Slip, Slop, Slap - Worth Remembering When You're out in the Sun; There Are Many Different Types of Skin Cancer but the Most Serious Is Malignant Melanoma. Dr Alun Evans Explains How the Cancer Develops and What We Can All Do to Reduce Our Risk

Article excerpt

Byline: Alun Evans

MELANOMA is a skin cancer that develops in normal skin or in a pre-existing mole.There are more than 8,000 new cases and 1,800 deaths from the disease in the UK every year.

Melanoma can develop on any part of the skin including the palms of the hands, soles of the feet and under the nails.

It usually appears as a new or changing mole which may become raised or grow larger in size. It may also become darker in colour or bleed spontaneously.

They occur most commonly on the back in men and on the legs in women, but a new or changing mole on any part of the body must not be ignored.

If you think you have a new or changing mole you should see your GP to have it examined as soon as possible.

In all cases early detection and diagnosis are crucial.

Often reassurance and simple observation are all that are required but if your GP has any concerns about the possibility of skin cancer you will be referred to a dermatologist for assessment.

Sometimes it will be necessary to remove the mole to check if it is cancerous. While the majority of these will be benign, some may show pre-cancerous changes.

The earliest known example of melanoma was found in mummified Peruvian remains from around 400BC but it is likely to have existed for as long as skin itself. Damage to the DNA in the skin, caused by ultraviolet radiation from the sun or indeed sun beds, is the major contributing factor in the development of melanoma.

The increase in overseas travel has resulted in many people visiting countries with much stronger sun than their skin was designed for. How many of us can say we have never had sunburn on a foreign holiday? Secondly, sun beds have become more popular over the past few decades and it is now considered fashionable by some to have a yearround tan which greatly increases a person's cumulative ultraviolet exposure.

For these reasons melanoma is becoming increasingly common in the UK and particularly in Wales due to our Celtic ancestry - a high proportion of the population has light-coloured skin, which contains little pigment to offer protection against the sun's harmful rays, leaving them at a higher risk of sun damage and skin cancer. People with a large number of moles and those with a strong family history of melanoma are also at greater risk.

When a melanoma is diagnosed on biopsy there are two main factors which determine the seriousness of the situation.

The first is the thickness of the mole when measured under the microscope - the thinner it is, the better the prognosis. Secondly, for reasons that we do not entirely understand, the presence of ulceration usually indicates a poorer prognosis.

Some centres take the investigations a step further and offer a procedure called sentinel node biopsy.

This involves the injection of a coloured dye and a radioactive tracer around the site of the skin cancer. …