www.melanomafocus.com

MelanomaWhat It Is and How To

Reduce Your Risk

melanomafocus.com1

MelanomaWhat It Is And How To Reduce Your Risk

What is melanoma?• Itisapotentiallyseriousformofcancer,usually startingintheskin,arisingfrompigment-producing cellscalledmelanocytes• Mostlikelytoaffectthosewithlargenumbersof moles,afamilyhistoryofmelanomaandthosewhose skinissun-sensitive–whichmeansitburnsreadily anddoesn’ttaneasilyoratall• TheUK’sfifthmostcommonandmostrapidly- increasingcancer,withmorethan13,000newcases everyyear–afourfoldincreasesincethe1970s• Thesecondmostcommoncancerinthe15-34age group• Adiseaseforwhichthenumberofcasesisexpectedto risemorethananyothercancerby2030

Why is melanoma on the increase?The rapid rate of increase is thought to be linked tothe increasing exposure of people to ultraviolet (UV)radiation.Melanomahasbecomesomuchmorecommonasaresultofdamage(sunburn)duringholidaysinthesun,whichmanypeoplenowexperiencefromearlyonintheirlives.Sunbeds,whicharestillpopularintheUKdespitetheirdanger,mayalsoplayarole.

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’?Thetwoareoneandthesame.Thereisnosuchthingasa‘non-malignantmelanoma’sothediseaseisincreasinglyknownbythesingleword‘melanoma’.

How does melanoma start?Manymelanomasdeveloponnormalskin; thissimplefactisnotaswell-knownasitshouldbe.Othersdevelopinanexistingmole.Melanomamayoccuranywhereontheskinincludingthepalmsandsoles,thescalporunder

2

andaroundthenails.Infemalesitismostcommononthelowerlimbs.

‘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 ‘ABCDEChecklist’ canhelpyou identify someofthesignsthatmaypointtowardstherebeingaproblem:• Asymmetry –thelesionmaynotbesymmetrical, withthetwohalvesdifferinginshape• Border–theedgesmaybeirregularorjagged• Colour–unevenandpatchy,withdifferentshadesof black,white,grey,brownorpink;anylesionwithtwo ormorecoloursmaybesuspicious• Diameter–most(butnotall)melanomasareatleast 6mmacross,oraboutthewidthoftherubberonthe endofapencil• Evolving–thelesionischanginginsize,shapeor colour,regardlessofwhetheritremainsflator becomeselevated

How reliable is this checklist?While it is relevant for the most common type ofmelanoma,thechecklistisnotcompletelyreliablesincea significant number of melanomas don’t show thesefeatures. Tomake sure, you should also use the ‘skinsafetyfirst’guidelinesbelow.

The ‘skin safety first’ guidelinesIfthereisanabnormalityonyourskinthatis...• Changed–itisneworseemstohavechangedsince youlastsawit(don’tlookfordetail;ifyoucansee ithaschangedjustbyglancingatthelesion,that’s enough)• Not going away–onceanewlesionhasappeared,it remainsontheskinforlongerthan6-8weeks• Odd(themostcrucialtest)–itsimplylooksstrange, worriesyouorseemstobedifferentfromotherlesions onyourskin...thenyoushouldgetitlookedatbyadoctor,whomayreferyou to specialist (generallyadermatologist). It is

melanomafocus.com3

very important that theresult isaconfidentdiagnosisofthelesion.Thephrase‘looksOK’isnotadiagnosis.

Remember: if in doubt, get it checked!What happens if a skin lesion is diagnosed as a melanoma?If found early,most cases ofmelanoma can be curedbysurgicalremoval.Theearlierthisisdone,thebetterthelong-termoutlookislikelytobe.However,insomepatientsthemelanomacanspreadfromtheskintothelymph nodes or bloodstream. This is a more serioussituation.

What are the implications of melanoma spreading?In its advanced stages, melanoma may spread (or‘metastasise’) to organs such as the liver, brain andlungs. Advanced melanoma is often incurable. Eachyear more than 2,000 people in the UK die from thedisease.

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?Dependingonthenatureand‘stage’ofthedisease(seebelow),possibletreatmentoptionsmayincludesurgery,radiotherapy, chemotherapy (administering drugs)or immunotherapy (encouraging the body’s immunesystemtoidentifyandgetridofcancerouscells).

‘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.

4

How do doctors decide which treatment to use?It is becoming clear that there are several – perhapsnumerous – types of melanoma. These differ in theirbehaviourandintheirresponsetothevariousformsoftherapy,aswellastoindividualdrugs.Thismeansthateverymelanomamustbefullyassessed,categorisedand‘staged’inordertodecidewhichtreatmentislikelytobemosteffective.

Are any major advances in sight in the fight against melanoma?Therehasbeensignificantprogress in the treatmentofadvancedmelanoma in recentyears,with someof thelatest drug therapies beginning to show encouragingresults. However these have all been in terms ofprolonging,byamodestamount,thelivesofmelanomasufferers with disease that has spread, rather than anoutright‘cure’.Nonetheless,thereisadegreeofguardedoptimismamongclinicians.

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.

Aswithotherseriousdiseases,thebestoptionofall isprevention.Thenextsectiondealswiththisaspect.

How can I reduce the risk of melanoma?Put simply, the main task is to avoid an excessiveamountof skinexposure toUVradiation.Amoderatequantityof sunshine isbeneficial formostpeople.Butoverdoingexposuretothesuntotheextentofburning(whichmeanscausinganydegreeofredness),especiallywhenyoung,canhaveseriousconsequenceslateron.

Thekeyisto‘knowyourownskin’:melanomaismainlyacanceraffectingpaleskinsotheadvicehereisaimedatanyonewhohaseverburntinthesun,hasredorauburnhair, any freckles, lots ofmoles or a family history ofmelanoma.Ifyouhavedarkskinwhichneverburnsand

melanomafocus.com5

nootherriskfactor,then–solongasyoudon’tburn–therigorousprotectivemeasuresbelowareunnecessaryexcept in very sunny places. Indeed, sun exposuremakesusfeelgoodandallowsthebodytomanufacturesufficientvitaminD,whichislikelytobeimportant.

ThemethodsofavoidingexposuretoexcessiveamountsofUVarelargelycommonsense.Adviceincludes:• InsunnyweatheruseaUVA+UVBsunscreen, preferablywithasunprotectionfactor(SPF)of30 orhigherwith5starsUVAprotection;followthe instructionsaboutrepeatapplications• Coverexposedskinwithclothingandabroad- brimmedhat,especiallyintheheatofthedayorwhen oneparticularareaofthebodyiscontinuously exposed(suchastheshoulders,theearsorabald head)whenwalking,gardeningorplayingsport• Protecttheeyesbywearingwrap-aroundsunglasses• Avoiddirectsunlightaltogetherbystayinginthe shade,especiallybetweenabout11amand3pm• NEVERusesunbeds

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-thereisevidencethatsunbedsincreasetheriskofmelanoma. According to Cancer Research UK, it hasbeenfoundthatusingsunbedsforthefirsttimebeforethe age of 35 increases the risk ofmelanoma by 60%.Herearesomefurthersunbedfacts:• Since2011ithasbeenillegalintheUKforunder-18s tousesunbedsinpremisessuchasbeautysalons• ManysunbedsgiveoutdosesofUVthatare higherthanfromthemiddayMediterraneansun;and researchershaveassessedthecancerriskfrom sunbedsastwicethatofanequivalentperiodspent outinthesunintheMed

6

• Manysunbedsarefaulty:acheckbyCancerResearch UKfoundtheirUVoutputwas,onaverage,twicethe recommendedlevel,with9outof10sunbedsemitting UVatlevelshigherthanBritishandEUstandards

The background to Melanoma FocusWewereformedin2012astheresultofamergerbetweentwowell-establishedcharities,theUKMelanomaStudyGroupandtheformerMelanomaFocus.Thisinitiativehas allowed us to build our public, patient and carerservicesonthefoundationsofresearchandprofessionaleducation inherited fromour predecessors.MelanomaFocusisnowtheprincipalUKmelanomacharity.

How are donations to Melanoma Focus used?Melanoma Focus differs from other charities inmaintainingaprofessionalcore,consistingofmelanomascientists,cliniciansandnurses,combinedwithitspublicinformationservicesandactivities.OuruniquenationaleducationaleventsassisttheUKmelanomacommunitytoachieveabetterunderstandingofthedisease.

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.

DonatingWecanarrangeforadonationtobegift-aidedifyouletusknowyourdetails.Todonateplease• ClickontheJustGivingbuttononourwebsite(www. melanomafocus.com);or• Writeachequeto‘MelanomaFocus’andforwarditto theaddressoverleaf;or• Donateonline.Bankdetails–HSBCaccountname: MelanomaFocus;sortcode:40-34-38;accountnumber: 51458485;reference:surnameandtheword‘donation’. Pleaseletusknowaboutthedonationbymailor email.Please contact us if youhave any questions about thecontentofthisleafletorthecharityitself.

QueenAnneHouseGonvillePlaceCambridgeCB11NDPhone:01223324359Email:info@melanomafocus.comWebsite:www.melanomafocus.comorscanheretovisitourwebsite3/10.14

RegisteredCharityNo.1124716