We’ve heard the catch phrase, slip, slop, slap and wrap – slip on a t-shirt, slop on some sunscreen, slap on a hat and wrap on some sunglasses. It is key advice to help prevent skin cancer, and advice we should all adhere to as melanoma rates amongst Maori and Pacific people rise.
Skin cancer is by far the most common cancer affecting New Zealanders. And although it is not the biggest cancer concern for Maori and Pacific people, our rates of melanoma are increasing dramatically.
According to the most recent data, there were 22 cases of melanoma amongst Maori in 2005, and six deaths. For Pacific people, there were eight cases and one death. While the incident rates are relatively low, the types of melanoma are proving to be more serious.
“The types of melanoma that Maori and Pacific people experience are often thicker at the point of diagnosis,” says Dr Judith Galtry from the Cancer Society of New Zealand. “Research presented last year by two epidemiologists of Otago University, has shown melanoma rates among Maori and Pacific people are increasing; particularly among Maori.
“Skin pigmentation is more the issue,” she explains. “Darker skin, to some extent, protects you against skin cancer and melanoma, however it may also disguise moles and make cancers harder to diagnose.”
There are three different types of skin cancer. Melanoma is the most deadly. There are also different types of melanoma. Approximately 1,600 Europeans were diagnosed with nodula melanoma in 2005, which equates to 10 per cent of the population of Europeans who had melanoma. Fifteen per cent of the Maori melanoma population were diagnosed with nodula melanoma, showing a higher incidence of the more serious cancer.
Dr Mark Gray, a MoleMap dermatologist, said in a statement that many melanomas go undetected and New Zealanders with darker skin tones shouldn’t become complacent. Acral melanomas are, surprisingly, the most common form of melanoma in Maori and Pacific Island populations. In some cases, when under toenails, they are hard to spot, but are more frequent than many people realise.
“Melanoma is often without symptoms,” he says. “Left untreated, in severe cases the cancer can progress to other areas of the body such as the lymph nodes or brain.”
“You can get [acral melanomas] under fingernails, in the mouth and in the eyes. Bob Marley had one on his toe and the cancer metastasised (spread to other parts of the body) to his brain, lungs, and stomach, eventually killing him aged only 36.”
The ultra violet radiation levels during Summer in New Zealand are almost 40 per cent higher than equivalent latitudes in the northern hemisphere. We have clearer skies, less pollution and the hole in the ozone layer is still significant. Dr Galtry says no matter what ethnicity, we need to be aware of the dangers of the sun.
“Behaviourally we have an outdoor lifestyle, it’s important for Maori and Pacific people not to assume they aren’t at risk. Everyone needs to be vigilant about keeping an eye on their skin and being safe in the sun.”
Risk Factors
• Family history (there is new evidence of a genetic component to melanoma)
• Colouring (fairer skin, green/blue/light coloured eyes)
• Large number of moles, particularly unusually shaped or irregular looking
• History of sun burn
Symptoms
Moles are not only black or brown; they can sometimes be pink or red. Look for any signs of change in your skin. If your mole develops a border, changes in shape, size or colour, is itchy or bleeding, or you notice any other concerning change, seek medical advice from your GP.
The important thing is to always take preventative care when in the sun. The Cancer Society recommends using a sunscreen with a broad spectrum sun protection factor (SPF) of 30+. Make sure the sunscreen is applied thickly and evenly, and reapplied throughout the day. And always remember to cover up with a t-shirt and a hat.