How we can combat risks of skin cancer

I’VE so often advised patients in the pharmacy about their risk of skin cancer, and dispensed medications to those undergoing treatment for it, but as with lots of health-related matters, it’s very easy to overlook yourself!

Thanks to my typical Irish complexion, I have a significant number of moles and large freckles located all over my body. This was something that until recently, I hadn’t done anything about in terms of official checks or monitoring. It was a non-pigmented lump on my leg that eventually prompted me to begin taking my own risk of skin cancer seriously.

Skin cancer statistics

Skin cancer is the most common type of cancer in Ireland, with an annual incidence of over 10,000 according to the Irish Cancer Society. It can present as melanoma (pigmented cancer) or non- melanoma (non-pigmented). Worldwide, more people are diagnosed with skin cancer than all other cancers combined.

The trunk of the body is the most common location for melanoma in men, and the legs for women. With melanoma, incidence increases with age, however over a third of melanoma cases in the UK are found in patients under the age of 55.

My own skin journey

The innocuous lump that appeared on the side of my right calf began as a little dot, and gradually grew to the size of a pea. It didn’t have a defined border, and wasn’t pigmented, but could be felt distinctly under the skin, and had a kind of shiny, red appearance. Several months passed, and it simply didn’t go away.

I showed the lump to my GP, who reassured me that whilst it was probably a build-up of dead cells after lodging under the surface, the best course of action would be to get it looked at, along with my collection of moles. She noted that I ticked most of the the “at-risk” boxes for skin cancer, and I knew that I should be taking those risks seriously:

fair skin (enough freckles to make me look like I’ve sunbathed under a sieve!);

history of bad sunburn in the past (on the J1, seeking that American glow);

family history of skin cancer (genetics plays a role in all of this too).

The consultation reminded me of the importance of skin awareness. What should we be looking out for day-to-day? What can we do to minimise our risks?

1. Self-checks are vital

A good checklist to keep in mind when conducting visual checks of your own moles is the ABCDE Checklist;

A – Asymmetry: an unusual or uneven shape.

B – Border: the development of a jagged or uneven edge.

C – Colour: the presence of at least two different shades.

D – Diameter: in particular, moles over 6-7mm in diameter.

E – Evolutionary changes: changes in colour, size, shape, or texture. In particular, watch out for the development of any oozing, scabbing, roughness or inflammation around the area.

Remember that there doesn’t need to be pigment for something to be suspicious. Any other unusual growths or changes also warrant investigation.

2. Avoid the harmful rays

Stay out of direct sunlight between 11am and 3pm when UVA/UVB rays are at their peak. Wear loose clothing that covers the skin e.g. long sleeves and a hat. Also remember that even one session on a tanning bed increases your risk for skin cancer – stick to the bottled bronze instead, why take the risk?

3. Wear SPF – and reapply!

For skin that does get exposed, make sure to wear sun protection factor, or SPF daily. The weather doesn’t need to be amazing for damage from the sun’s rays to occur.

Be conscious of all exposed skin, especially the face.

Factor 50 is the protection level of choice, particularly for fairer skin.

The key is to reapply regularly. Friction, water and sweating leads to the wearing off of protection, leaving you at risk of a surprise scalding.

4. Assess your medications

Some medications can cause photosensitivity, an increase in your skin’s sensitivity to light. Examples of these medications include some types of antibiotics, antihistamines, statins, blood pressure and chemotherapy drugs to name but a few. If in doubt, check with your pharmacist to see if your medication warrants further precautions during exposure to light.

All’s well that ends well

My GP referred me for a “mole-mapping”, whereby your moles are documented in very specific detail, and each one is scored in order to flag those which may warrant further investigation. It was a quick process, taking just over 20 minutes to complete.

Happily, all my moles were deemed to be “non-suspicious.” They have now been photographed and catalogued, and shall be checked annually for any significant changes going forward. The lump on my leg was removed and biopsied for peace of mind, and thankfully came back as a “benign” or “non-cancerous” growth.

The whole process has given me peace of mind that my skin health is currently in a good place. However, it is something that requires regular monitoring. With the right actions I can minimise my risks as much as possible to ensure prevention and/or early detection. So can you.

Thought for the week “If you’re tired, learn to rest, not to quit!” - Bansky

Next week’s column Seasonal Affective Disorder – the ins and outs of SAD.

About Michelle O’Connell

Michelle began her healthcare career as a community pharmacist in 2012, and has since expanded into pharmacy research and education. She has just completed a PhD in the area of wellness education, publishing her findings in academic journals, and presenting at international conferences.

She has a particular passion for mental health education, and holds a Professional Diploma in the Teaching of Mindfulness-Based Interventions from the Mindfulness Centre for Professional Training in Ireland. Michelle’s weekly column shall explore a variety of physical and mental health topics, supporting WOW readers in all aspects of health and wellness development.