Angela Price has tumour removed from groin, advocates for check-ups

Dermatologist on difficulties detecting melanoma Following Angela Price's disclosure, Dr. Beatrice Wang of the MUHC explains that melanoma can be hard to diagnose.

Angela Price had a tumour removed from the inside of her thigh, she announced in a series of stories on Instagram on Wednesday, describing the melanoma and all the procedures she's endured.

Price, who is married to Habs goalie Carey Price, said she went to see her dermatologist earlier this summer about her concerns, revealing later she'd been worried about "dark spots" the summer before.

"We found what was just a cluster of red blood cells. Had it removed and it did come back as melanoma, and it was just deep enough where it could have had the potential to spread to my lymph nodes," she explained.

"From there, my doctor sends me to OHSU," she said, referring to Oregon Health & Science University in Portland Oregon.

Price described packing up to leave Kelowna, B.C., where the Price family has a home, and being greeted by her mother in Portland.

There. at the oncology unit, a specialist removed a larger piece of skin around the tumour along with a lymph node so they could perform a biopsy "to see if the cancer had spread," she said.

Melanoma is a rare type of skin cancer compared to other types of the disease, says Montreal dermatologist, Dr. Beatrice Wang, but it is the most aggressive.

"It is the one that has the potential to metastasize or spread, so it is the one that is the most dangerous," said Wang who is the Director of the Melanoma Clinic at the McGill University Health Centre (MUHC).

Price said that based on the medical evaluation she's received so far, her doctor estimated "that the chance of it spreading was only around 12 percent," so her "odds are pretty good," she thinks. She's still waiting for the test results.

All the results, once analyzed, help a doctor decide how to treat the patient initially and in the long term, explained Wang, since there are different stages of melanoma.

"The most important thing is the depth of the melanoma when it's found because that will dictate everything that we do," Wang said.

If it's superficial enough, surgery can be enough to treat it, along with regular follow-ups.

If it's a little deeper, as Price said hers was at 1.1 mm, a doctor "may suggest a central lymph node biopsy to make sure it hasn't spread to the lymph nodes," Wang explained, which reflects Price's experience.

'BE AN ADVOCATE FOR YOUR OWN HEALTH'

Price shared her story, while recovering on her couch back in Kelowna.

"I'm icing my groin," because it's "sore and kinda hard to walk."

She said she isn't trying to gain sympathy, rather she hopes that after listening to her story, her followers remember to take care of themselves.

She also divulged that the previous summer she showed the dark spot to a dermatologist but was told it was a "part of aging don't worry about it."

She did worry, she said, and she watched it. She waited eight months before seeking advice again.

"Yes, I should have gone back way sooner."

THE ABCDE'S OF SKIN CANCER

Wang says it can be difficult, even for doctors to distinguish between something on the skin that's innocuous and something that is cancer, especially when it's early.

"We do tell our patients about what we call the ABCDE. So we ask them to look for lesions that are: Asymmetric, irregular Border, irregular Colour, Diameter -- greater than 5 millimetres or the end of the pencil eraser," she said.

But 'E' is the most important marker: 'E' for evolution.

"If things continue to change, that worries me, that should worry my patient, that is confirmation that you need to go back even if somebody said that initially, it looked OK," she said.

That was Price's primary message. "Just a reminder to get your skin checked...the earlier you get it the better," she said. "Be an advocate for your own health!" she wrote in a later post.

MORE DIAGNOSTIC CHALLENGES

Melanoma can also be visually tricky because they're not always pigmented.

"We can have what are called amelanotic melanomas, which are flesh-coloured or red in colour, so it can be challenging to make a diagnosis of melanoma," said Wang.

"But as I say, we have to listen to our patients when they say there is something changing. And if we're not sure we biopsy."

That inclination to do a biopsy also stems from the scientific knowledge that, a mark or spot on the skin can sometimes be non-cancerous at first and then can change into cancer, Wang explained.

"That's a hot topic in melanoma. We believe that maybe 30 per cent of melanoma starts off from a mole, from a naevus, and then it changes. But the other ones come de novo (with no associated mole or naevus).

A true melanoma develops after a certain number of mutations have occurred, and can grow very slowly over years, or can start expanding over several weeks and months, depending on the type of melanoma it is, said Wang.

PEOPLE ARE GETTING 'MUCH MORE RADIATION'

As for prevention, Wang can't believe she's still repeating the same message but she sees that there's a lack of understanding, still, about sun protection.

She's not only concerned about those who lie down in the sun to get a tan.

"It's just the fact of being outside. You are exposed to light and everybody knows, you can see the sun is different, people are getting much more radiation these days from sun exposure," she said.

As a result, she and her colleagues are urging people to use physical protection because she says they don't use enough sunscreen.

"Use long sleeves, hats, long pants, there are many things, many companies out there that have clothes that are comfortable and cool enough to do your sports, your gardening, everything but be fully protected from the sun," she said.

Clothing, along with a good coating of mineral sunscreen when you're exposed, that contains zinc oxide or titanium dioxide will also help prevent skin cancers, Wang advised.