Natalie Grantham was having breakfast with her dad over Thanksgiving break a few months ago when she got a call from her dermatologist.

A mole on her thigh that the physician's assistant had recently removed tested positive for melanoma. 

Grantham, who lives in Mount Pleasant and works in public relations, was diagnosed with cancer at 29. 

"I never expected it to come back and be malignant — ever," she said. "I was just shocked."

The next day, a larger chunk of her thigh was surgically removed to extract the entire mole and its margins. If she had waited another month for a routine skin check, her dermatologist said Grantham would have likely needed to see an oncologist. 

"It wasn't fun ... but I caught it," Grantham said. "I really don’t think people understand that your skin is an organ. I don’t think they understand how quickly it spreads. ... I think it has to do with my age group and the way we didn’t pay attention, went to the tanning beds, and now it’s catching up to us."

A new study shows melanoma cases are on the rise in South Carolina and in several other states across the country. The American Cancer Society estimates that when 2016 cases are tallied, more than 76,000 Americans will have been diagnosed during the year. The results were published last month in JAMA Dermatology. 

Most skin cancers rarely spread, but melanoma is different. It may show up looking like an unusual, irregularly shaped or colored mole. It can invade tissues beneath the skin's surface and spread throughout the body. Overexposure to sunlight and indoor tanning are among the risk factors. It is the deadliest type of skin cancer and can be difficult to treat when it spreads to other organs. 

A separate study published last month showed that U.S. melanoma rates climbed from about 22 per 100,000 people in 2009 to an estimated nearly 24 per 100,000 in 2016. Earlier research showed the number of cases has increased sharply since 1980.

Dr. Andrea Abbott, a surgical oncologist at the Medical University of South Carolina and the East Cooper Medical Center, said the good news is that melanoma cases are likely increasing because patients and their doctors are doing a better job catching it. 

"People are more aware of melanoma. They’re going to get examined more frequently," Abbott said. "I think what (the study) is telling us is we’re doing a good job educating the public."

Genetics, regional ethnic differences and other demographics play a role. Melanoma is more common in whites and in people with light-colored eyes and red or blond hair. Because Lowcountry residents are exposed to more sunlight throughout the year than people in other parts of the country, Abbott recommends that nearly everyone in the area see a dermatologist for routine skin checks. 

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Dr. John Maize Jr. at Trident Dermatology agreed. 

"We stress that to patients all the time," he said. "Sometimes these things hide in plain sight."

Maize said patients should particularly look out for any new or rapidly growing mole or any moles that itch, bleed or change colors. Those are often the earliest signs of melanoma, and they need to be tested as soon as possible. 

Since her diagnosis, Grantham must undergo skin checks by her dermatologist once every three months. Just last week, she had other suspicious moles removed. 

"Moral of the story: get checked!," she said. "If you go (to the doctor), if you pay attention to your body, if you have a good dermatologist, you will catch melanoma early enough."

The Associated Press contributed to this report. Reach Lauren Sausser at 843-937-5598. 

The Associated Press contributed to this report. Reach Lauren Sausser at 843-937-5598. 

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