- Skin cancer is the most common cancer in Ireland with over 12,000 people diagnosed each year
- Melanoma is the most serious form of skin cancer as it the most likely form of cancer to spread to other parts of the body (known as metastasis)
- Skin cancer is one of the most preventable forms of cancer and by making some simple changes to your routine, you can help to drastically reduce your risk of developing skin cancer.
How does skin cancer occur?
Skin cancer occurs when cells in the skin change and become abnormal. These abnormal cells can then develop into a tumour. This tumour then grows and develops into a skin cancer.
Nine out of every ten cases of skin cancer are caused by UV radiation from the sun. This means that by making SunSmart practices a part of your daily routine, many forms of skin cancer can be prevented.
Facts about skin cancer info square*
Most common cancer
Skin cancers are divided into two main categories: melanoma and non-melanoma.
Non-melanoma skin cancer is the most common cancer in Ireland. There are over 11,555 non-melanoma skin cancers and over 1,194 melanomas diagnosed in Ireland every year. The number of people diagnosed rises each year, meaning being aware of how to protect our skin and following the 5 S’s of the SunSmart code is now more important than ever. (link to SunSmart section)
Overexposure to ultraviolet (UV) light from the sun or sunbeds is the main cause of skin cancer. That means that most cases of skin cancer are preventable.
Top tips for preventing skin cancer
Whatever your age, the best way to enjoy the sun safely and protect your skin from the sun’s damaging rays is to make being SunSmart a part of your daily routine. To do this, you can simply follow the 5 S’s of the SunSmart code and:
- Slip on sun-protective clothing that covers as much of your body exposed to the sun as possible
- Slop on sunscreen with a factor 30+ and good UV protection at least 20 minutes before going outdoors. Reapply every two hours when outdoors or more often if perspiring or swimming.
- Slap on a broad-brimmed hat that shades your face, neck, and ears
- Seek shade.
- Slide on sunglasses.
Children and teenagers might need a reminder or a helping hand but setting a good example yourself is a great way to help them learn and get into good habits.
Remember, your skin can still be damaged by harmful rays even when it is not sunny or when you are not getting burnt so you need to protect your skin every day.
Dr Patrick Ormond, skin cancer specialist and Consultant Dermatologist at St James’s Hospital, Dublin, emphasises that to avoid skin cancer you must:
- Avoid sunbathing
- Avoid sunburn
- Check your skin regularly
- Never, ever use sunbeds
By following these simple steps and making slight changes to your daily routine, you can help to reduce your risk of Ireland’s most common cancer.
Early detection is key
Early detection is the key to the successful treatment of skin cancer and if you regularly check your skin for damage or changes, it could save your life. Moles and freckles change and alter as part of our normal ageing and changing. But some may change in an abnormal way.
You should make a point to check your skin regularly and go to your doctor if you notice:
- A new growth or sore that does not heal in a few weeks
- A spot or sore that continues to itch, hurt, scab or bleed
- A skin ulcer that you cannot explain.
Types of skin cancer
The type of skin cancer depends on the cells in the body that are affected. There are two groups:
- Non-melanoma skin cancer
- Melanoma skin cancer
Both of these types of skin cancer can be caused by overexposure to the sun.
Dr Ormond explained that the sun can damage our skin in two ways, leaving it susceptible to developing cancer in later years. It can do this by:
- Burning the skin
- Radiation penetrating the skin with or without burning.
Non-melanoma skin cancer
Non-melanoma skin cancer is a result of a combination of:
- Your genetic skin type: how good your skin is at protecting itself against the sun’s radiation
- Your level of exposure: How much radiation you get from the sun.
About 11,555 people in Ireland are diagnosed with non-melanoma skin cancer each year, and this number is still on the rise.
Non-melanoma skin cancer
The two most common types of non-melanoma skin cancer are:
- Basal cell carcinoma
- Squamous cell carcinoma.
Basal cell cancer (BCC)
This cancer develops from basal cells which are in the deepest layer of the epidermis and around the hair follicle. It develops mostly in areas of skin exposed to the sun, including the face. It can also develop on your lower legs or your back, particularly in men. It is most often diagnosed in people of middle or old age due to the fact that they have been exposed to more sun damage.
Basal cell cancer may start as a small lump that gets bigger slowly over months and years. The edges usually have a shiny or pearly look and a sunken middle. Sometimes the middle becomes crusty or an ulcer develops. It usually will not hurt unless knocked but it can be itchy and may bleed if scratched.
It is very rare for basal cell skin cancer to spread. It is possible to have more than one basal cell cancer at any one time.
Squamous cell cancer (SCC)
This cancer begins in cells called keratinocytes, which are the cells lying just above the basal cells on the surface of the skin. Squamous cell cancer most often develops in areas that have been exposed to the sun, including parts of the head, neck, and on the back of your hands and forearms.
It can also develop in sensitive areas on the skin such as scars, areas of skin that have been burnt in the past or areas of skin that have been ulcerated for a long time.
Non-melanoma skin cancer tends to appear on the areas of your body that are exposed to the sun – your head, face, arms and legs.
Many non-melanoma skin cancers are very curable if caught at an early stage so being vigilant and seeking help when you notice any changed is paramount to the successful treatment of skin cancer.
Doctor Ormond’s advice is - “If you are worried about a mole, get it checked by a doctor. Don’t wait and see. Get it checked,”
Melanoma skin cancer
The second type of skin cancer is melanoma. Melanoma skin cancer is a much rarer form of skin cancer; however, the number of people being diagnosed each year is increasing.
Melanoma is a cancer that begins in the melanocytes. It is also known as ‘malignant melanoma’. Most melanoma cells make melanin, the pigment in your skin, so melanoma tumours are usually brown or black, but can also appear to be pink, tan, or even white.
Melanomas can develop anywhere on the skin, but they are more likely to start on the trunk (chest and back) in men and on the legs in women. They are also common on the neck and face.
Melanoma is less common than basal cell and squamous cell skin cancers, but it is far more dangerous, as melanoma is much more likely to metastasise (spread) than other forms of skin cancer. The number of people affected in Ireland is rising rapidly. Like basal cell and squamous cell cancers, melanoma is almost always curable when caught in its early stages.
Dr Patrick Ormond says “I want people to enjoy the sun and the outdoors and a healthy lifestyle, but you have to be aware of and balance this with the risks associated with being outdoors. We have to be sensible with our behaviour outdoors, in the sun,” says Dr Ormond.
Watch our Skintervention video about Irish people affected by melanoma
Facts about melanoma
If you draw a line through a melanoma, the two sides will not match
The border of an early melanoma tends to be uneven. The edges may be scalloped or notched.
Most healthy moles are all one colour. A mole with a number of different shades of brown, black or tan is a warning sign. Melanomas may also be blue, red or some other colour
Melanomas are usually larger in size than the rubber at the top of a pencil (¼ inch or 6mm)
Any change in shape, colour, size, elevation (height), or any other trait, or a new symptom like bleeding, itching or crusting is a warning sign.
Get to know the ABCDE’s of melanoma:
A: Asymmetrical: Do you have any moles that are not symmetrical – if you drew a line down the middle of the mole would it be the same size and shape on both sides of the line? If your mole is different on either side, you should have it checked by your doctor.
B: Border: If the edges around any of your moles are ragged, or uneven, you should show it to your doctor.
C: Colour: If any of your moles change colour, or any mole has a number of different shades of brown, black or tan it is a warning sign, and you should show it to your doctor.
D: Diameter: Has the diameter, the size, of your mole got bigger over time. Is it bigger than the top of a pencil (the blunt end)? If so, show it to your doctor.
E: Evolved: Is your mole changing over time? Has it started to bleed, itch or be crusty? If it has, you should show it to your doctor.
Skin Cancer, how it’s diagnosed:
If you have a suspicious looking mole or a mole that you notice has changed over time, go to your GP without delay. If they think the mole may be cancerous, you may need to go to a dermatologist.
If the mole needs to be removed, you will have an excision biopsy under local anaesthetic. The doctor will cut out the whole mole and 2 mm of tissue all around to ensure the cancer has not spread. The tissue is sent to the laboratory for testing and you may need some stitches.
Follow ups will be arranged if needed.
If the mole does not contain any cancerous cells, you will not need any more treatment. If the mole contains any cancerous cells, you may need to have more tests.
Who is at risk of skin cancer?
Skin cancer can affect everyone, but certain groups are more susceptible to the disease. Usually, skin cancer is developed through unprotected sun exposure. Sun exposure is the main risk for developing skin cancer. You should take extra care if you have:
- Fair or freckled skin
- Fair or red hair
- Grey, green or blue eyes
- A large number of moles
- Have already had skin cancer, or a close family member has already had skin cancer
- Had radiotherapy
- Been exposed to chemicals in the workplace.
- Sustaining five or more sunburns in youth increases the lifetime melanoma risk by 80%. As such, children are especially at risk
If you are at an increased risk of developing skin cancer, it is essential that you check your body regularly for new and changing moles.
“Everyone can keep an eye on their own skin and will know their own skin better than anyone” says Dr Ormond. “Use two mirrors or get your partner to look at your back. We all have cameras now, so take photographs of your mole.
“You should be as familiar with your skin as you are with your kitchen. The only way you can do that is by looking at it on a regular basis. Strip down to your underwear and use a full-length mirror in daylight. Do it frequently enough so that you become familiar with your skin.
The use of sunbeds dramatically increases the risk of melanoma and skin cancer, especially if you have used them under the age of 30. Using sunbeds is not a safe way to get a tan. You should never use sunbeds.
Research shows that women, and worryingly, young women are the biggest demographic of sunbed users.
Why are sunbed’s so dangerous?
Sunbeds are designed to provide a tan rapidly and, to achieve this, emit UVR at high intensity. Most tanning beds in Europe emit UV rays equivalent to midday tropical sun but some of the more powerful tanning beds may emit UVR with an intensity equivalent to an “extreme” UV index (>11), and with UVA intensities well above anything experienced in nature
Just one sunbed session can increase your risk of developing squamous cell skin cancer by 67% and basal cell skin cancer by 29%. A person’s first use of sunbeds before the age of 35 increases the risk of developing melanoma by 59%. If you have ever used a sunbed your risk of melanoma, the most deadly form of skin cancer, increases by 20%.
It is estimated that sunbed use is responsible for over 450 000 non-melanoma skin cancer cases and more than 10 000 melanoma cases per year in the combined populations of the United States of America, Europe and Australia.
Sunbeds are most frequently used by women aged between 25-34 according to the 2019 Healthy Ireland Survey.
There are some myths surrounding sunbeds, which may result it high uptake, especially in younger users. So, let us be clear:
- Sunbeds do not help to clear up acne
- Sunbeds are not a healthy way to prepare your skin for a sun holiday
- Sunbeds are not a good way to get Vitamin D
- Sunbeds are not a healthy way to tan.
- If you are using sunbeds, stop immediately before you damage your skin further.
For more information on the damaging effects of UV and advice on how to keep your skin safe from the sun, click here
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