www.melanomafocus.com Melanoma What It Is and How To Reduce Your Risk
1 Melanoma What It Is And How To Reduce Your Risk What is melanoma? It is a potentially serious form of cancer, usually starting in the skin, arising from pigment-producing cells called melanocytes Most likely to affect those with large numbers of moles, a family history of melanoma and those whose skin is sun-sensitive which means it burns readily and doesn t tan easily or at all The UK s fifth most common and most rapidlyincreasing cancer, with more than 13,000 new cases every year a fourfold increase since the 1970s The second most common cancer in the 15-34 age group A disease for which the number of cases is expected to rise more than any other cancer by 2030 Why is melanoma on the increase? The rapid rate of increase is thought to be linked to the increasing exposure of people to ultraviolet (UV) radiation. Melanoma has become so much more common as a result of damage (sunburn) during holidays in the sun, which many people now experience from early on in their lives. Sunbeds, which are still popular in the UK despite their danger, may also play a role. People who have had excessive exposure to UV rays before the age of 20 have a greater chance of developing melanoma later in life. Is there a difference between melanoma and malignant melanoma? The two are one and the same. There is no such thing as a non-malignant melanoma so the disease is increasingly known by the single word melanoma. How does melanoma start? Many melanomas develop on normal skin; this simple fact is not as well-known as it should be. Others develop in an existing mole. Melanoma may occur anywhere on the skin including the palms and soles, the scalp or under melanomafocus.com
and around the nails. In females it is most common on the lower limbs. Skin lesion is a medical term for a patch, spot, lump or any other abnormality on otherwise normal skin. How do I know if a lesion on my skin could be suspicious? The ABCDE Checklist can help you identify some of the signs that may point towards there being a problem: Asymmetry the lesion may not be symmetrical, with the two halves differing in shape Border the edges may be irregular or jagged Colour uneven and patchy, with different shades of black, white, grey, brown or pink; any lesion with two or more colours may be suspicious Diameter most (but not all) melanomas are at least 6mm across, or about the width of the rubber on the end of a pencil Evolving the lesion is changing in size, shape or colour, regardless of whether it remains flat or becomes elevated How reliable is this checklist? While it is relevant for the most common type of melanoma, the checklist is not completely reliable since a significant number of melanomas don t show these features. To make sure, you should also use the skin safety first guidelines below. The skin safety first guidelines If there is an abnormality on your skin that is... Changed it is new or seems to have changed since you last saw it (don t look for detail; if you can see it has changed just by glancing at the lesion, that s enough) Not going away once a new lesion has appeared, it remains on the skin for longer than 6-8 weeks Odd (the most crucial test) it simply looks strange, worries you or seems to be different from other lesions on your skin...then you should get it looked at by a doctor, who may refer you to specialist (generally a dermatologist). It is 2
very important that the result is a confident diagnosis of the lesion. The phrase looks OK is not a diagnosis. Remember: if in doubt, get it checked! What happens if a skin lesion is diagnosed as a melanoma? If found early, most cases of melanoma can be cured by surgical removal. The earlier this is done, the better the long-term outlook is likely to be. However, in some patients the melanoma can spread from the skin to the lymph nodes or bloodstream. This is a more serious situation. What are the implications of melanoma spreading? In its advanced stages, melanoma may spread (or metastasise ) to organs such as the liver, brain and lungs. Advanced melanoma is often incurable. Each year more than 2,000 people in the UK die from the disease. When melanoma spreads, it remains a form of the same disease regardless of the organ in which it appears; for example, if it spreads to the liver it is still melanoma rather than liver cancer. What are the treatment options if melanoma spreads? Depending on the nature and stage of the disease (see below), possible treatment options may include surgery, radiotherapy, chemotherapy (administering drugs) or immunotherapy (encouraging the body s immune system to identify and get rid of cancerous cells). Staging is a system of identifying how far melanoma has spread. Stages 1 and 2 mean that cancerous cells have been found but at present there is no evidence they have spread beyond the original location in the skin. At the other end of the scale, stage 4 means the melanoma has spread to distant organs or other parts of the body and the disease has become much more serious. 3 melanomafocus.com
How do doctors decide which treatment to use? It is becoming clear that there are several perhaps numerous types of melanoma. These differ in their behaviour and in their response to the various forms of therapy, as well as to individual drugs. This means that every melanoma must be fully assessed, categorised and staged in order to decide which treatment is likely to be most effective. Are any major advances in sight in the fight against melanoma? There has been significant progress in the treatment of advanced melanoma in recent years, with some of the latest drug therapies beginning to show encouraging results. However these have all been in terms of prolonging, by a modest amount, the lives of melanoma sufferers with disease that has spread, rather than an outright cure. Nonetheless, there is a degree of guarded optimism among clinicians. Improvement may seem slow but behind the scenes enormous efforts, backed by extensive clinical trials, are being made to reduce the lethal effects of this disease. Melanoma Focus supports several research initiatives which is why we need to raise as much money as possible. As with other serious diseases, the best option of all is prevention. The next section deals with this aspect. How can I reduce the risk of melanoma? Put simply, the main task is to avoid an excessive amount of skin exposure to UV radiation. A moderate quantity of sunshine is beneficial for most people. But overdoing exposure to the sun to the extent of burning (which means causing any degree of redness), especially when young, can have serious consequences later on. The key is to know your own skin : melanoma is mainly a cancer affecting pale skin so the advice here is aimed at anyone who has ever burnt in the sun, has red or auburn hair, any freckles, lots of moles or a family history of melanoma. If you have dark skin which never burns and 4
5 no other risk factor, then so long as you don t burn the rigorous protective measures below are unnecessary except in very sunny places. Indeed, sun exposure makes us feel good and allows the body to manufacture sufficient vitamin D, which is likely to be important. The methods of avoiding exposure to excessive amounts of UV are largely common sense. Advice includes: In sunny weather use a UVA + UVB sunscreen, preferably with a sun protection factor (SPF) of 30 or higher with 5 stars UVA protection; follow the instructions about repeat applications Cover exposed skin with clothing and a broadbrimmed hat, especially in the heat of the day or when one particular area of the body is continuously exposed (such as the shoulders, the ears or a bald head) when walking, gardening or playing sport Protect the eyes by wearing wrap-around sunglasses Avoid direct sunlight altogether by staying in the shade, especially between about 11am and 3pm NEVER use sunbeds Sunscreen should be applied regularly and thickly during the day. By not using sufficient amounts or not repeating applications you can easily halve the sun protection factor. If redness of the skin occurs this means that not enough sunscreen is being used, or it suggests that more clothing is needed (or you should be moving inside) earlier in the day. Is it certain that sunbeds are bad for you? Yes - there is evidence that sunbeds increase the risk of melanoma. According to Cancer Research UK, it has been found that using sunbeds for the first time before the age of 35 increases the risk of melanoma by 60%. Here are some further sunbed facts: Since 2011 it has been illegal in the UK for under-18s to use sunbeds in premises such as beauty salons Many sunbeds give out doses of UV that are higher than from the midday Mediterranean sun; and researchers have assessed the cancer risk from sunbeds as twice that of an equivalent period spent out in the sun in the Med melanomafocus.com
Many sunbeds are faulty: a check by Cancer Research UK found their UV output was, on average, twice the recommended level, with 9 out of 10 sunbeds emitting UV at levels higher than British and EU standards The background to Melanoma Focus We were formed in 2012 as the result of a merger between two well-established charities, the UK Melanoma Study Group and the former Melanoma Focus. This initiative has allowed us to build our public, patient and carer services on the foundations of research and professional education inherited from our predecessors. Melanoma Focus is now the principal UK melanoma charity. How are donations to Melanoma Focus used? Melanoma Focus differs from other charities in maintaining a professional core, consisting of melanoma scientists, clinicians and nurses, combined with its public information services and activities. Our unique national educational events assist the UK melanoma community to achieve a better understanding of the disease. The charity organises and funds a number of research projects under its Patient Impact Programme. Described in detail on the website (www. melanomafocus.com > Activities), these involve scientific investigation into various aspects of melanoma. Donating We can arrange for a donation to be gift-aided if you let us know your details. To donate please Click on the JustGiving button on our website (www. melanomafocus.com); or Write a cheque to Melanoma Focus and forward it to the address overleaf; or Donate online. Bank details HSBC account name: Melanoma Focus; sort code: 40-34-38; account number: 51458485; reference: surname and the word donation. Please let us know about the donation by mail or email. Please contact us if you have any questions about the content of this leaflet or the charity itself. 6
Registered Charity No.1124716 Queen Anne House Gonville Place Cambridge CB1 1ND Phone: 01223 324359 Email: info@melanomafocus.com Website: www.melanomafocus.com or scan here to visit our website 3/10.14