Money Worries and Melanoma

Here’s one of the many things that keep dermatologist Jennifer Stein, MD, PhD, up at night: people who could be at risk of melanoma and avoid seeing a doctor because they think they can’t afford it.

A melanoma expert and member of The Skin Cancer Foundation, Dr. Stein and colleagues at NYU Langone Medical Center published a 2016 study in the journal Oncology based on a database of Caucasian melanoma patients. It showed that the higher the household income, the better the prognosis. “In our society, people of higher socioeconomic status have better access to health care. And access leads to a better outcome,” she says. Patients with lower income were diagnosed with melanomas at a more advanced stage and also had shorter survival.

Avoiding the Doctor Can Cost You

It’s easy to understand why people who have money worries or high deductibles might skip going to a doctor. But because melanoma can metastasize, or spread to other parts of the body, time is of the essence. Early diagnosis, when a melanoma is most likely to be cured, is crucial. Postponing seeing a dermatologist who is experienced in diagnosing and treating skin cancer could cost far more in the long run.

There are some things you can do (at no cost) to help determine when a trip to the dermatologist is important.

• Know your risk factors. But also be aware that “just because you don’t have lots of moles, or funny-looking moles, doesn’t mean you can’t have melanoma,” Dr. Stein says. “In fact, you can get a melanoma no matter what skin type you are.” People of color have lower risk because they have more natural protection. “But it can happen,” she says, “and when it does, the prognosis tends to be worse.”

• Learn about the ABCDEs of melanoma and do a skin self-exam every month, grabbing a mirror and a partner for hard-to-see areas. If you notice anything that’s new or changing, keep track of it. “You can also use a selfie stick and your phone to take pictures of your back,” says Dr. Stein. “The cameras have gotten so good you can even zoom in on your moles, then use the photos to monitor and keep track of them.”

• Look for the “ugly duckling.” Watch for something that doesn’t fit in with all the other spots on your skin, says Dr. Stein — “the thing that just stands out from everything else.” Even if it’s small, if it appeared suddenly, is growing fast (either outward or upward) or is a different color from everything else, that’s a warning, she says. And if you think it’s just a pimple or a sore, it should go away. If it doesn’t within a month or two, it needs to be checked. “If you see something that looks like a melanoma, or that just doesn’t seem right to you, get yourself to a dermatologist and have it checked out right away,” she says.

If you’re concerned about the cost because you have a high deductible on your insurance, for example, talk to someone in the doctor’s business office to ask about prices and see if you can work out a payment plan. Search online for a free skin cancer screening in your area. You can visit a city or county hospital, which often charges on a sliding scale.

“No matter what,” says Dr. Stein, “please don’t ignore it, because early detection is the key to surviving melanoma.”