HEALTH Skin cancer most common cancer in Ireland

TAKE ACTION?If you notice changes in an existing mole or freckle, or a new skin lesion, get it checked without delay.

Skin cancer is the most common cancer in Ireland


Doctor's Insight
Dr Ronan Clancy

Skin cancer is currently the most common cancer in Ireland, and numbers are rising every year. In 2009 there were over 8,000 cases diagnosed.
The main skin cancers that arise as a result of sun exposure are squamous cell cancer, basal cell cancer and malignant melanoma. Melanoma is more likely to occur in younger people and although it accounts for only 10 percent of all skin cancers, it is responsible for the majority of deaths – and it’s rising at an alarming rate worldwide.
The reality is no different in Ireland. Although we are not the Canary Islands, and bikinis are rarely spotted along the blue flag beaches of Clew Bay, adequate skin care needs to be taken here as well as abroad.
The prevention of melanoma and other skin cancers starts early with sensible sun habits, regular high SPF block application in strong light or sunny conditions, good skin coverage with light clothing, sun hats and sun glasses. This especially applies to infants and children.
It is well accepted that recurrent sunburn and severe sunburn in childhood increase the risk of skin cancer and that people with fairer skin types (red or blond hair, freckled or albino skin complexions) are at higher risk, because they don’t produce enough protective melanin.
Melanoma is a cancer of melanocytes. These are the cells that produce the skin pigment melanin.
Anyone who has a first-degree relative with melanoma has twice the risk of developing melanoma themselves. People with multiple large multi-coloured moles may have dysplastic naevus syndrome, which in itself carries a significantly increased risk of melanoma.

What to look out for
Melanoma typically appears as a dark colored or blackish patch, freckle or raised area (nodule) that is slowly becoming larger or changing in colour or shape. It may become itchy or bleed. It can arise within a mole that was always there or on skin that had no previous colouration or pigment. It can also appear as discolouration under the nails of the fingers or toes or on the palms of the hands, soles of the feet or scalp. It is more common on the legs of women and the chest and back in males. Occasionally it may occur as a colourless growth called amelanotic melanoma. It can sometimes arises from the internal tissues of the body.
It is really important to get to know your own skin and check it regularly. More than 50 percent of melanomas are detected by patients themselves when they notice the appearance of a new lesion or change in an existing mole or freckle.
The next most important thing to do is have it assessed by your doctor. Early detection and removal of Melanoma often results in complete cure. The risk of spread is associated with how deeply the melanoma has penetrated into the skin, thus the earlier it is removed, the better.
Unfortunately, melanoma that has spread can be very difficult to manage, despite numerous types of therapy and huge research.

Melanoma alphabet
The ABCDE signs and the Ugly Duckling Sign describe the main changes that suggest irregular behaviour in a pigmented skin lesion. If you notice any these in an existing mole or freckle or a new skin lesion, you should have it assessed without delay.
Asymmetry: If you draw a line through this mole, the two halves will not match.
Border: The borders of an early melanoma tend to be uneven with notched or scalloped edges.
Colour variation: A variety of colours or shades – brown, tan, black, blue, red, whitish – is another warning sign
Diameter: Melanomas usually are larger (1/4 inch or 6 mm), but they may be smaller initially.
Evolution:  Any change in size, shape, colour or another trait, or new symptoms such as bleeding, itching or crusting
Ugly duckling sign: Melanomas look different (they are ugly ducklings) when compared with surrounding moles)

Visit www.skincancer.org for more information and pictorial examples of the warning signs.

Dr Ronan Clancy is a GP at the newly opened Clancy Medical Practice, James Street, Westport (www.westportgp.ie). He is in practice with Sarah Kavanagh, chartered physiotherapist.