Opinions wanted on work/real life situation

In My Humble Opinion
1

Here’s the deal:
I work as an assistant in a dermatology office, for going on 3 years. At this point, I have a fairly good idea of what melanomas look like. They are most often a brand new growth, not arising out of a mole, and the colors and shapes are quite distinctive. It’s not hard to spot a well-developed melanoma from across a room- they tend to stand out. And then there’s lentigo maligna, which is a type of melanoma in situ, and can look similiar to a benign growth, as it’s often flat and light-to-moderate brown in color. Lentigo maligna isn’t as easy for me to identify by sight (not that I ever need to, mind you, not being a doctor and all) as a regular melanoma.
Now, for the opinions part: The other night I was at the U of A football game (we suck, by the way), and I spied on the cheekbone of the guy in front of me, a (to me) worrisome-looking growth that I thought might be lentigo maligna. I didn’t say anything, because he did have a lot of benign keratoses, so it very well could be just a weird-looking one of those, and I didn’t know how I’d feel about worrying him needlessly and having him rush to a doctor (possibly even my own office!) and it be nothing. Also, they are season tickets (I have seen him sitting there at the only other previous game I’ve been to), so if I was wrong and it cost him time, money, and thoughts of “oh my god, I’m going to die!”, then I would have to see him if I ever went to another game.

Would you want to be alerted to something like that, even if the person was talking out their ass?

2

Yes, I’d want to know. If it’s nothing, then I haven’t lost much.

3

I would want to be told, and I’d be grateful for your concern.

4

ABCD:

Assymetry
Borders
Color
Diameter

I’d add in rapidity of growth or change.

5

Whatever you do, don’t mention melanoma or cancer.

True story. Last year I was at my internest for a routine checkup. He saw a spot on my chest and suggested I check in with a dermatologist. Fine, no big deal. I knew that most spots aren’t skin cancer and most skin cancer isn’t life threatening.

I went to the dermatologist, who removed it and sent it off for a biopsy with the cheery words, “don’t worry, I’m 95% sure it isn’t melanoma.”

Yeah, I freaked non-stop until the biopsy came back (it was benign.)

So, you might want to phrase you concern more like “I’m not a doctor, but I work for a dermatologist and I know those partricular types of marks can sometimes cause trouble” – rather than “I work for a doctor and I’ve seen plenty of cancer that looks just like that.”

6

Yes, the ABCD rule is in effect. Add E for “evolving” as in your last sentence.

7

Absolutely.

8

Yes, I’d want to be told.

I understand why you’d be reluctant to approach him, however.

Here’s a suggestion:

Approach him in a fashion that acknowledges that you are crossing a boundary–“Sorry to bug you. I know this is really none of my business…”

State your qualifications honestly–“I’m not a doctor, but I do work for a dermatologist…”

Don’t assume he hasn’t seen a doctor–“I’m wondering if you’ve had that mole on your cheek looked at?”

The guy will probably respond in one of three ways:

  1. He’ll tell you to MYOB.

  2. He’ll say that he has had it looked at, maybe adding that it’s benign or that he’s being treated for it.

  3. He’ll ask you why you want to know.

If it’s #3, you can just encourage him to have it looked at. If he presses you, you can just reiterate that you’re not a doctor, but you are afraid that it doesn’t look quite normal, and that it would probably be worth having a dermatologist take a look.