saw him.) I have not heard of a primary on a cutaneous surface spreading to the rectum, but will not say that a colonoscopy every now and then should be ruled out. The main thing is what you will feel the most comfortable with. Your concerns should be brought to the forefront with the Dermatologist.In general I suspect that the dermaatologist is trying to be circumspect aand prevent ny imbarrishment on your part. However I think he should at a least discuss the issue with you before ignoring the private areas.
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- October 22, 2013 at 6:22 am
A lady I respect very much, after learning of my case and then a few ladies cases told me she jumped her female Dermatologist "because she never had me remove my panties nor bra". (You are welcome to look at my profile on the MPIP).
If your primary was not in the anal nor genital areas and you have not had additional primaries, the odds on having a new primary in one of these areas is extremely low. (My Oncologist checks my butt about once a year. I have found all that was there before I saw him.) I have not heard of a primary on a cutaneous surface spreading to the rectum, but will not say that a colonoscopy every now and then should be ruled out. The main thing is what you will feel the most comfortable with. Your concerns should be brought to the forefront with the Dermatologist.In general I suspect that the dermaatologist is trying to be circumspect aand prevent ny imbarrishment on your part. However I think he should at a least discuss the issue with you before ignoring the private areas.
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- October 22, 2013 at 6:22 am
A lady I respect very much, after learning of my case and then a few ladies cases told me she jumped her female Dermatologist "because she never had me remove my panties nor bra". (You are welcome to look at my profile on the MPIP).
If your primary was not in the anal nor genital areas and you have not had additional primaries, the odds on having a new primary in one of these areas is extremely low. (My Oncologist checks my butt about once a year. I have found all that was there before I saw him.) I have not heard of a primary on a cutaneous surface spreading to the rectum, but will not say that a colonoscopy every now and then should be ruled out. The main thing is what you will feel the most comfortable with. Your concerns should be brought to the forefront with the Dermatologist.In general I suspect that the dermaatologist is trying to be circumspect aand prevent ny imbarrishment on your part. However I think he should at a least discuss the issue with you before ignoring the private areas.
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