Melanoma Facts

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Who is at risk? Ways to help yourself Malignant Gene

6000 people in the UK are diagnosed with malignant melanoma every year. Melanoma begins in the melanacytes - the part of our skin that produces pigment and also protects us from burning in the sun. This type of skin cancer is not very common here, though in Australia it is the most prevalent cancer after lung, prostate and breast cancers.

Even in Britain the incidence is supposed to have doubled in the past 10 years as hot holidays become increasingly popular.

BUT. New Research published at the end of 2011 and published in the Journal of Dermatology concludes that stage 2, 3 and 4 skin lesions have stayed at the same levels for over ten years. What is happening is that stage 1 lesions are being treated as if they are major developmenents in melanoma. The researchers call it an artefact of diagnosis. So apparently we are not all about to get melanoma.

Also, about half of all cases have lesions in places the sun did not attack - so they are not actually caused by the sun!

This fits with other research that shows, rather than having too much sun, melanoma patients do not have enough vitamin D in their bodies.

So there must be causes other than sunshine - and this leads us to the conclusion that concerns over oestrogen levels in the blood (from the pill or HRT0 and localised oestrogen, from xenoestrogens in sun creams, skin creams and ’after suns’ may be a real concern.

Melanoma is easily curable if picked up early, and thus Doctors would argue that they are right to be overdiagnosing and treating even simple lesions.

State-of-the-art diagnosis in Australia involves a video microscope magnifying moles up to 200 times so that doctors can distinguish the benign from the malignant without having to remove them for biopsy. Research is also focussing on the benefits of immunotherapy for advanced melanoma - using patients’ gene-modified tumour cells as vaccines.

Who is most at risk?

People with a close relative who has had malignant melanoma. Although the condition itself is not usually inherited, many family members have similar skin type and colouring.

People with multiple moles especially if they are fair-skinned and blue-eyed and those with a tendency to freckles. Having a darker skin is not a total safeguard.

People who burn easily in the sun, have been badly sunburned at least once in the past five years and those who have exposed their skin to ultraviolet light whether in the sun or on a sunbed.

Many family members have similar skin type and colouring

Those with malignant melanoma are more than three times as likely to have been badly sunburned several times in their lives as those without the disease. An Australian study found that going all-out for a tan on a fortnight’s holiday is more risky than working constantly outdoors.

More women than men are affected by melanoma, but research has so far ruled out any significant hormonal link. Taking a high oestrogen contraceptive pill (now rarely prescribed) for more than 10 years may be a minor risk factor. Melanomas in women are most commonly found on the legs, while in men they appear on the back.

Ways to help yourself

If you have many moles (the average adult has between 15 and 40) it is worth visiting the doctor for a simple check-up. At least one specialist clinic in the US (American Academy of Dermatology, Illinois) suggests that anyone over ’18 with risk factors has an annual check and self-checks every month as well. Use a hand-held mirror to look between your toes, under your arms and in the pubic area for any unusual mole or growth. Ask a friend or partner to check the bits of your body such as back and scalp- that you can’t see yourself.

Visit your doctor without delay if you have a mole or some other raised pigmented area that is larger than a pencil eraser - is growing, changing shape (particularly where the outline is irregular) or colour (it could be getting darker or patchy). Itching, bleeding and inflammation are also warning signs. ’Bad’ moles may be black, red, brown, blue or white.

Visit your doctor without delay if you have a mole or some other raised pigmented area that is larger than a pencil eraser

Tell partners or friends if you think they have a suspicious mole and discourage them from sun-worshipping. Always protect babies and children from the sun and ensure that they wear hats to keep the sun off their face and the back of their neck. Use waterproof sun cream as it will last longer. Children playing near water are more likely to burn because the sun reflects off the water’s surface.

Keep out of the sun between 11 am and 3pm when it is hottest. Follow the simple advice - Do go in the sun, don’t get burned:

Choose a cream that offers protection against both UVA and UVB radiation and take note of its SPF (sun protection factor). Without cream you may get burned in just 15 minutes. Factor 2 protects you for just half an hour and factor 15 for about three and three-quarter hours. Some creams contain chemicals that may cause problems - check the Environmental Working Group in the USA for the one in five creams that don’t contain any ’nasties’.