Thursday, July 7, 2016

"Psss... You have skin cancer"

Recently I was at a pool party that my daughter was invited to. Several of the adults also dared to wear swimsuits, so needless to say, there was a lot of skin showing.

And I happened to notice that one of the mothers had a lesion on her back that looked a lot like skin cancer (not melanoma).

Of course, I wasn't sure. I'm not exactly a dermatologist or even a PCP. It could very well have been a benign lesion. But it did look like some of the cases I saw during med school.

I ended up not saying anything. I assumed she probably knew about the lesion and whether or not it was cancer. And even so, it would have been incredibly uncomfortable for me to go up to a woman I didn't know very well and start questioning her about a skin growth. That is a surefire way to ensure your child will never be invited to another party again.

Sometimes it's hard being a doctor in the real world.


  1. Does she have a husband? I guess I would worry more if she doesn't have a husband/boyfriend/partner/whatever. But surely even a kid would say "Mommy what is that thing on your back?" My son constantly teases me about the witchy mole on my chin. I'll bet you are right not to say anything.

  2. There was a story online a while back about a dermatologist telling a man she saw at a pool that he likely had a melanoma on his back. He had never noticed it. It did turn out to be melanoma and he was so thankful that he was trying to track her down to thank her. Maybe you could send an email? I think that even if she knew it was there she might not have any idea what a malignant lesion looks like and even if she had some inkling, I've seen denial do some terrible things.

    1. That's a good point Anna! I still remember the time a guy with an orange sized mass growing out of his neck - I was doing FNA - told me it was from a car accident six months before. Um, no. Metastatic squamous cell carcinoma.

  3. I totally would have said something myself :) but I'm a GP and nosy (and I qualify anything i say with that). You should hear me asking women how their breastfeeding is going! For the record, I universally find people receptive and easy to tell if they want to keep talking or not...

  4. As a derm resident I am plagued by inadvertently examining the skin of just about anyone I see in public on a day to day basis. I've found this ethics article published in JAAD a few years ago to be really helpful when determining whether its appropriate to deliver unsolicited advice...

  5. I am in med school and not sure how I would handle the situation yet, wanting to balance not being intrusive but possibly making a difference. In fact I have a related story:

    My mother was a server with sketchy healthcare coverage when she was 28. One day during a shift a customer identified himself as a doctor and said he thought he saw a lump on her neck and she should see a doctor. Turns out it was thyroid cancer and she needed a total thyroidectomy. A fun tidbit is that she was super pro-life and the physician was an ob/gyn who performed abortions (she recognized him from holding signs outside the clinic he worked at).


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