EDP column by Professor Ketan Dhatariya
“I have had tablet controlled diabetes for 6 years, and have now been put onto insulin. Does this mean I have gone from type 2 diabetes to type 1?”
There are several sorts of skin cancer and lots of different causes. The one that people worry about is called a malignant melanoma. This a rare, but potentially very nasty cancer of the skin, but can also occur in the bowel or the eyes. The main causes of this kind of cancer are sun or ultraviolet light exposure in someone who is genetically predisposed to develop it. This is especially in pale skinned people who do not have adequate sun protection when they go outside, or under a sun bed.
Things to look out for can be classified as ABCDE: These are:
- Asymmetrical skin lesions (non-cancerous skin markings are often symmetrical).
- Border of the spot on the skin is irregular.
- Colour: melanomas usually have multiple colours, unlike non-cancerous spots, that are uniform in colour.
- Diameter: moles greater than 5 mm are more likely to be melanomas than smaller moles.
- Evolution: The evolution (i.e. a rapid change) of a mole or lesion may be a hint that the lesion is becoming malignant
–or–
- Elevation: The mole is raised or elevated above the surrounding skin.
Your doctor will probably send you to see a dermatologist so that they can do a skin biopsy to have a look at the cells under a microscope. This will enable them to tell you what kind of problem it is. If it is not a cancer, then it is important to ensure that you wear plenty of sun screen on exposed areas when you go out – ideally wearing a wide brimmed hat to ensure you stay safe. If however, the biopsy shows that it is a cancer, then there are several things that the doctor will want to know. These include how deep into the skin the cancer has gone. This is very important because this helps to determine the outlook. The more superficial the cancer, the better the likely outcome. Often, however, the treatment is an operation to ensure that any cancer cells are removed.
You are correct when you say that there is a certain sort of common skin cancer that is relatively safe. This is known as a basal cell carcinoma. These are sometimes known as rodent ulcers. Once again, it is those people who spend a lot of time outside who are most at risk of developing this condition. The difference with this kind of cancer is that it is often an open sore. The treatment is surgery, often under local anaesthetic. But the danger is assuming that the condition is the common, safer cancer when it is in fact the nasty cancer. It is important, therefore, to see your doctor if you have a spot on your skin that shows any of the warning symptoms I outlined below.
For more information about Skin Cancer click these links: