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Your essential skin cancer checklist

Cancer is always a scary word, but the least deadly kind is a skin cancer called basal cell cancer. Although obviously it needs treating, it can usually be sorted with fairly minor surgery. By contrast, melanoma can be deadly. Even basal cell cancer can cause serious complications if left untreated, so it's essential to know the signs of all skin cancers and get any suspicious skin changes checked out quickly.

Skin cancer is basically divided into two groups, melanoma and non-melanoma cancers. Melanoma is about 20 times less common than non-melanoma, but far more serious. That's because it's much more likely to spread to other parts of the body.

The two types of non-melanoma cancers are basal cell cancer and squamous cell cancer. They affect over 60,000 people in the UK every year. In fact, while it doesn't get nearly the same publicity as other cancers such as breast and prostate cancer, basal cell cancer is the most commonly diagnosed cancer in the UK.

Melanoma isn't common - about one to two people in every 10,000 are diagnosed with it every year in the UK - that's about 9,000 people a year. While it does affect younger people, it definitely gets more common with age - about half of people diagnosed are over 65.

Malignant melanomas occur most often on women's legs - but they can develop on any part of your skin. By contrast, men are most likely to get melanomas on the back or chest. But they can occur anywhere, so have any new or changing mole with any of the warning signs below checked out.

Who's most at risk?

Melanoma is a subject close to my heart, because unfortunately I tick all the boxes for being high risk for developing it. I have red hair (some blondes are at risk too), freckles and the sort of pale skin that only has to look at a sun ray to turn red.

What's more, I had several episodes of severe sunburn in childhood, when the highest sun protection factor (SPF) in sun cream that existed was factor 12. Children's skin is particularly sensitive, and melanoma can develop many years after episodes of sunburn in childhood. Frequent or severe sunburn in childhood puts you at higher risk for life.

Your risk of non-melanoma skin cancers largely depends on your lifetime sun exposure. Numerous non-sun-related factors, including family history, alcohol intake, smoking and taking medication which suppresses your immune system, can all increase your risk further.

Melanomas, on the other hand, seem to be more closely related to how often you've been burned. Any colouring of your skin is your body's reaction to sun damage, but sunburn is particularly risky. People who have naturally dark skin have higher levels of melanin in the skin, which protects against both burning and melanoma.

But sun exposure isn't the only risk. You're more likely to get a melanoma if other people in your family have it. Of course, this can be partly explained by inheriting pale skin and freckles, but there does seem to be another genetic link too. About one in 10 people who get melanoma have a relative who had it.

Spotting non-melanoma skin cancer

Scalp and face are the most common sites for non-melanoma skin cancers, but like melanomas, they can appear anywhere.

Squamous cell cancers most often start as a pink or red area covered by a crust or scales. As they progress, they can become tender and raised (a bit like a wart) and can ulcerate. The surface is delicate and may bleed easily.

Basal cell cancers usually start with a lump which can be pearly, pink or red. Like squamous cell cancers, basal cell cancers can crust or bleed, but this often takes more time as they tend to grow very slowly. As a rule, they are not painful or tender.

Know your ABCDE

The key to spotting melanoma early is to know your alphabet - or at least your ABCDE. Most melanomas don't develop in an existing mole, but do look out for these changes in an existing mole, as well as any new mole which appears:

Asymmetry - most moles are circular or oval, while melanomas often have an irregular shape.
Border - look for irregular edges, or blurring of the borders so you can't see where the mole ends and normal skin begins.
Colour - a range of colours (browns and black) rather than a single colour.
Diameter - over 6 mm across.
Evolution - a rapidly changing mole.

You should also watch out for redness and inflammation, crusting, itching, a change in sensation of the skin, bleeding or oozing.

Protect yourself

Even if you've had sunburn as a child or have freckled, pale skin, it's never too late to protect yourself against skin cancer. While you need some sun to top up your vitamin D levels, you should always avoid burning (and ideally tanning). This includes sunbeds, which emit UV light.

Covering up with a wide-brimmed hat and shirt (ideally long-sleeved) in bright sunlight is a must. Sun damage can affect your eyes and you can get melanoma in them - wraparound sunglasses are not just for fashion. Stay inside when sun is at its strongest between 11 am and 3 pm. And apply high sun protection factor cream (at least factor 15, or factor 30 if you're pale or freckled).

Practise 'slip, slop, slap' - slip on a shirt, slop on sunscreen regularly and slap on a hat.Think pale and interesting - it really is healthier!

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