When Christy Staats was told that a red spot just below her eye was harmless, she assumed this was the end of her ordeal.
But moments later, her dermatologist was startled by a new spot on the same cheek.
The tiny spot, measuring just 0.65 mm and nearly invisible to the human eye, turned out to be melanoma – the deadliest form of skin cancer.
Doctors who have treated Ms Staats have now been told that her malignant tumor is the smallest skin cancer ever discovered and has been awarded a Guinness World Record.
Dr. Alexander Witkowski, an assistant professor of dermatology at Oregon Health & Science University who spotted the cancer, said the finding meant the melanoma could be treated before it spread.
Dermatologists at Oregon Health and Science University noticed a worrying mark on patient Christy Staats’ right cheek (pictured) after seeking advice about a separate mark
State-of-the-art scanning equipment highlighted atypical cells around the 0.65mm lesion (pictured), a telltale sign of melanoma – the most dangerous form of skin cancer
Dr. Alexander Witkowski (right), assistant professor of dermatology at the university’s School of Medicine, who spotted the cancer, said the finding meant the melanoma could be treated before it had a chance to spread
Mrs. Staats had been worried for years about a red spot under her eye. But she was repeatedly told by dermatologists that nothing was wrong.
However, she booked another appointment to view it after it grew larger and developed a ‘leg’.
During her consultation, dermatologist Dr. Witkowski diagnosed it as a cherry angioma – a fairly common, non-cancerous skin growth.
However, during that same evaluation, he noticed an awkward spot on her right cheek.
Dr. Witkowski snapped a photo of the mark with a Sklip smartphone attachment, a $150 (£120) device he made for medics to capture close-up images of skin growths.
He then performed a reflective confocal microscopy (RFM) – a new scan that uses a laser to illuminate a spot and highlight the cells below it.
The results showed that there were atypical cells, usually seen in cases of melanoma.
Dr. Witkowski recalled Mrs. Staats’s appointment and said, “I said to Christy there at the bedside, ‘I think this is the tiniest skin cancer ever discovered.'”
Dr. Witkowski then took a biopsy of the birthmark, which his team, which included his wife Dr. Joanna Ludzik, Dr. Jina Chung, Dr. Sancy Leachman and Claudia Lee, further inspected.
During the diagnostic process, the case was also reviewed by Dr. Giovanni Pellacani, President of the World Congress of Dermatology and Chair of Dermatology at La Sapienza University in Rome, Italy.
He is a leading expert on RFM and mentored both Dr Witkowski and Dr Ludzik before they moved to the US from Europe in 2019.
The team confirmed that the spot was a melanoma in situ, also known as stage 0 melanoma.
It means that there are cancer cells in the top layer of the skin, the epidermis, but they are contained and have not penetrated deeper into the skin.
It can be cured with surgery, which removes the melanoma and a border of healthy skin around it to ensure that all abnormal cells are removed.
He then performed a reflective confocal microscopy (RFM) – a new scan that uses a laser to illuminate a spot and highlight the cells below it. Dr. Witkowski said his university is one of the few centers in the US to have this device (pictured)
Dr. Witkowski and Dr. Ludzik (pictured) — a husband and wife team — describe the case at an event on May 1
Getting this skin cancer so early meant that the melanoma was small, earning the team the Guinness World Record for the “smallest skin cancer detected.”
On May 1, a Guinness World Records judge visited the university to present each team member with a certificate for their newly achieved record.
Dr. Witkowski said: ‘What our team has achieved together embodies my personal mission: ‘Catch the inevitable early’.’
He said the early diagnosis meant Ms Staats’ cancer was detected “before it had a chance to spread to other parts of the body.”
Ms Staats said she is grateful her melanoma was discovered before it could grow or spread and was in the ‘right place at the right time… with the right technology.’
She said, “I believe it is possible for anyone to be as lucky as I am with the right technology.
“If they can find mine when it’s this early, it’s a good idea that this technology can help other people.”
Ms. Staats said she was glad she followed her instincts about her original concern that led her to make an appointment in the first place.
“It’s an important reminder that you can’t get lazy with your skin. You have to stay on top of it and let new things figure out,” she added.
Every year, nearly 17,000 Britons and 100,000 Americans are diagnosed with melanoma, resulting in 2,300 and 8,000 deaths respectively.
Although melanoma generally accounts for only a fraction of skin cancers, it causes a large majority of skin cancer deaths.
It is usually caused by ultraviolet (UV) light, which comes from the sun and is used in tanning beds.
The main symptom is a new mole or a change in an existing one, which can appear anywhere on the body, but is most common in areas that are frequently exposed to the sun.
Dr. Leachman, director of the university’s Knight Cancer Institute’s melanoma program, said the case “really demonstrates the power of new technology to identify potentially dangerous spots early.”
She said, “With melanoma, your eyes really can be your best resource.
“A mole or spot on your skin that changes in appearance — size, shape, color — is an important indicator of melanoma.”
Melanoma: the most dangerous form of skin cancer
Melanoma is the most dangerous form of skin cancer. It happens after the DNA in skin cells is damaged (usually due to harmful UV rays) and then left unrepaired, causing mutations that can form malignant tumors.
- Sun exposure: UV and UVB rays from the sun and tanning beds are harmful to the skin
- Moles: The more moles you have, the greater the risk of developing melanoma
- Skin type: Paler skin has a higher risk of getting melanoma
- Hair Color: Redheads are more at risk than others
- Personal history: Once you’ve had melanoma, you’re more likely to get it again
- Family history: If previous relatives have been diagnosed, that increases your risk
This can be done by removing the entire part of the tumor or by the surgeon removing the skin layer by layer. When a surgeon removes it layer by layer, it helps them pinpoint exactly where the cancer stops so they don’t have to remove more skin than necessary.
The patient may decide to use a skin graft if the surgery left discoloration or an indentation.
- Immunotherapy, radiation or chemotherapy:
This is necessary if the cancer reaches stage III or IV. That means the cancer cells have spread to the lymph nodes or other organs in the body.
- Use sunscreen and don’t burn
- Avoid tanning outdoors and in beds
- Apply sunscreen 30 minutes before going outside
- Keep newborns out of the sun
- Examine your skin every month
- See your doctor for a skin exam every year
Source: Skin Cancer Foundation and American Cancer Society