Checking for skin cancer

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Skin cancer is the result of skin cell damage and begins in the lower part of the epidermis, the top layer of skin. Protecting your skin against the harmful rays of the sun only goes halfway against preventing cancer. The other half is doing regular skin checks to nip any worrying skin issues in the bud early.

Jeremy Yatt, Principal Officer of Fedhealth, says you should examine your skin, head to toe, once a month, looking for any suspicious lesions. "Self-exams can help you detect potential skin cancers early enough to be completely cured. If melanoma, the deadliest form of skin cancer, is recognised and treated early, it is almost always curable, but if it is not, the cancer can advance and spread to other parts of the body where it becomes hard to treat and can be fatal."

Often resembling moles, the majority of melanomas are black or brown, but they can also be skin-coloured, pink, red, purple, blue or white. "Finding an atypical mole will often give you the first clue that something's amiss. That is why it's important to know your skin very well and to recognise any changes in the moles on your body. However for a successful self-exam, you need to know what you're looking for, and to aid this, physicians have developed specific strategies for early recognition of the disease."

ABCDE of melanoma

One strategy is to look for the ABCDE signs of melanoma. If you see one or more of these signs, make an appointment with a physician immediately.

• A is for asymmetry - if you draw a line through the mole, the two halves should match. If not, check it out.
  
• B is for borders - since the borders of an early melanoma tend to be uneven.
  
• C is for colour - since having a variety of colours is another warning signal. A number of different shades of brown, tan or black could appear in one, or also become red, blue or some other colour.
  
• D is for diameter - melanomas are usually larger in diameter than the size of a pencil's eraser (6 mm), but they may sometimes be smaller when first detected.
  
• E is for evolving - as any change in size, shape, colour, elevation or another trait, or any new symptom such as bleeding, itching or crusting, points to danger.

"As a general rule, to spot either melanomas or non-melanoma skin cancers, take note of any new moles or growths, and any existing growths that begin to grow or change significantly in anyway. Lesions that change, itch, bleed or don't heal are also alarm signals," he adds.

Another strategy physicians developed is the ugly duckling sign, based on the concept that these melanomas look different compared to surrounding moles. The idea is that the patient's 'normal' moles resemble each other, while the potential melanoma is an 'outlier,' a lesion that looks or feels different than the patient's other moles, or changes differently than the patient's other moles.

"While everyone is at risk for melanoma, increased risk depends on several factors, including sun exposure, number of moles on the skin, skin type and family history. Heredity plays a major role in melanoma as about one in every 10 patients diagnosed with the disease has a family member with a history of melanoma. Each person with a first-degree relative diagnosed with melanoma has a 50 percent greater chance of developing the disease than people who do not have a family history of the disease," explains Jordan.

Once a melanoma is diagnosed, the first step in treatment is the removal of the melanoma - the standard method being by cutting it out. Surgery has made great advances in the past decade, and much less tissue is removed than in the past. Patients do just as well after the lesser surgery, which is easier to tolerate and produces a smaller scar.

"In most cases, the surgery for thin melanomas can easily be done in the doctor's office or as an outpatient procedure under local anaesthesia. Stitches remain in place for one to two weeks and scars are usually small and improve over time."

Yet even if you check your skin regularly, sun protection remains essential to skin cancer prevention - as about 90% of non-melanoma skin cancers and 65% of melanomas are associated with exposure to UV radiation from the sun. "Always protect yourself and stay safe," concludes Yatt.

Protecting your skin

• If it takes 3 to 4 minutes for your unprotected skin to start burning red, using a SPF30 sunscreen theoretically prevents reddening 30 times longer (which is around 1.5 to 2 hours on average.) You need to reapply it constantly while in the sun to ensure the best protection.
  
• Remember if you have red or blonde hair with blue or green eyes, you have the greatest risk of developing skin cancer. Use a SPF50 if possible.
  
• Brown haired, brown-eyed people may tan easily but is still vulnerable. An SPF 30 or 40 is recommended.
  
• Dark Brown haired people can get away with a 20 to 30 SPF sunscreen.
  
• People with black or dark brown hair rarely burn, but could have sensitivity on eyes, palms of hands and soles of feet. An SPF 20 is usually sufficient.
  
• Check the expiry date on your SPF. Do not use more than one year after the sunscreen has been opened.