Wednesday 24 July 2019

'Sinead was a beautiful girl. Cancer stole who she was' - Daily SPF application can save lives from skin cancer

Experts believe that making the application of SPF a part of our daily routine could save lives from skin cancer. By Kathy Donaghy

Barbara Brown, who lost her sister, Sinead to skin cancer, urges people to protect themselves from the sun's harmful rays. Photo: Damien Eagers
Barbara Brown, who lost her sister, Sinead to skin cancer, urges people to protect themselves from the sun's harmful rays. Photo: Damien Eagers

Barbara Brown will never understand why some people won't stop and take two minutes to put on their sun protection factor (SPF) before going outdoors at this time of year.

She makes sure her three children - Sophie (8), Scott (5) and one-year-old Laura - are covered up and wearing SPF 50 if they're outside in summer. The mum from Ballycullen in Dublin doesn't much like being out in the sun, never goes away on a sun holiday and shields her skin with the highest SPF if she's going to be outside.

Barbara knows only too well that there's no room for complacency when it comes to the sun. She lost her beloved older sister, Sinead, in 2002 after melanoma - the most dangerous kind of skin cancer - spread to her brain. Sinead was diagnosed with melanoma two weeks before her 30th birthday. She passed away a week after turning 31 on December 11, 2004.

Speaking about the beautiful life force her sister was is still difficult for Barbara. She says she has learned to live with the loss over time and has found a way to keep going without her. Her voice cracks as she explains that if Sinead's story makes one person change their behaviour and be vigilant about the sun, it will be worth the pain that comes with talking about what happened.

Sinead, she says, had the classic "Irish look" with pale skin, freckles and rich, auburn hair. She loved the sun and would sunbathe in the back garden and was fond of her sun holidays. Barbara explains that Sinead wasn't always diligent about putting on SPF and that for the most part she didn't react well to the sun, often coming out in a heat rash.

By her late twenties, Sinead had developed what was like an open wound on the inside of her foot. It wouldn't heal. By the time melanoma was diagnosed, it was too late for Sinead, even though Barbara says she never gave up hope that she would survive it.

Barbara, who joined the Marie Keating Foundation as an ambassador after Sinead's death, believes that if people made putting on their SPF part of their morning routine, skin cancer would not be costing as many lives as it is.

And the figures are stark. Despite all the warnings about the damage the sun can do, the figures show that skin cancer is on the increase. Most cases are caused by UV rays from the sun.

According to the Department of Health, which last month launched a National Skin Cancer Prevention Plan, skin cancer is the most common type of cancer in Ireland.

Over 11,000 people are diagnosed each year; this number is projected to double by 2045. This is all despite the fact that most skin cancers could be prevented.

According to the Irish Cancer Society, which last week launched a skin cancer campaign targeting outdoor workers like farmers and construction workers, early detection is also vital. If spotted early, up to 90pc of cases are curable. In the case of melanoma skin cancer, spotting it early can save your life.

Professor Anne-Marie Tobin, a consultant dermatologist at Tallaght University Hospital, says what we will see over the next 20 years is people who were exposed to the sun in early life being diagnosed with skin cancer. She explains that blistering as a result of sun exposure or sun burn in childhood increases the risk of melanoma in adulthood.

Prof Tobin, who is also the national clinical lead for dermatology, says that from April to September people need to take precautions when they're outdoors and putting on SPF must become a part of their daily routine.

According to Prof Tobin, of the 11,000 cases of skin cancer diagnosed every year, 1,100 are melanomas. The vast majority of the total - some 70pc - are basal cell carcinomas. While these are not life threatening, they can leave people with significant scarring.

A further 70 deaths a year are caused as a result of another type of skin cancer called squamous cell carcinoma.

She explains that when skin is tanned, it's a sign the skin has been trying to protect itself and when skin burns, the DNA in skin cells becomes damaged. "There's no such thing as a safe tan - people shouldn't be sun bathing to get a tan," she says.

As well as wearing a high SPF of at least 30 in the months from April to September, Prof Tobin says parents need to be extra vigilant about their children, slathering them in SPF 50 and making sure they don't get burned.

She says knowing your skin type is also important as is keeping an eye on moles, which fair-skinned people are prone to.

The changes in moles to look out for are governed by the A, BC, D, E rule.

• A stands for asymmetry or irregular shape: the two halves should be symmetrical.

• B stands for border: the edges of the area may be unclear, irregular or ragged against normal skin.

• C stands for colour: watch out for changes in colour especially black, blue or uneven colours.

• D stands for diameter: most melanomas are at least 6mm in diameter. Report any change in size, shape or diameter to your doctor.

• E stands for evolution: any changes such as any new symptoms, including itching, should be reported to your doctor.

 

In her work, Prof Tobin has seen people extremely regretful about their behaviours of sun worshipping and using sunbeds in the past.

And while she says people are becoming more informed about using SPF, there needs to be more awareness of how people can protect themselves in the sun. She points out that levels of awareness are much higher in countries like Australia.

"Using a good sun block is also anti-ageing. The sun damages collagen in the skin and to prevent pigmentation and premature ageing you need to be using a good SPF," says Prof Tobin.

Helen Forristal, director of nursing services with the Marie Keating Foundation, says while Irish people have become much better at making sure their children are protected in the sun, adults are less vigilant when it comes to themselves.

"There seems to have been a big behavioural change when it comes to children. Parents don't want their children to get burned. They make sure they are wearing a high SPF and that they are wearing hats. But for the adult population, the message doesn't seem as clear," says Forristal.

What she would like to see is another big behavioural change so that putting on sun block becomes part of a person's daily routine, a bit like brushing your teeth.

Even on cloudy, overcast days the sun's UV rays can still penetrate the skin's deepest layers, which is why there is no room for complacency between the hours of 11am to 3pm in the months from April to September. "Everybody should know their own body in terms of moles and birth marks. Anything unusual on your body, you need to know about it. If a mole changes in its shape or form in any way, go to your GP," says Forristal.

Watching her children play in the back garden on her home in Dublin, Barbara Brown makes sure they're covered up and wearing hats as well wearing SPF 50.

"Modern science allows us to have the best SPF for us not to burn. Sinead was a beautiful girl. Cancer stole who she was. If this saves one person, Sinead would have been behind it," says Barbara.

For more information, see cancer.ie/sunsmart and mariekeating.ie/spotthedifference

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