People at a high risk of melanoma:
• Previous history of malignant melanoma
• Family history of malignant melanoma
• Numerous moles
• Immuno-suppression therapy, such as for organ transplants
• Fair skinned, lots of freckles, red hair
• Repeated or severe episodes of sunburn, particularly in childhood
• Fair skinned people born in hot countries such as Australia or Israel
• Excess sun exposure both at home and abroad
• Sunbed use, particularly before the age of 35
The following people are at a much higher risk of melanoma:
• Those with more than one melanoma
• Those who have two family members with melanoma and many abnormal moles
• Those who have three or more people in the family diagnosed with melanoma or pancreatic cancer
• Those born with very large moles (bigger than 20cm)
What everyone should look for:
• An enlarging mole
• Changing shape, particularly getting an irregular edge
• Changing colour
• Getting darker or being multi-shaded
• Asymmetry (the two halves not looking the same)
• Itchy or painful
• Crusted or bleeding
• Looking inflamed
Moles with three or more shades of brown or black are particularly likely to be cancerous. In men, the most common site for melanoma is the back, and in women it is the legs. A dark area under the nail that is enlarging and is not due to trauma should also be checked by a doctor.
• Make sure you are familiar with the normal appearance of your skin and any moles you have.
• This is very important if you are fair skinned, have many moles or a tendency to freckle or burn in the sun. Get your partner to look at areas of skin that you can’t easily see. If you think you have a mole that could be melanoma, go to your GP.
• Not all melanomas develop from a pre-existing mole. In fact according to various studies only 15-50% of malignant melanoma show evidence of a pre-existing mole. (Robin Marks et al. Australian Journal of Dermatology, 31 (2),pp 77-80 August 1990) The majority of melanomata therefore develop as a melanoma rather than a change from a pre-existing mole. Multiple mole removal as a preventative measure therefore is not recommended and, by the same token, UV protection is important for the entire exposed skin and not just for the moles.
Some sun-smart advice from Cancer Research UK:
• Spend time in the shade between 11am and 3pm
• Wear a t-shirt, hat and sunglasses
• Use sunscreen with at least an SPF of 15
The higher the SPF the better the UVA protection. For UVA protection we have star rating of up to five on UK sunscreens. The minimum recommended is four stars. Symbol of a circle with letters UVA inside is a European mark indicating good UVA protection.
Checking skin cancers:
• It is important to make a habit of checking your own skin and your partner’s including difficult areas such as the back
• If you find any changes see your GP
What about technology?
Standard computerised systems are now becoming available for full body automated skin examination, photography and detection of melanomata. Total body photography with dermatoscopy (close-up examination of an individual skin lesion using a specialist high resolution device) increases diagnostic accuracy for follow up, especially for those who are at a higher risk of development of malignant melanoma. Comparing the images taken with those taken previously is proving to be a highly effective approach, allowing for early diagnosis and in turn reducing the number of surgical procedures. This technology is advancing rapidly and will be a very helpful tool, helping early diagnosis of malignant melanoma.
Call Springfield Hospital on 01245806710.