Melissa Albin was at a park playing with her children near her home in Lyndhurst, Ohio, last summer when she noticed a stranger watching her intently.
“Finally she came up to me and she said, ‘I’m really sorry if this is weird, but I’ve been looking at the mole on the back of your arm and I’m wondering if you ever had it checked out,’’ Albin, 37, recalled in an interview with TODAY.
“She said, ‘I’m a dermatologist and it’s very concerning to me. I think you need to go get it checked as soon as possible.’”
It was the push Albin needed. As a person with fair skin and lots of freckles and moles, she had been urged by her primary care doctor to get regular skin checks, but never followed up on the advice because she never saw anything suspicious.
There was no history of skin cancer in her family, Albin said, but she loved being in the sun. She sunburned easily so she always used sunscreen, describing her tans as her many “freckles merging together” rather than her skin actually turning bronze
But there was one mole on the back of her arm she didn’t pay attention to because she couldn’t see it — until the mystery dermatologist flagged it.
“I thank God for her every day,” Albin said. “For a complete stranger to have such concern and to take the time to say something made me realize how serious this was… if she hadn’t said something to me, I would have keep putting it off.”
'It could have had a bad outcome'
The mole was very dark brown, about the diameter of a penny and had an oval shape, she recalled. It was “out of sight, out of mind” because it lurked in her triceps area so she would rarely catch a glimpse of it in the mirror or in pictures.
Dr. Philip Bernard, a Cleveland Clinic doctor in Solon, Ohio, who examined Albin’s mole last September, called the stranger a “savior” for flagging the spot.
“Sometimes, people are afraid to approach a total stranger and just say things like that. People are just very reticent to put themselves on the line, especially if they could be wrong,” Bernard told TODAY.
“She was very courageous to do that and I’m really thankful for Melissa for following through… she loved being outdoors, so (delaying the skin check) could have had a bad outcome.”
Bernard removed the mole for a biopsy. The result: melanoma, the deadliest type of skin cancer. But it was stage 1, meaning it had been caught early and had not spread.
Albin was referred to a skin cancer surgeon, who removed more tissue from her arm in November to make sure all of the cancerous cells were gone. She will have to get full dermatology checks every three months for the next few years to monitor her skin.
Bernard said he has many friends who have lost loved ones because of melanoma occurring in their late 30s and early 40s. That’s why it’s important for people to pay attention to their skin and get to know the ABCDEs of melanoma — warning signs that a mole is cancerous.
In Albin’s case, “the thing that really stood out was what we call the ugly duckling sign — a mole that looks very different than the other moles on her body,” he said.
A dermatologist can see spots on the body a patient often can’t, such as on the back of the arms, upper back, lower legs, the scalp and the back of the neck, Bernard noted.
He recommended regular skin checks for people who are very fair skinned with light eyes and blond or red hair; those who have a history of blistering sunburns in their childhood; and those who have have lots of freckles or moles on their body.
Melanoma rates in the U.S. doubled from 1988 to 2019, according to the American Academy of Dermatology.
But there’s concern many people may be overdiagnosed, or aggressively treated for a spot that would have never caused harm during a patient’s lifetime.
Researchers estimate about 60% of white men and women with melanoma were overdiagnosed in 2014, according to a study published in JAMA Dermatology in March.
While several studies have explored whether melanoma is overdiagnosed, this is not the consensus of the specialty or the position of the American Academy of Dermatology, the organization said in a statement.
"We know that melanoma kills thousands of Americans every year, and we also know that cancers found at an earlier stage are much less likely to be lethal," Dr. Mark Kaufmann, president of the AAD, said in the statement.
"While we have no way to predict which individual melanomas will be lethal, we must assume that all have that potential."
It's key for dermatologists to use dermoscopic tools — noninvasive gadgets that illuminate and magnify a spot, allowing doctors to look up to 1 millimeter below the skin surface, Bernard said. He estimated that without those tools, he’d be performing three or four times as many biopsies as he does.
Meanwhile, Albin would love to find the mystery dermatologist who urged her to get the mole checked out. The woman told her she used to practice near Cleveland but had since moved to the East Coast and was briefly back in the area for a visit.
Finding her “would be fantastic because how amazing would it make you feel to know that you had such an impact on someone’s life?” Albin said.
This story was updated on May 9 to add the American Academy of Dermatology's comments on the potential overdiagnosis of melanoma.