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


Denny A. Patel, DPT, CSCS. Dr. Patel graduated from Loma Linda Univeristy with a Masters in 1999 and recently received his Doctorate from Western Univeristy of Health Sciences. He is currently Owner of Santa Ana Tustin Physical Therapy, Inc in Orange County, California. Dr. Patel has been practicing physical therapy for over 10 years now and is also a certified strength and conditioning specialist. He has advised many professional athletes by performing musculosketal evaluations and presenting proper training programs to their personal trainers. He is also a certified clinical instructor by the APTA and takes students/interns on a regular basis. Dr. Patel is also a Part-time instructor for Human Anatomy and Biology at Santa Ana College.

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)

ABCD Checklist What to look for…
A= asymmetry When bisected, one half of the lesion is not identical to the other half.
B= Border The border is uneven or ragged as opposed to smooth and straight.
C= Color The lesion is more than one shade of pigment.
D= Diameter The diameter is greater than 6 mm. This is usually the size of a pencil eraser.

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.

Last revised: October 13, 2009
by Denny Patel, DPT, CSCS


1) Guide to Physical Therapy Practice. (2001). Phys Ther , 9-744.
2) Koh HK, M. D. (1992). Who discovers melanoma? J Am Acad Dermatol. , 914-919.
3) McGovern TW, L. M. (1992). Clinical predictors of malignant pigmented lesions: a comparison of the Glasgow seven-point checklist and the American Cancer Society's ABCDs of pigmented lesions. J Dermatol Surg Oncol , 22-26.
4) Whited JD, G. J. (1998). Does this patient have a mole or a melanoma? JAMA , 696-701.
5) (ABCD image)

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