PT Classroom - The Role of the Physical Therapist with Skin Cancer Screening ׀ by Denny Patel, DPT, CSCS

The Role of the Physical Therapist with Skin Cancer Screening

As physical therapists transition to direct access across the United States, we have quickly become the first line of defense for many medical conditions. One condition that is readily seen in practice is skin cancer. Since physical therapists regularly require their patients to expose large parts of their body, we can easily detect cancerous lesions and hopefully reduce the morbidity and mortality associated with the most common malignancy occurring in humans.

Early detection is critical in reducing the morbidity and mortality from skin cancers. Most melanomas, approximately 53% were self discovered. Twenty six percent were discovered by medical providers, 17% by family members, and 3% by others. (Koh HK, 1992) The Guide of Physical Therapist Practice has described the role of physical therapists in secondary prevention, or “decreasing duration of illness, severity of disease, and number of sequelae through early diagnosis and prompt intervention. (Guide to Physical Therapy Practice, 2001).

Skin Cancer screening can be easy as 1-2-3, or as easy as A-B-C-D. The general guide to skin cancer screening is presented in the following chart. (McGovern TW, 1992)

The following is a quick screen, but the presence of one or more of these elements raises concern that the lesion may be cancerous and should be referred out. The physical therapist can also ask basic questions such as, “Has the mole changed color, size or shape within the last few weeks?” If the mole has been present for many years with no change, then the therapist can advise the patient to monitor it. Although the gold standard for diagnosis of skin cancer remains the evaluation of the excised tissue (Whited JD, 1998), physical therapists can still play their role in the early detection of skin cancer.