As Melanoma Awareness Month kicks off on Thursday, Melanoma Canada is rolling out its Mole Mobile to raise awareness about skin cancer and provide screenings for the disease to those that might not otherwise be able to access those services.
Along with major cities like Toronto and Calgary, the rolling screening clinic will be making stops in remote areas, including Indigenous and underserved communities. The Mole Mobile will be active from May through October in Ontario, Alberta, British Columbia and Quebec. Locations in Ontario and Alberta have been announced and more tour stops will be announced two weeks in advance on their website.
The CEO of Melanoma Canada explains that the idea for the Mole Mobile was partly born out of the severe shortage of dermatologists in Canada.
“There’s only 800 dermatologists for a population 40 million,” explains Falyn Katz.
“And the majority are practicing in major urban centers, leaving those in remote areas without access. So if someone has a lesion of concern in a remote area, they may need to travel hours to go to an appointment for a screening.”
Katz adds the instance and mortality rate of skin cancers are on the rise in Canada and around the world and catching it early is critical.
“If we can get these, detected earlier, we can save lives. So a mobile solution came to be.”
Usually, if a patient is concerned with a spot or lesion, they would first go to their family doctor, who then might refer them to a dermatologist. Katz notes that many do not currently have a family doctor and if they do, wait times to see a dermatologist can range from six to 12 months or longer, hindering early detection.
“So essentially we’re bringing the dermatologist to you. They are the skin expert … this brings the skin expert to the forefront, lets them have a look right away,” she says.
If something concerning is detected, Katz says the dermatologist on board the Mole Mobile has the option to take the patient into their practice if they are both local to the area.
However in remote locations, the dermatologist may not be able to take on the patient and in that case, they are referred back to their primary health-care provider.
“In the event that they don’t have a primary health-care provider, Melanoma Canada has sourced a network of General Practitioners (GP) who will be able to issue a referral to a dermatologist for follow-up care. So they will receive an expedited referral, depending on their diagnosis, to have whatever follow up is necessary,” says Katz.
Along with checking moles or skin lesions, patients will also be provided with education on how to conduct self exams and what to look for to identify melanoma, basal cell carcinoma and cutaneous squamous cell carcinoma. They will also be given a skin health-care package and digital resources.
“The important thing is they’ll leave with an answer. So if they had a mole or a lesion of concern, they’ll leave with a ‘you know what, it’s nothing to be concerned about.’ And at that point, we’ve taken this patient out of the queue so they are no longer waiting and taking the spot of somebody who needs an appointment … and they can now feel better,” says Katz.
“On the flip side, they’ll have an answer that it is something that needs some follow-up care and their follow-up care will be had and sought at a more expedited pace.”
Dr. Cheryl Rosen, a participating dermatologist from Toronto Western Hospital, adds that the Mole Mobile also offers a window to emphasize the importance of prevention and protection.
“I think that the Mole Mobile is not so much about primary prevention, but secondary prevention — catching things once they’re there. But it is also an opportunity to talk about how to protect yourself from further sun exposure. So when somebody might come in and show us a spot and it’s completely benign, it’s a chance to talk about prevention and how to be careful in the sun — use sunscreen and wear protective clothing etc.”
“A lot of people don’t take melanoma and skin cancer seriously. They think a tan is sexy, not deadly,” adds Katz.
“As we’re approaching the summer months, I think it’s really important that everybody understand proper prevention. Put on a hat, some sunglasses and UPF apparel or a thick woven fabric or get out of the sun altogether, stay in the shade.”
Learn more about sun safety here.
What to expect at the Mole Mobile
The Mole Mobile is a large RV style trailer with two exam rooms. It operates on a first-come-first-served basis, similar to a walk-in clinic.
The screening is free for both adults and children and does not require a health card. However provincial ID is required to prove the patient is a resident or citizen.
If there is a long wait time, patients have the option to leave their phone numbers at the clinic and they will be notified via text message 20 minutes before their turn.
While waiting, patients are given two short forms to fill out.
Katz says patients have the option of a spot check or a full body screening, as per their comfort.
The dermatologist will then take the patient to the exam room and if they have specific spots or lesion they are concerned about, they will be looked at with a dermatoscope that can look deep beneath the layers of the skin. Patients are advised to wear loose clothing that allows easy access to the areas they would like checked.
If a patient requires a full body screening, they are asked to change into a gown for a thorough check that includes fingernails, scalp and even the soles of the feet.
Following the screening, the dermatologist will record their findings and recommendations on the patient’s form.
The exam takes about 15 minutes and is a preliminary screening which helps determine if further investigation is needed.
A dermatologist conducts a skin cancer screening in the Mole Mobile at a stop in Quebec in 2023. HANDOUT/Melanoma Canada
So far, since its inception, the Mole Mobile has screened more than 4,000 people and helped detect 915 potential incidences of skin cancer.
“[Each] is the opportunity to save somebody’s life possibly, depending on the stage of diagnosis,” says Katz.
Spotting skin cancer
Skin cancer is more common than breast, prostate, lung and colon cancer combined, with one in every three cancers diagnosed in Canada being skin cancer.
Melanoma is the most dangerous form of skin cancer and can spread to other parts of the body — 22 Canadian are diagnosed daily and three people die from it every day.
However survival rate is high if detected early enough and unlike most other cancers, it is often clearly visible on the skin.
Dr. Rosen says for most people, a monthly self-check is sufficient.
“If you’re a person who has many, many moles, then you might want to check more often or you may want to have your family doctor or a dermatologist assist you,” she says.
“But if you don’t have very many moles, if your skin is fairly easy to check, then you start with one part of your body, your hand, your arm, then your leg and your foot, then your stomach, your chest, your back. You do a once over and see if there’s anything that you don’t recognize as having been there before or something that seems to be changing.”
She adds that it’s best to have a partner or family member check areas you cannot easily see yourself and ensure areas like the back, scalp, finger and toenails as well as palms and soles of the feet are checked.
If you have a spot or lesion with colour that you’re worried about, Dr. Rosen advises to use the ABCDE’s of melanoma to determine if it might be cause for concern and to keep an eye on it. If the mole exhibits any of the following signs, get checked by a professional.
A stands for Asymmetry: The two halves of the mole are not symmetrical and have different shapes.
B stands for Borders: The border or edge of the mole is irregular – it is not smooth but may seem blurred or notched and pigment has spread into the skin around the mole.
C stands for Colour: The mole is not one, uniform colour and has different shades of tan, brown or black and sometimes can have blue, grey, pink or white colouring.
D stands for Diametre: Melanomas are usually bigger than six millimetres — approximately the size of a pencil eraser — however they can be smaller. “We would really rather see spots that are of concern before they reach six millimetres,” says Dr. Rosen.
E stands for Evolution: The mole has changed in some way in the recent past and perhaps is itchy or bleeding.
Along with melanoma, it is also important to watch for other skin cancers, that do not present in the same way.
Basal cell carcinoma and squamous cell carcinoma can appear as spots that are not pigmented.
“It can be the same color as the person’s skin, it can have a reddish hue, it can be a little bit scaly or crusty. Sometimes they have a little ulcer in the middle, a little opening that’s got a crust, sometimes they can actually be pretty flat and a little bit scaly,” explains Dr. Rosen.
“A person might notice a bump or a lump on their skin that came up over time, or sometimes they come up rather quickly … but if it’s a bump that hasn’t been there before it might be worth checking out because it could be a benign cyst or it could be a skin cancer … all of these spots are worth checking. We don’t expect people to be able to make the diagnosis themselves, but it’s good to have a feeling of what you’re looking for and to notice change in something that’s been there before or the appearance of something new.”
Some factors increase the risk of skin cancer such as lighter skin, certain medications that suppress the immune system or increase sensitivity to ultraviolet radiation and outdoor jobs that may lead to greater sun exposure over time.
Dr. Rosen says anyone with higher risk factors should be vigilant, but skin cancer can and does effect people from all walks of life so it should not be taken lightly. She hopes the Mole Mobile will spread that message more widely.
“One of the main things that I think is important about the Mole Mobile is increasing awareness. Not everybody can get to the Mole Mobile the day that it’s in their neighborhood. But if they read about it or if they hear about it, it reminds them, ‘oh yeah, let’s think about examining my skin and seeing if there’s something there that wasn’t there before or that has changed,’” she says.
Click here to find out where the Mole Mobile will be stopping next.
