Skin Cancers Time costs lives, and nowhere is that more apparent than when it comes to skin cancers caused by unrelenting sun. Fiona Tyrrell reports
Although people are aware of the hidden dangers of the sun, they often fail to put this knowledge into practice, according to a leading dermatologist, Dr Gillian Murphy, consultant dermatologist at Beaumont Hospital, Dublin. She warned against getting caught out unawares in the sun, putting off that visit to the doctor and false reassurance from inappropriate sources.
The good news is that the best ways to avoid the most common forms of skin cancer are quite simple - avoid frequent sunburns in childhood and cut down on your exposure to the sun in middle age.
"Very little things can make a big difference," Dr Murphy explained.
"People are very conscious of sunburn now but it is easy to make mistakes. It's easy to get caught out because our weather is so unexpected. People don't bring hats or sunscreen with them in cloudy weather and then suddenly we get a great day. I would be the last person to blame people. I think it is very hard to judge how much sun you can take without getting sunburn, especially if you haven't had any for a year."
It's a question of being prepared at a certain time of year rather than watch the weather, according to Dr Murphy. "From the month of May onward people need to be very careful because it is very easy to misjudge."
The most recent figures from the National Cancer Registry indicate that skin cancer is by far the most common cancer in Ireland among both men and women. In the past seven years there were on average 5,565 new cases diagnosed every year. One in every six men and one in every six women will develop skin cancer by the age of 74 years
Of the three types of skin cancer, malignant melanoma is the least common and most dangerous form, according to the Irish Cancer Society (ICS), which launches it annual SunSmart campaign today. On average there are 392 cases of malignant melanoma in Ireland every year and 65 deaths. It is linked to prolonged exposure to the sun and it most often appears as a changing mole or freckle.
Non-melanoma cancer is highly curable. On average there are 5,173 cases of non-melanoma skin cancer in Ireland every year. People should look out for a new growth or sore that does not heal within four weeks, a spot or sore that continues to itch, hurt, crust, scab or bleed or constant skin ulcers that are not explained.
Primarily there are two types of this non-life threatening form of skin cancer: squamous cell and basal cell carcinoma. Basal cell cancer usually develops on the head and neck (90 per cent of cases), but can also develop on the scalp and back. Repeated sunburn in childhood is a risk factor for this type, which usually develops 30, 40 or 50 years later.
To protect against this form of skin cancer as well as the more serious malignant form, Dr Murphy says avoid sunburn in childhood. .
It is your exposure to the sun throughout your lifetime that determines your risk of developing squamous cell cancer, which tends to develop on the hands, forearms, face and neck.
"This is usually skin cancer of the elderly. One of the reasons it is on the increase is because people are living longer, long enough to get skin cancer. People do not get it just because they are old. They get it because they have lived long enough to stock up a huge amount of ultra violet radiation."
This form of cancer can be avoided by cutting down exposure to these harmful rays. Dr Murphy advises those in middle age to take the simple measure of wearing a hat while in the sun.
Even if it is too late for prevention, early detection can make all difference - both in melanoma and the less serious forms. Dermatologists recommend that you become familiar with the moles on your skin and that you check them at least twice a year.
The ICS advises people to look out for new lumps or growths, a sore that does not heal or scaling red areas which bleed easily. It is particularly important to watch for changes in moles as they can indicate malignant melanoma (these changes may or may not be painful or itchy).
Aside from vigilance, people need to make sure that they seek professional help from the right quarters, according to Dr Murphy, who said it is "very easy to get melanoma wrong".
"Sometimes false reassurance from someone delays an appointment. I have seen it happen where the person thinks, for example, an obstetrician, or an orthopaedic surgeon should know. If they are not specialists in the area they may not know."
Medical literature, according to Dr Murphy, has indicated that reassurance by a doctor of an indeterminate type, a nurse or someone that the patient "thinks should know", can delay attendance and diagnosis from an expert. This delay can be "life-threatening," she said.
Another problem is when people put off making a trip to a dermatologist even after being advised to do so by their GP. "Many people leave it for months, even though they have been warned," according to Dr Murphy, who stressed again how "early detection leads to cure."
For information and advice on all types of cancer, phone the Irish Cancer Society's helpline on 1800 200 700.