Jacqueline Mills is used to seeing spots — but this one was different.
The 32-year-old public school teacher rushed to a dermatologist after a small mark suddenly appeared on her right cheek, the threat of skin cancer weighing on her mind.
But instead of a diagnosis, Mills got dismissed. “They were worried about me getting a scar on my face and not wanting to test it,” she told The Post. “That’s when I sought a second opinion.”
It’s a good thing she did. Tests at Mount Sinai revealed the spot was stage zero melanoma, a deadly form of skin cancer that’s been rising rapidly in young adults, especially women.
Known for spreading quickly throughout the body, melanoma can become life-threatening in as little as six weeks if left untreated.
Mole patrol
With a family history of melanoma, Mills was no stranger to skin checks and gets a full-body scan from her dermatologist once a year.
While she’s “covered with spots,” the mark on her cheek stood out when it began to change and grow rapidly.
“The first thing I noticed was that there was some discoloration, one side of it was lighter than the other side, ” Mills said.
“What really set me off was that the borders were very jagged and irregular. The shape was also strange, it wasn’t a perfect circle,” she added.
Those are classic red flags for skin cancer, said Dr. Jesse Miller Lewin, vice chair of surgical operations and system chief of the Division of Dermatologic and Cosmetic Surgery at Mount Sinai Health System.
He told The Post that one easy way to remember the warning signs is to follow the ABCDEs of melanoma:
- A is for asymmetry: Cancerous moles tend to be misshapen.
- B is for border: Melanomas often have jagged, uneven edges.
- C is for color: Look out for lesions that are more than one color or shade.
- D is for diameter: Spots larger than 6 mm (about the size of a pencil eraser) are a concern.
- E is for evolution: Changes in a mole’s size, shape or color can signal danger.
“A history of change or “evolution” of an existing pigmented lesion is the most predictive sign of melanoma among all the ABCDE criteria,” Lewin said.
No moles? That doesn’t mean you’re off the hook. Most melanomas appear as brand-new spots on previously clear, healthy skin. The cancer can develop anywhere, including the eyes, scalp, nails, feet and even inside the mouth.
Face to face with cancer
Melanoma may be one of the deadliest skin cancers. However, if caught early, it’s highly treatable.
When diagnosed at stage zero, the five-year survival rate is over 99%. But once it spreads to distant organs and body parts, like the lungs or bones, that number nosedives to just 35%, according to the American Cancer Society.
“It was a blessing and a curse that this was on my face,” Mills said. “It made it harder to remove, and I do have a scar, but I think it’s why I noticed the changes so quickly and they caught it at stage zero.”
“I think if this spot was in a different part of my body, I wouldn’t have noticed how quickly it was changing and it could have been a very different outcome for me,” she added.
Within weeks of her diagnosis, Mills underwent Mohs surgery at Mount Sinai. The highly technical procedure involves removing skin in layers, examining each under a microscope until all the cancer cells are gone while preserving as much healthy tissue as possible.
“Melanoma has cells that can be visible on slides under the microscope extending beyond what you can be see with the naked eye,” Lewin said. “If cells are left behind the melanoma can get deeper or spread to lymph nodes.”
Though the original spot was tiny — no bigger than the top of a push pin — by the time Lewin was done removing the cancer, Mills had a wound about the size of a quarter on her face.
“You look at your skin every day. If you sense something is wrong, no one is going to judge you for going to the doctor and having it looked at.”
Jacqueline Mills
It took about a year for the wound to fully heal and the scar to fade. To minimize it, she turned to laser treatments and silicone scar cream.
“Now most people can’t even really tell that I have a scar,” Mills said. “The only people that know are the people that knew me at the time, it’s healed really, really nicely.”
Scan it, spot it, stop it
Now 34 and cancer-free, Mills sees the dermatologist twice a year and uses advanced technologies like the Vectra scan to monitor any changes in her skin.
“When you get a full body yearly scan, you’re relying on your dermatologist to record and remember your moles and your spots from the year before,” she said.
The Vectra WB360 scan, by contrast, is a 3D whole-body imaging system with more than 40 cameras that can document all of your freckles, moles and other growths in a matter of minutes.
“If you’re someone with a skin type that has a lot of spots, this is a really good option because it’s an added layer of protection,” Mills said.
“Now you can have the doctor’s eyes and a computerized scan of your entire body, which can measure the size and the pigment and the type of spots that you have and compare them from year to year,” she added.
If you’re average risk for skin cancer, get a full head-to-toe check by a dermatologist once a year, according to Lewin. But if you’ve got a history, he recommends going twice.
But you don’t have to wait for your annual appointment to stay on top of your skin.
“Doctors are an important tool, but you are your first line of defense when it comes to dermatology,” Mills said.
“You look at your skin every day. If you sense something is wrong, no one is going to judge you for going to the doctor and having it looked at,” she added.
If you run into a dismissive provider like Mills did, don’t back down.
“Hesitation when it comes to melanoma could be the difference between a simple removal and getting chemotherapy, because that’s how quickly it moves and how deadly it is,” Mills said.
Lewin echoed her warning.
“Trust your gut — if a lesion on your skin is new or changing and you are concerned, see a dermatologist,” he said. “If you remain concerned after seeing one doctor, get a second opinion. Because [Mills] did that, it saved her life.”
The dark side of sun kissed
Melanoma makes up just 1% of all skin cancers, but it causes the vast majority of skin cancer deaths, according to the ACS.
In 2025, the group estimates that about 104,960 new melanomas will be diagnosed in the US, and roughly 8,430 Americans will die from it.
While melanoma risk increases with age, studies show that rates among children, adolescents and young adults have increased by more than 250% over the past four decades.
Soaking up UV rays — whether from the sun or tanning beds — is a major risk factor for melanoma. Having a lot of moles or lighter skin, hair or eyes increases your chances, too.
Your odds also go up if you have a weakened immune system or a family history of the disease.