We sent seven people with moles and freckles to a clinic to see if they were at risk of cancer. One found she HAD the disease. This feature could save your life...
Tomorrow sees the start of Sun Awareness Week 2010 (May 3-9) and, while we all love the warmer days, the summer also brings real health risks.
A new case of skin cancer is diagnosed in the UK every four minutes and, even with our washout summers, someone dies from the disease every four hours. So why are we Brits so at risk? Experts believe our lousy weather is actually part of the problem.
"Most of us wouldn't dream of heading out without sunscreen on holiday, but back home it's a different story," says Rebecca Freeman from the British Association of Dermatologists (BAD). "Pale skin can burn in 10 minutes." That's why BAD recommends SPF30+ sunscreen, even in the British sun.
Despite the risks, when it comes to checking our skin for signs of skin cancer, only 47 per cent of us look for new or changing moles*, which can turn cancerous (malignant) over time. Luckily, getting advice has never been easier. As well as consulting your GP, there are specialist mole clinics nationwide - appointments cost around £115. One in 10 of us will be diagnosed with skin cancer at some stage, and prevention is better than cure.
So, what happened when we sent seven volunteers - each with their own skin worries - to get checked out at The Mole Clinic?
5 step mole check
Look at your moles and follow the ABCDE rule. If any of the below apply, visit a mole clinic or see your GP.
Asymmetry - the two halves of the area are a different shape.
Border - the edges are ragged.
Colour - uneven and different shades of black, brown or pink.
Diameter - most melanomas (cancerous moles) are at least 6mm wide.
Expert - if in doubt, check it out!
Cancer found: Needed a mole removed
Nicola Macaulay, 36, is an insurance broker from Kingston, Surrey.
"I'm covered in moles, which worries me because the more you have, the greater your risk of skin cancer. I've always loved having a tan and used sunbeds on and off for 15 years - I even hired a facial tanning machine in my 20s. After a year in Australia and Thailand using SPF8, I'm concerned about the damage I might have done."
Test results: The nurse spotted a dark mole around 2mm wide on Nicola's right shin, which was photographed and sent to the dermatologist for tests. He advised Nicola to use her private health insurance to have the mole removed by a Harley Street dermatologist. She had surgery four days later. Tests revealed the mole was cancerous and, three weeks later, she had skin removed around it as a precaution. She's been advised to have an annual mole check and to use SPF30 daily.
Nicola says: "There have been a lot of tears since my diagnosis. I assumed I'd be OK, so the results threw me into a panic and I was convinced I wouldn't see my three-year-old son, Thomas, grow up. Now I've had time to come to terms with it, I'm relieved this was picked up early. You think skin cancer won't happen to you - but it does."
High risk: Needs regular checks
Rowan Waller, 28, is a PA and office manager for a fashion company and is from Brighton.
"I love frying in the sun and all my holidays since my teens have been spent lying on a sunlounger wearing SPF2 oil. Between the ages of 18 and 26 I was also a total sunbed addict - in the summer, I'd use coin-operated booths once a week. I'm naturally quite dark-skinned, but despite this, I've suffered some serious burns in the past - while travelling abroad in 2001, I burnt my shoulders so badly I couldn't carry my backpack for a week. I'm worried the damage has already been done."
Test results: The nurse told Rowan she has around 70 moles, which is slightly more than average. One darker-than-usual mole on her stomach needed to be checked with a hand-held microscope and a photograph sent off to a dermatologist for further examination. At the moment it's not a melanoma, but Rowan's history of using sunbeds means she's been advised to have it checked again in three months.
Rowan says: "Considering how many sunbed sessions I've had, it was a relief to get the all-clear - but the nurse did warn me that it can take 10 years or more before the damage shows, so I will definitely be getting checked every two years, as advised. I'm also going to get the mole on my stomach tested in three months' time to make sure it hasn't turned cancerous. Obviously I'm worried, but I've now changed my sun-worshipping ways."
High risk: Needs further tests
Lucy Bower, 26, is a buyer for Asda and is from Leeds.
"Despite having loads of moles, I've always loved the sun. In 2002, I spent a year in the Seychelles training as a diving instructor. I also chase the rays on holidays, loving places like Miami and Ibiza. I use SPF30 abroad, but I'm lax in the UK. I've got pale skin so I often end up burning. I've had a couple of bad burns and I have scars on my back from where I blistered and peeled as a child."
Test results: Lucy has atypical mole syndrome (AMS), which means she has a large volume of atypical moles - moles that are large, asymmetric or uneven in colour - and is at high risk of skin cancer. To be diagnosed with AMS means a patient has over 100 moles, at least five of which are atypical. It also includes moles in areas you wouldn't normally find them, such as the buttocks or soles of the feet. Lucy's AMS means there are too many moles for the dermatologist to check at the clinic so she's been referred to a hospital for mole mapping, where photos of her moles will be taken for further examination.
Lucy says: "It's all a bit frightening. There's always a part of you that thinks you'll get away with it. At least now my moles will be monitored, so if any of them are melanomas or anything develops in the future, there's a stronger chance it will be noticed early."
Very high risk: Needed a mole removed
Piers Francis, 32, is a lawyer from London.
"I grew up on the Cornish coast and practically lived in board shorts until I was 18. When I wasn't surfing I'd be on the beach all day or outdoors having barbecues. Being a typical man, I didn't give sun protection a second thought. I still love the heat and always head for the sun on holidays. While I do try to use a bit of suncream, I'm quite lax about it and don't reapply it as much as I should. My girlfriend nags me all the time to cover up. Having said that, I'm worried about my skin as I have a lot of moles and there is a history of skin cancer in my family."
Test Results: The nurse was concerned about a mole near Piers' ankle that was almost black in colour. A photograph was sent to the dermatologist who stated it was "very high risk" and recommended Piers saw his GP for further dermalogical tests. He had the mole removed two weeks ago and is waiting to hear whether it's a melanoma.
Piers says: "Bearing in mind my history, I was surprised the nurse only discovered one dodgy mole - I thought there might be more. The results shocked me though, and when I had the mole removed I was relieved. I'm concerned the result will be a melanoma, but at the same time, if it is bad news, hopefully it will have been caught in time."
High rish: Needs regular checks
Cheryl Hersey, 29, is a company director from Eastbourne.
"I've got auburn hair and pale skin, and I burn very easily. When I was younger I was desperate to be brown so I'd always sunbathe using low SPF sunscreens, even though I'd end up looking like a lobster. But since 2005, when I spent a year living in Australia, I've used SPF30 whenever I'm in the sun. Both my parents have had melanomas removed in the past, so I do worry about my own risk."
Test Results: The nurse photographed a mole on Cheryl's back as it was darker than expected on someone with fair skin. This photo was sent to a dermatologist for further examination. The result came back clear, but Cheryl will need to get this mole checked again in three months' time as it has the potential to become cancerous.
Cheryl says: "I wasn't surprised when the nurse said I was high risk. After all, my complexion is fair, I've lived in sunnier climes for a year and both my parents have had melanomas removed. Obviously it's a relief that none of my moles are cancerous at the moment, but I'll be keeping an eye on the one on my back and mentioning it to my GP. The test has also taught me to check the smaller, flat moles on my body that look more like freckles than standard moles. I always thought raised ones were more dangerous than flat ones, but through going to the mole clinic I've learnt that this isn't the case."
At risk: Needs treatment
Mark Smith, 38, is a media manager, originally from Australia but now living in London.
"I grew up in Tasmania back when no one had a clue about how dangerous the sun could be. I never wore sunscreen, even though we were always outside, and I remember burning and peeling constantly. Since moving to England 14 years ago, I cover up more but I still love being outdoors. I have a sun-soaked holiday in Greece every year where I might put on a hat and sunscreen, but never wear a T-shirt on the beach."
Test Results: Mark has a patch of scaly skin on his nose, which the nurse suspected was actinic keratosis - a pre-cancerous condition - which could develop into basal cell carcinoma (the most common type of skin cancer). He needs to go to his GP for a cream to treat this, and keep his nose protected with SPF30 sunscreen in future. Mark also has a dark patch of skin under his toenail, where melanomas can occur. The dermatologist felt this wasn't cancerous, but has advised him to see his GP about it.
Mark says: "I was relieved to get the results. I didn't know you can get skin cancer under your nails, but now I know where the problem areas are, I'm going to monitor my moles carefully. And I'll cover up in future."
At risk: Needs further tests
Dan Sheppard, 30, is a personal trainer and part-time PE teacher from Salisbury.
"My job means I'm outside all the time, in all weathers. In the summer I'm in the sun from 9am until 6pm, running with clients or doing circuit training. I use a face moisturiser with added SPF15, but I don't use sunscreen on my body because it comes off when I sweat, so I do burn sometimes."
Test results: Dan had four moles that were checked, photographed ¿and then referred to a dermatologist. Two got the all-clear, but two were described as "moderately atypical". A mole on Dan's back was larger than the blunt end of a pencil and one on his arm was asymmetrical. These can be indicators of cancer, so Dan will need to have them checked in three months' time.
Dan says: "Waiting 24 hours for the results was horrible and I kept thinking: 'If only I'd bothered to apply sunscreen.'" It's scary having two moles that could turn nasty, but I see having the test results as a positive thing as at least I know which moles I need to keep an eye on."
What happens at the clinic?
1: You strip down to your smalls while a nurse checks your moles, excluding your scalp and places covered by underwear unless requested. They're looking for melanomas that can develop in moles you already have or new moles. Kate Grant, senior skin cancer screening nurse at The Mole Clinic says: "As well as melanomas there are two other forms of skin cancer to watch out for. Squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) may appear as a lesion that won't heal, or a crusty area of skin that won't go away."
2: Anything atypical - a mole that's unusually dark, large, asymmetrical or with two colour patterns on it - is examined and photographed using a hand-held microscope called a dermoscope.
3: If anything unusual is discovered, an image will be sent to a dermatologist for assessment. Diagnosis will either be that the mole/lesion needs no further action, needs re-examining in three months or needs to be removed.
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