Medical experts warn about melanoma skin cancer

The chances of treating the most deadly type of skin cancer, melanoma, are quite high if it is caught quickly. But early diagnosis is imperative, three local doctors stressed yesterday.

Speaking during the launch of the fifth annual melanoma campaign, Maltese Association of Dermatology president Joseph Pace, Department of Dermatology head Lawrence Scerri and consultant Michael Boffa called on people to pay attention to their bodies and report any changes in warts, or newly emerging ones which fitted the description of melanoma.

"If melanoma is caught early, we can save that person's life," Dr Pace stressed.

Melanoma is the most serious form of skin cancer, which might develop anywhere on the skin, although it is commonest on the chest in men and on the legs in women. The cancer normally appears as a brown or black patch or lump with irregular features - it is usually asymmetrical, has an irregular border, consists of more than one colour and is usually larger than six millimetres in diameter.

Melanoma has claimed the lives of 51 people in Malta in the past 11 years (between 1993 and 2003), while a total of 258 new cases have been reported over this period.

Statistics from the Maltese National Cancer Registry showed that the mean number of cases of melanoma increased from 19 per year during the five-year period between 1993 and 1997 to 27 cases annually between 1998 and 2002 - a 42 per cent increase in the past 10 years. An increased incidence was also reported in both sexes, with a sharper rise in men (76 per cent) compared with a 21 per cent increase in women.

On a positive note, the statistics showed that the mean incidence has remained the same in under-35s in the past 10 years, but there had been a 16 per cent rise in incidence in those between 35 and 59, and a 100 per cent increase in those over 60.

The mean mortality has also gone down by 67 per cent in the younger age group between 1993 and 2002, but increased by 50 per cent for the 35 to 59 age group and by 217 per cent in the older age group.

Dr Scerri said melanoma was usually caused by ultra violet rays, repeated sunburn and sun exposure in childhood, and he added that the dangerous cancer developed decades after sun damage had taken place.

And although melanoma was usually caused through exposure to the sun's harmful rays, this did not necessarily have to be the case, and the doctors explained that even people who did not expose themselves to the sun may develop melanoma.

The risk of developing melanoma was higher in people with fair skin that burned and freckled easily and those with numerous moles, a history of sunburn, especially in childhood, and a family history of melanoma.

Dr Boffa said melanoma could start from an already existent wart, or else de novo, and was slightly more common in women.

Dr Scerri said that like every year on Melanoma Monday, which would be marked all over the world next week, people who had a suspicion they might have melanoma would be able to be screened at the Dermatology Department at Boffa Hospital. He stressed that screenings were strictly by appointment and people should phone beforehand, but added that those who did not manage to get an appointment for the day, and suspected they might have the disease, should make an appointment for another day.

The head of dermatology also stressed the importance of phasing out the glamorous image of suntans. Showing a number of adverts of different products, Dr Scerri said these passed on the image of brown being beautiful. He said it was important for adverts to promote white skin. He said those people who really wanted a tan should use fake tan products instead of getting a natural tan and harming their skin.

Dr Pace stressed that tanning salons were also dangerous, and might cause melanoma. He also said that people should not get the idea that they would not be affected if they were not exposed to the sun.

On a positive note, Dr Scerri commended the Meteorological Office, which started to inform the public about the UV index level around three years ago. He said that if the UV level was over six, then this was dangerous and people should cover themselves.

A study about sun awareness among local secondary school students, which would be published shortly, showed that there was quite a high level of knowledge about the harm caused by the sun's rays, but there was not enough knowledge about the harm of sunburn, UV exposure on cloudy summer days, and the duration of the protective effect of sunscreen.

A cutting-edge project is expected to start later on this year, with Malta, Siena and Sydney taking part. Dr Pace said the project, which would be a first in the world, aimed to scan big groups of people. He said the initial study was likely to be in Gozo.