Sunday Mirror
June 27, 2004
Britain is hardly sunshine central, yet people living here are twice as likely to die from skin cancer as those living in Australia. Melanoma is now the third most common cancer in the 15- 39 age group, and cases have shot up by a quarter in the last five years. Each year, around 7,000 people are diagnosed and around 1,700 will die.
The difference between survival rates in Britain and Australia is all down to early detection. 'In Australia, people get their moles checked as regularly as their teeth,' says Iain. Early detection can be the difference between a cure and a death sentence because melanoma is a very aggressive cancer, with no proven cure. 'If you catch it early, while the cancer is still in the mole there's a 97% survival rate,' says Iain. 'If you catch it late, the melanoma can spread through the body and kill you.'
SKIN'S WARNING SIGNS
Freckles: Although safe, freckles are a sign of sun damage. Since excess UV exposure can cause melanoma, you should keep a close eye on your skin and protect it better in the future.
Spot or lesion that won't heal: This could be a non-melanoma skin cancer, basal cell, which is caused by excessive sun. The spot appears in an area that's been exposed to UV, grows slowly and doesn't hurt. It's not life-threatening unless totally ignored - but consider it a warning.
Scaly or crusty patch: This might be squamous cell cancer, also caused by excess UV. It usually pops up on areas exposed to sun. It's easy to cure but the cancer can spread if untreated. Both basal and squamous cell cancer must be removed.
HOW SUN SMART ARE YOU?
We asked Mike Brown, Boots suncare advisor, and Graham Hill, founder of Delph, how to stay safe in the sun this summer
Is a high SPF enough to protect me?
No. An SPF only measures how well you are protected against UVB rays, the ones mainly responsible for burning and cancer. Always pick your sun cream by the SPF, but also opt for UVA protection as it's now believed to contribute to melanoma. UVA also causes 95% of skin ageing because it destroys skin elasticity.
How can I check the UVA protection?
Look at the star rating. This shows how much UVA protection you are getting proportional to the SPF. One star equals 20%, two star equals 40%, three star equals 60% and four star equals 80%+. That's the UVA protection relative to the SPF - so a four-star SPF4 gives far less UVA protection than a four-star SPF30. This year, Boots (who owns the star system) has introduced a new five-star category which shows the product blocks 90%+ UVA. At the moment, Boots sun care is the only brand marked five-star, but some four-star products from other brands already provide this much UVA protection, so expect relabelling next year.
Are SPFs accurate?
Only if you use them properly. You need to apply them liberally, give them time to be absorbed and keep reapplying as the sun breaks down the protective ingredients.
Can I stay out if I reapply my SPF when I start going red?
No. Once you've pushed your exposure to the limit that's it. If you don't get out of the sun, you will fry.
Can a single sunning session increase my risk?
Yes. All sun exposure causes DNA damage. One study found just a week in the sun produced significant changes in moles and made them more likely to turn cancerous.
Is clothing enough to protect my skin?
No. A T-shirt only gives roughly SPF10 (and about SPF2 if wet). A chiffon- type beach shirt definitely won't stop you burning, so it's important to use cream too. (To protect kids, we like www.koolsun.com who have a cute range of SPF50+ beach wear.)
Can I reverse the DNA damage I've done?
No. Your body repairs everything it can within 48 hours of sun exposure but after that you're stuck with what's left. Too much damage means cells can't replicate perfectly, which leads to everything from photoageing to skin cancer. We've all got an inbuilt limit for how much UV we can take in a lifetime, so it's never too late to protect yourself.
OUR EXPERT
Iain Mack, founder of The Mole Clinic, the UK's first skin cancer screening service with up to 94% accuracy at detecting melanoma. Call 020 7297 2075 or www.themoleclinic.co.uk. Screening from pounds 95.
KNOW YOUR MOLES
Moles are not cancerous in themselves. However, excess UV can trigger changes and increase the risk of melanoma developing*
Normal moles
A normal mole can be flat or raised, round or oval. Some are there at birth, some appear later, especially in areas exposed to the sun. It's vital to know what your moles look like so you can spot any changes in size, shape or colour that might suggest melanoma is developing. Always get changes or new moles checked out.
The A, B, C, D of danger
A = Asymmetry Normal moles tend to be symmetrical, while melanoma lesions are usually asymmetrical.
B = Border Normal moles have smooth, even borders, while most melanoma lesions have irregular borders with ragged edges.
C = Colour Normal moles are usually one colour, while melanoma lesions tend to have several shades of brown, black and even pink.
D = Diameter It's not a fixed rule, but melanoma lesions are often more than 5mm in diameter. Be cautious if a mole grows. Other warning signs may include inflammation, crusting or bleeding and itching.
If you spot anything unusual, see your GP or go for expert screening. If the mole is deemed suspicious, it will be cut out and sent off to be tested for melanoma. The majority come back clear, but even if the result is positive, cutting the mole out will destroy the cancer as long as it hasn't spread. Look out for asymmetrical shape and irregular borders. Melanomas often have more than one colour.
GET TESTED
Health Editor Lynne Michelle was screened at The Mole Clinic. 'My melanoma risk is above average as I've got lots of moles and fair skin with freckles. Although I've never had bad sunburn, I spent my teenage years trying and failing to get a tan, and doing stupid things like putting cooking oil on my legs. The first part of the screening was a visual check of my moles from top to toe. Five - not ones I'd have picked out as potentially dodgy - were deemed in need of further investigation. The suspects were photographed with a special mole-cam, magnified 50 times and analysed on software which compares them with a database of 25,000 other moles. Each was given a Melanoma Risk Score of 1-10, showing how likely it was to be cancerous.
The first four scored under 2.5, showing slight abnormalities but nothing to worry about. However mole number five, on my back, showed significant irregularities and scored almost four, just on the edge of the danger zone. As it's on my back and I've no idea whether it's changed or not, I was told to have it cut out and tested. Chances are it's fine, but the screening was a wake-up call - I'll be wearing sunblock this summer.
Are you a melanoma risk?
Assess your danger level with our check list of skin cancer risk factors
RISK: You've had lots of UV exposure, either from the sun or sunbeds.
WHY: The main cause of skin cancer is DNA damage from excessive UV exposure. Sunbeds can be just as dangerous as sunlight.
RISK: You have lots of moles.
WHY: More moles = more sites that could potentially become cancerous if you have too much UV exposure.
RISK: You like to sunbathe intensively on holiday.
WHY: 80% of melanoma is thought to be triggered by very intense but occasional bursts of sun (eg a week in the Med).
RISK: You are fair-skinned, with blonde or red hair or blue or green eyes.
WHY: You have less pigment to offer inbuilt UV protection.
RISK: You were badly sunburnt when you were young.
WHY: The most damaging sunburn is during childhood or adolescence.
RISK: You go on winter sports holidays.
WHY: At high altitude, there's less atmosphere to filter the sun's damaging rays and snow reflects them back at you.
RISK: You have a family history of melanoma.
WHY: There seems also to be a genetic element to skin cancer.
RISK: You have a giant congenital nevus birthmark.
WHY: Statistically these are a higher melanoma risk.
(C) 2004 Sunday Mirror. via ProQuest Information and Learning Company; All Rights Reserved
