This article has been reproduced by kind permission of The Mail on Sunday YOU Magazine.
The potentially fatal skin cancer, malignant melanoma, affects one in 110 women with no family history of the disease (slightly more than men). About 8,000 cases are diagnosed annually and it claims nearly 1800 lives. It’s the fastest growing cancer in young people, aged 15 to 34, and the first evidence is likely to be a tiny mole.
Jane Neal, now 38, a working mother from Oxfordshire, admits she always liked ‘a bit of sun. As a child, my mother would shoo me outside to play on fine days. I tanned eventually, after going pink first and sometimes burning. We didn’t really “do” sun cream then…’ As she grew up, holidays meant dedicated sun bathing. ‘We’d fry on the beach all day. It wasn’t ‘til our twenties that we started to worry about the possible effects.’
Two years ago, Jane spotted a little mole on her left shin. ‘It was always quite dark but I was certain it used to be lighter and a more regular shape. I read up about skin cancer and went to my GP. He wasn’t worried and said I should only come back if it got bigger than 5 or 6 mm diameter, bled or itched.’
Six months later Jane returned. There was a patch of scaly skin next to the mole and it seemed to have changed shape. ‘Another GP said the patch wasn’t sinister and the mole didn’t display any worrying characteristics. He’d refer me if I was really worried, but the hospital didn’t like GPs referring patients unless they were a real cause for concern.’
Ten months on, Jane’s mole looked like “a little butterfly, asymmetrical with wavy, petal-like edges and different from my other moles. It was almost black in one corner and mydaughter said it definitely looked bigger, thicker and darker.’ Back she went to the GP. ‘He ran through a checklist and said the only concern was that it didn’t have regular edges, and was I sure it was changing?’
Jane panicked. ‘I told him it definitely was, and insisted he refer me to a specialist. I’m sure he thought I was neurotic but he agreed.’ At the Churchill Hospital in Oxford, a dermatologist reassured her the patch was ‘acquired through ageing’, then examined her mole through a dermascope. This sophisticated magnifying device helps distinguish between benign and malignant lesions, and is particularly useful for diagnosing melanoma at an early stage. ‘He told me the mole had to come out. Now.’
Within an hour, consultant dermatologist Dr. Jonathan Bowling (who has pioneered the use ofdermoscopy in the UK) told Jane he’d remove her mole under local anaesthetic then send it for examination. ‘Is it malignant melanoma? Will it kill me?’ Jane asked. ‘He said carefully: “It’s a funny one but the chances of it impacting on your life are vanishingly small”.’
Three weeks later, Jane learnt she ‘most likely’ had very early stage melanoma. Dr. Bowling advised removing more tissue surgically for a wider, deeper safety margin, followed by three-monthly check ups. ‘I discovered my case was horribly typical. He said GPs often miss melanoma because they’ve only been trained to look for more advanced tumours. But if they had a dermascope in theirpractice and someone trained to use it, early detection would be much easier, giving a much better prognosis’.
Jane is passionate about this issue: ‘Dermoscopy helped save my life and could save many others. Dr Bowling has pioneered its use in Oxford and the Thames Valley Cancer Network now has the best survival data for malignant melanoma. Experts say it’s one of the greatest developments in dermatology. It should be available for everyone.’
She also wants to alert others to watch their moles: ‘If you notice anything, see someone at your GP practice who specialises in skin conditions. If they’re concerned, they should refer you to a dermatologist. If there’s a question mark, ask for the mole to be measured, photographed and reviewed in three months.’
But do still enjoy getting outside in the sun, says Dr Bowling. ‘As well as the vitamin D effects, the benefits on cardiovascular, respiratory and mental health are enormous. Just don’t burn, stay in the shade in the middle of the day – and seek medical advice early if you’re worried.’
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Website of the week: parkinsons.org.uk
A reader asks where to find support and information for Parkinson’s disease, the progressive neurological condition that affects one in 500 people. This website provides both, and much more, including contact details for local groups and news on research.