Saving face the Mohs way

Tue, Mar 5, 2013, 00:00

When I was told just a few days before Christmas that I had skin cancer, I wasn’t really surprised. I had already had two visual examinations by consultant dermatologists who had put me on notice. Now, after a biopsy, the diagnosis was confirmed.

Thankfully, the type of cancer I had, basal cell carcinoma, or BCC, is seldom life threatening.

It rarely spreads beyond the initial site, but if treatment is delayed, or unsuccessful, it can do a lot of local damage. Compared with other cancers, cure rates are relatively high – and higher for some treatments than others. So I was more hopeful than despondent.

Skin cancer is primarily caused by unprotected exposure to the sun, and I confess to having had lots of that.

You would think we’d know better by now, but the message that sunbathing and sunbeds cause cancer is slow to get through. And fair-skinned Celts are more prone than most, as is evident from the soaring number of new cases.

Most prevalent

According to provisional, and as yet unpublished figures from the National Cancer Registry, 34 per cent – more than one person in every three – of those diagnosed with cancer in Ireland in 2010 had skin cancer, making it by far the most prevalent type of cancer.

The number presenting with melanoma, the worst of all the skin cancers, has more than doubled in the past decade. No other cancer is increasing at anywhere near this rate.

And for every melanoma diagnosed here, there are 10 non-melanoma skin cancers – basal cell and squamous cell carcinomas. BCC is linked to short, intense blasts of sun such as we might experience on holiday, while SCC is more likely in those who are constantly exposed.

The Cancer Registry’s provisional figures show 8,570 new cases of non-melanoma skin cancer in Ireland in 2010, 1,146 more than in 2009, and 3,426 up on 1994 when statistics began.

But even this daunting figure greatly underestimates the full extent of the disease because regardless of how many tumours someone may have in their lifetime, only one per patient is officially counted.

“Non-melanoma skin cancer is not only the most common of all the cancers,” says Dr Aoife Lally, a consultant dermatologist in Dublin, “it is also the most under-recorded and the poorest resourced.

“Our clinics are over-booked, and we face a chronic lack of resources.”

One UK hospital where Dr Lally used to work had nine inhouse consultant dermatologists. “Here,” she says, “we have 30 for the entire population.”

My own BCC started as a small sore on the bridge of my nose that simply wouldn’t heal.

My GP referred me to a consultant dermatologist, but before I could be treated, I had moved home from Dublin to London where my BCC was confirmed.

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