Cancer ranks as the second most common cause of death following cardiovascular disease in most parts of the civilised world. This is in spite of advances registered on the therapeutic front over the years. No wonder even the mere mention of the dreaded "C" word instils such a profound feeling of fear and drives so many people to become paranoid whenever they develop some new unexplained sign or symptom.
Great efforts have been invested in educational programmes aimed at promoting primary prevention of cancer, particularly with regard to cancers undeniably linked to well known contributing causative factors such as smoking and ultraviolet exposure. Although such is the way forward in the long term, it must be acknowledged that the cornerstone of improving survival rates from cancer lies with early detection and treatment. The perfect model for such strategy is of course skin cancer. The skin, being an external organ, is readily amenable to scrutiny and is well suited for routine self-screening.
The aims of the Euro-Melanoma campaign are twofold: to educate the public on preventive measures, particularly in the form of sun protection starting early on in life, and to raise awareness about the most dangerous form of skin cancer, melanoma, with a particular emphasis on early detection. Indeed, the theme chosen by the Euro-Melanoma task force for this year is Don't Trust A Changing Mole - Check Your Skin.
The stage of a melanoma tumour is determined according to the depth it has reached in the skin at the time of diagnosis and is classified as thin, intermediate or thick. As expected, the five-year survival rates are significantly better for thinner tumours. According to a study of Melanoma in Malta (A Profile Of Invasive Malignant Melanoma In Malta 1993-2002. S. Aquilina, M. Dalmas, N. Calleja, P. Gatt, L. Scerri. Journal of the European Academy of Dermatology and Venereology) the five-year survival rates were 93 per cent for thin, 77 per cent for intermediate, and 56 per cent for thick melanomas.
A positive trend which came out of this study is the fact that although the incidence of melanoma has progressively increased, the overall survival rates for melanoma in Malta have improved over the 10-year period in question, from 74 per cent to 92 per cent. This is predominantly due to the fact that melanoma is being detected earlier, and one may attribute this to the increasingly aggressive public "sun and skin cancer" awareness campaigns in the last couple of decades.
Once more the public is reminded of the ABCDE rule to help distinguish melanoma from a benign mole.
A suspicious appearance is indicated by: Asymmetry (non-symmetrical shape); irregular Border; more than one Colour or shade within same mole or blemish; Diameter greater than six millimetres (in conjunction with the other criteria); Evolving mole (recent change in size, shape, colour or spontaneous bleeding, itching or crusting).
However, one should not be alarmed if hair grows out of a mole, or if a mole gradually becomes more raised and fleshy over the years in the absence of the suspicious signs listed above.
Let's hope that, armed with such knowledge, the Maltese population continues to benefit from the currently improved survival rates for melanoma.
Dr Scerri is chairman of the Department of Dermatology at Sir Paul Boffa Hospital