Every year, over 40,000 Britons develop skin cancer. Here's what you can do to minimise your chances of becoming one of them

You might feel pretty smug about how often you stay out in the sun. You probably think you have nothing to worry about because you use sunscreen, wear a hat and only take one beach holiday a year, right? Well, the truth about sun damage is that it has a cumulative effect, so anyone who has ever spent time in the sun may be vulnerable to skin cancer. The key to fighting this disease is early detection. Dermatologists recommend having your moles checked annually by a doctor and doing a monthly self-exam. If you notice any new developments or changes in the size, shape or colour of moles, freckles, skin tags, brown spots, bumps or nodules on your body, see your doctor right away to make sure it's nothing serious.

Types of skin cancer
There are three basic types of skin cancer. Here is a profile of each:

Basal cell carcinoma: This is the most common form of skin cancer, which usually appears on areas of the body that are most exposed to the sun, such as the face, neck and head. Originating on the top layer of the skin, or epidermis, this type of cancer appears as a small, round lump that is pink or flesh-coloured with a smooth texture. It may, in some cases, bleed and form a crust. Although slow growing and unlikely to metastasise (develop somewhere else) to other parts of the body, this type of skin cancer can spread under the skin and to the bones and organs if left untreated.

If caught early, the cure rate of basal cell carcinoma is around 95 per cent. Treatment involves surgical biopsy and removal - under a local anaesthetic - of the cancerous lesion and the area around it. Your doctor may also decide to directly treat the growth with small doses of radiation. However, after the growth is removed, it can reappear, so pay close attention to the area. After having basal cell carcinoma, your chance of getting another lesion is increased by 20 to 30 per cent.

Squamous cell carcinoma: This type of skin cancer is usually found on the rim of the ears, face, lips or mouth. It appears as an ulcer or sore, similar to a red patch of skin or a lump that hasn't healed. Since it can occur in the mouth, it's more common in people who smoke. The second most common type of skin cancer, squamous cell carcinoma grows faster and is more likely to spread than basal cell carcinoma, especially when it's close to the mouth. There is a 90 per cent cure rate if detected early, and treatment is the same as with basal cell carcinoma.

Malignant melanoma. This is the most serious and potentially lethal kind of skin cancer - six out of seven skin cancer deaths occur from melanomas. The incidence of melanoma has tripled among Caucasians in the last 20 years. In the UK, annually, more than 5,000 people are diagnosed with malignant melanomas and around 1,500 people die from them each year.

Melanomas can develop from an existing or newly appearing mole that may change in colour, size and shape. A melanoma originates in the melanocytes, the cells that produce the skin pigment known as melanin, and the mole may bleed, form a scab or even itch. Melanomas have distinct features. An easy way to remember these is by the anagram ABCDE:

• A:Asymmetrical (one half is not identical to the other)


• B:Borders are irregular or uneven


• C:Colour varies from one area to another, from shades of tan and brown to black. Sometimes the colour can be white, red and even bluish


• D:Diameter is larger than 6mm (or bigger than a pencil rubber)
• E:Enlargement

If diagnosed at an early stage, melanomas can usually be cured. But if not, skin cancer can spread to other organs and cause death.

Who is at risk?
The sun's ultraviolet rays are the number one cause of skin cancer, but there are other risk factors as well. You are at risk if you:

• Have had chronic and prolonged exposure to the sun or multiple sunburns since childhood.
• Are Caucasian. People with white skin are at a greater risk than other groups. Those who are fair or light-skinned are 20 times more at risk than people with other skin types.
• Have a family history of skin cancer. If your parents or grandparents had it, you may also be prone.
• Have a personal history of skin cancer.
• Have a large number of moles.
• Have a large number of atypical, unusual-looking moles.

Prevention:

• Before going outdoors, especially in warm weather, apply a sunscreen that protects against both UVA and UVB rays. Make sure the SPF (sun-protection factor) is at least 15.
• Avoid excessive exposure to the sun. Do not spend hours sunbathing at the beach.
• Avoid tanning salons.
• Always wear a broad-brimmed hat, shirt and sunglasses when out in the sun.
• Wear a sunscreen year-round.

• Stay out of the sun during the hottest part of the day (between 11am and 3pm).

How to conduct a self-examination
Follow these five steps when checking yourself for signs of skin cancer:

STEP 1 Examine the front and back of your body in the mirror, then raise your right and left arms and check your sides.

STEP 2 Bend your elbows and look carefully at your forearms, upper arms, underarms and palms.

STEP 3 Look at the backs of your legs and feet, the area between your toes and on the soles of your feet.

STEP 4 Examine the back of your neck and scalp using a hand mirror. Part your hair for a closer look.

STEP 5 Finally, check your back and buttocks using a hand mirror.

Resources
For general information about advice and treatment of certain cancers, try one of these helpful organisations.

Cancer Research UK
www.cancerresearchuk.org

CancerBACUP
www.cancerbacup.org.uk

CancerHelp UK
www.cancerhelp.org.uk