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Guernsey has globally leading rates of certain types of skin cancers with residents facing increased risks because of the lifestyles we lead and high levels of UV.
At the start of Sun Awareness month, Express spoke to experts about the trends, what to look out for, the precautions we can take and the risk sports people are at.
You can listen to David Thompson’s story about a life changing diagnosis on The Cool Down podcast.
Healthcare Group GP Edward Partridge, a member of the Guernsey Multidisciplinary Skin Cancer Team, said that the island is experiencing the same trends as the UK, where skin cancer is the most common cancer.
In England and Wales, the incidence is increasing by around 8% per year, equivalent to doubling at least every 14 to 15 years.
It now accounts for approximately half of all cancers in the UK. Dermatology services there receive more urgent referrals for suspected skin cancer than any other speciality.
“Alongside this, the incidence of Melanoma and non-melanoma skin cancers is substantially above that of the UK, with a significant burden of skin cancer affecting the Guernsey population,” said Dr Partridge.
The reasons for this are multifactorial.
Pictured: Dr Ed Partridge.
“The leading cause of skin cancer is sun exposure. Guernsey's geographic location exposes it to more direct sunlight. Additionally, factors such as the outdoor lifestyle contribute to increased time spent in the sun and, thus, a higher risk of skin cancer.
“Other factors include an ageing population, more foreign travel, and genetic factors leading to an increased predisposition to skin cancer, alongside improvements in diagnosis and reporting and greater public awareness of the features of skin cancer.”
Skin cancer is mainly divided into three types: basal cell carcinoma (80%), squamous cell carcinoma (20%), and Melanoma (1%).
“Most skin cancers can be effectively treated. However, Melanoma can be very dangerous and difficult to treat if not identified early. This underscores the crucial role of early detection. By conducting regular skin checks and promptly seeking a medical review if any changes are noticed, individuals can take control of their health and potentially save lives.”
What to look out for
Regular self-examination can help patients learn where their moles are and what they look like.
“This is best done after a shower or bath," said Dr Partidge.
“Patients should stand in front of a full-length mirror with a hand-held mirror and plenty of light and check themselves from head to toe. It is essential to keep the examination simple.
“As individuals, we tend to produce similar-looking moles based on our skin type. People with darker skin generally have darker moles.
“People with fair skin usually have lighter or pinkish moles. The first step when checking your skin is to look for anything that stands out as different. An example would be a mole that is a different colour or shape from the others. We call these ugly ducklings.”
The next step is to look for anything new.
“Over 70% of Melanoma develops on normal-looking skin and not from existing moles. That is why it is so important to get new moles checked, even if they look normal.”
Clinical Nurse Specialist for Dermatology, Sofia Gouveia said that Melanoma and non-Melanoma skin cancer each look different.
There is a simple guide to help:
A – Asymmetry, the two halves of the mole may differ in their shape and not match
B – Border, the outside edges of the mole or area may be blurred and sometimes show notches or look ‘ragged’
C – Colour this may be uneven and patchy. Notice new colours appearing. Different shades of black, brown, pink and even purple may be seen.
D – Diameter – melanomas will progressively change. If you see any mole, or mole- like mark getting bigger over a period of two weeks to months, tell your doctor
E – Expert, look out for change and if in doubt get it checked by your doctor.
"You should tell your doctor about any changes to your skin or moles even if they are not the same as described,” she said.
“In short, keep an eye on your skin and see your doctor if you notice changes.”
If a patient has concerns about a skin lesion, they should always have it assessed urgently.
In Guernsey, primary care providers have worked hard alongside the dermatology services and the local multidisciplinary skin cancer team to ensure each GP group has a doctor accredited in skin lesion management.
These doctors have additional experience in skin cancer diagnosis and treatment and have been trained in using a dermatoscope.
A dermatoscope is a type of skin microscope that can allow a very detailed assessment of skin lesions and moles.
“This means we can diagnose and, in many instances, treat pre-cancerous and low-risk cancers in the community and reduce the number of people going into secondary care where possible,” said Dr Partidge.
High-risk skin cancers or surgically complex lesions will usually require referral for further treatment at the Princess Elizabeth Hospital or the Medical Specialist Group.
There is already an increase in patient awareness of skin cancer.
“This is very positive as we encourage people to be skin-aware and take pre-emptive actions towards skin cancer. Early intervention in skin cancer or pre-cancerous lesions results in positive patient outcomes.
“An annual skin check is a standard part of patients' medical screening in jurisdictions like Australia. This is now also increasingly the case in Guernsey and Healthcare Group offers clinics specifically dedicated to skin lesion assessments and full-body skin checks.
“We have also invested in state-of-the-art digital mole mapping technology that can track changes in moles on a person's body over time. This technique is particularly valuable for individuals at higher risk of Melanoma, such as those with many moles, atypical moles, a personal or family history of skin cancer, or very fair skin.”
Public Health is clear that it is very positive that we have an outdoor lifestyle in Guernsey with many local people taking part in outdoor activities and sporting events.
However, this can cause a problem for sun safety.
Pictured: Lee Merrien.
Running coach Lee Merrien said: “Long training sessions are essential for any distance event in addition to the event itself often being outdoors in the sun.
“This makes being sun-safe difficult, but it is still important and there are things we can do.”
These include:
“Spectators are also an essential element of sport and we’d encourage sporting events to provide shade for their spectators where possible.”
But it is also important to remember that we need vitamin D for strong bones so 10 minute bursts of exposure to the sun can be good for our health.
You can also increase your vitamin D by taking a supplement.
Public Health’s Di Mathews said: “Simply put, there is no such thing as a healthy tan."
“Over exposure to ultra violet rays from the sun damages the skin and could lead to skin cancer,” she said.
“It’s important to start spreading this message early in the year because our skin is most vulnerable after the winter months. We’ve already seen high UV levels and burned skin during April so it’s important to start protecting ourselves early in the year. We can protect our skin by:
Covering up, wearing lightweight clothes during the spring and summer months.
Finding shade or staying out of the sun particularly between the hours of 11:00
and 15:00.
Wearing a wide brimmed hat.
Wear some sunscrean with a high SPF (skin protection factor)
"It’s sometimes harder than it sounds because life is busy and I’m sure we have all be unexpectedly ‘caught out’ and under prepared for a sunny day. It might help to leave suncream by the door, in a regularly used bag or in the car."
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