When Julie Bassett went to her dermatologist to seek help for a face rash last fall, something else caught the doctor’s attention during the visit.
Bassett, 54, who works in medical sales and wears a mask all day, wanted relief for irritated skin near her mouth. After that problem was addressed, she received a full body skin check — her first ever.
That’s when the doctor noticed the spot on the bottom of her left foot. Bassett knew about it, too — she’d had the mole for about 10 years. But it blended in, wasn’t raised and wasn't bothering her so she wasn’t concerned.
The spot did have a strange shape: It looked like “an upside down Africa,” she recalled, and was the size of a pencil eraser.
“In hindsight, of course, it looked like exactly what you might see on a chart in the dermatology office,” Bassett, who lives in Evergreen, Colorado, told TODAY.
“(The doctor) was concerned right away… I definitely think that I was in denial in the beginning.”
After the spot was removed for a biopsy, Bassett was shocked to find out she was diagnosed with stage 1 melanoma, the deadliest form of skin cancer. She would need surgery to remove more tissue from her foot and take out three lymph nodes from her groin to test if the disease had spread.
It’s not unusual to have moles anywhere on the body, including the soles of the feet and palms of the hands, and just because a person has a spot underneath his or her foot doesn’t automatically mean it’s a cause for concern. But skin cancer can lurk there, doctors say.
Melanoma on the extremities — nails, hands and feet — is the rarest subtype of the skin cancer, accounting for less than 5% of all melanomas, said Dr. Vishal Patel, assistant professor of dermatology at the George Washington University School of Medicine & Health Sciences, and director of the Cutaneous Oncology Program at the GW Cancer Center in Washington, D.C.
But it makes up about a third of all the melanomas that Black patients, Indians, Asians and other people with darker skin develop, which is a ten-fold increase compared to the general population, he noted.
This type of cancer — called acral lentiginous melanoma — tends to be more aggressive than other melanomas. Plus, many people just don’t check underneath their feet for any suspicious spots, potentially leading to a late diagnosis.
Sun exposure can still mutate moles on the soles and palms, but that’s not the main driver of acral lentiginous melanoma. It can be genetically driven or develop for other, unknown reasons.
Bassett had surgery last December, with doctors taking out a palm-size chunk of tissue from the ball of her foot. She and her family were relieved the cancer had not spread to the lymph nodes in her groin.
Bassett had to use a knee scooter for three months because couldn't put any weight on her foot as it healed. It’s still on the mend almost six months after the surgery. She doesn’t need to take any immunotherapy drugs, but is being closely monitored by an oncologist.
“I was just really very fortunate because something so small could actually kill you,” Bassett noted. “It's really important to pay attention to.”
What to look for:
Remember the ABCDEs of melanoma. They apply to spots on the palms and soles, too. Don’t forget to look for moles between the toes.
A foot injury may increase your risk of developing melanoma, so pay close attention to places on your feet that have been injured, even if it happened years ago, the American Academy of Dermatology advised.
Report any changes, or a blister or any lesion that’s not healing anywhere on your body to your doctor.
Think of you and your dermatologist as a team. Actively scan your body between appointments and take pictures of your moles to keep track of changes and show to your physician. Bring any spots that concern you to your doctor’s attention. Working together can boost the chances of catching melanoma in its earliest stages